People With Medicare

If a cancer drug is being used off-label, will Medicare cover it?

The U.S. Food and Drug Administration, or FDA, approves each new drug before it goes on the market. Each drug is approved based on how safe it is and how well it works to treat a specific condition.

After the FDA approves a drug, doctors may prescribe it. But doctors may give you a drug for a different use than the drug was meant for initially. This is called off-label use. It happens a lot, especially in treating cancer. Medicare may cover drugs prescribed for off-label use in cancer care. But Medicare has specific rules about when it will do so.

Medicare Part B covers most cancer care and chemotherapy. It also will cover these drugs if the off-label use has been described in special publications for cancer specialists.  Your doctor or treatment center can tell you if your drug has been.

Ask your doctor any questions you have about the drug's safety or cost.

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