Last updated: 2026-07-10 · Reviewed by Cancer Answers OC Care Coordination Team
Medicare plan types accepted
Medicare offers several plan types in California. Coverage rules and referral requirements vary by plan.
- Original Medicare (Parts A & B)
- Medicare Advantage (Part C)
- Medicare Supplement (Medigap)
What's typically covered
Most cancer services are covered when delivered by in-network providers. Coverage details vary by plan — verify your specific benefits before scheduling.
- Oncology consultations
- Chemotherapy (Part B for infused, Part D for oral)
- Radiation therapy
- Surgical oncology and hospitalization
- Approved clinical trial participation
Referrals & prior authorization
HMO members typically need a referral from their primary care physician before seeing an oncologist. PPO members can usually self-refer. Medicare commonly requires prior authorization for advanced imaging (PET, MRI), infusion therapy, and certain targeted or specialty medications. Our care coordinators help confirm what's needed before your first visit.
Infusion & chemotherapy coverage
Medicare plans generally cover medically necessary infusion therapy and chemotherapy administered at an in-network infusion center, hospital outpatient department, or physician's office. Oral chemotherapy is usually covered under the pharmacy benefit.
USC / Keck Medicine affiliation
Our featured Orange County provider — Keck Medicine of USC — Newport Beach — is part of the Keck Medicine of USC network, an NCI-designated academic cancer care system. Most major Medicare plans include in-network access. Care coordination, multidisciplinary tumor boards, and clinical trial screening are standard.
How to verify your specific plan
If you have a Medicare Advantage plan, confirm the provider is in-network. With Original Medicare plus a Medigap policy, you generally don't need a referral.
Frequently asked questions
Does Medicare cover chemotherapy in Orange County?
Yes. Medicare typically covers medically necessary chemotherapy delivered by in-network oncology providers in Orange County, including infusion therapy and most oral chemotherapy under the pharmacy benefit.
Does Medicare cover radiation therapy for cancer?
Yes. Medicare plans generally cover medically necessary radiation therapy — including external beam radiation, IMRT, and SBRT — when prescribed by an in-network oncologist. Prior authorization is common.
Do I need a referral to see an oncologist with Medicare?
If you have an HMO plan, yes — your primary care physician needs to issue a referral. PPO and EPO members can usually self-refer to an in-network oncologist. Our care coordinators help with referral logistics.
Does Medicare cover second opinions for cancer?
Yes. Medicare plans typically cover second opinions for a cancer diagnosis when the consulting oncologist is in-network. Second opinions are considered a standard part of cancer care.
Does Medicare cover clinical trial participation?
Medicare typically covers routine patient care costs associated with approved clinical trials, as required under federal and California law. Trial-specific costs are usually covered by the trial sponsor.
Want to know if your specific Medicare plan is accepted? Our team verifies benefits at no cost.
Other carriers in Orange County