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Clinical Trials

Clinical trials, or clinical research studies, are carefully controlled experimental studies. They test new and promising forms of medical care, such as a new cancer drug. They are meant to help people with cancer live longer and healthier lives.

Medicare may pay for you to join some clinical trials as part of your cancer treatment.

Do I qualify?

You may qualify for a clinical trial. It depends on:

  • The type of cancer you have, and
  • If a trial for your cancer is going on.

Your doctor can tell you if there is one that could help you.

People volunteer for clinical trials. But first, they learn about their trial. You should find out how long it lasts, what you must do as part of the study, and so on. The National Cancer Institute has more information on clinical trials.

Can I join a clinical trial if I am in a Medicare Advantage plan?

Yes. You can get the same benefits as someone who has Original Medicare. To learn more, see Medicare and Clinical Research Studies.

What are the pros and cons of clinical trials?

There are many clinical trials for cancer. But only a small number of cancer patients may choose to join one.

People with cancer may join a clinical trial because they can:

  • Try new treatments they could not get otherwise
  • Get medical care from doctors who are in the top of their field
  • Test new uses for existing treatments
  • Help others who will get the same type of illness

A clinical trial may be good for you. But depending on your diagnosis, it may not help you more than normal treatments. Some experimental treatments may make you worse. Some patients do not join a clinical trial because:

  • They are worried about possible risks
  • They may not get any benefits
  • Normal cancer care works faster or requires fewer doctor's visits

What costs does Medicare cover?

Medicare pays for routine costs of items and services. This can include:

  • Hospital room and board. Medicare would pay for this even if you were not in a study.
  • Implanting an item that is being tested
  • Treating side effects and complications you get from care in the study

What costs will Medicare NOT pay?

Medicare will not pay for:

  • The new item or service that the study is testing, unless Medicare would cover it anyway
  • Items and services you get for free from the study
  • Items or services not used in your direct health care. An example is monthly CAT (Computerized Axial Tomography) scans, if you normally and medically only needed one every six months.
  • Deductibles and coinsurances

Sometimes a study will pay some of the costs if Medicare does not. You will not have to pay for the treatment itself. That is paid for as part of the trial.

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