How does Medicare handle coverage for experimental treatments or clinical trials?

Answered by 5 licensed agents

Medicare typically doesn't cover experimental treatments, however it may cover certain testing required while the experimental treatment is going on but that would likely need prior authorization.

Answered by Deb Haley on April 13, 2025

Broker Licensed in MA, CT, FL & 10 other states

Answered by Deb Haley Medicare Insurance Agent
Medicare generally covers the routine costs of clinical trials and may cover certain experimental treatments or services, especially those that are part of a "Coverage with Evidence Development" (CED) study. Routine costs include services that would normally be covered by Medicare if not part of a clinical trial.

Answered by Vachik Chakhbazian on April 12, 2025

Agent Licensed in CA, AL, AR & 22 other states

Answered by Vachik Chakhbazian Medicare Insurance Agent
Medicare doesn’t cover clinical research itself; it may cover certain treatments or services you get as part of participating in the trial. You will need to check with your insurance carrier to ensure you can move forward with the clinical research.

Answered by Robert Baez on April 11, 2025

Agent Licensed in IL

Answered by Robert Baez Medicare Insurance Agent
If Medicare covers it and these clinical trials are available in your area network then it's covered by your health plan, your chances of getting that covered are greater when you have the flexibility that a Medigap plan offers.

Answered by Jack Mayer on April 12, 2025

Agent Licensed in CA

Answered by Jack Mayer Medicare Insurance Agent
Medicare usually doesn’t cover experimental treatments, but it does cover some costs if you're in an approved clinical trial. You may still have to pay some out-of-pocket expenses.

Answered by Marisol Torres on April 12, 2025

Broker Licensed in IL, CA, FL & 19 other states

Answered by Marisol Torres Medicare Insurance Agent

Tags: Coverage

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