Proton Therapy Cost

 

Proton therapy is nationally recognized for its effectiveness in treating certain cancers, which has led to most insurance providers including Medicare, to cover the treatment. Throughout the process, we will work directly with your insurance provider to obtain authorization for coverage.

Maryland Proton Treatment Center is committed to providing excellent access to care. We have taken a leadership role in the industry by offering proton therapy at the same cost as conventional radiation therapy. This means that we bill your insurance company the same amount for traditional X-ray radiation therapy as we do for proton therapy. This policy ensures that you are presented with the best radiation treatment type for your cancer.

The process

Throughout the process, our physicians as well as our dedicated team of patient representatives will work directly with your insurance provider to obtain authorization for coverage.

  • We will begin with a consultation with our team to review your treatment plan, your health background and insurance plan.
  • From there, we will reach out directly to your plan to establish coverage.
  • Before you begin treatment, we will review with you your insurance coverage, co-pays and out-of-pocket expenses so you know what to expect.

MPTC accepts a variety of insurance types and will be happy to discuss your specific coverage at 410-369-5200.

General guidelines include:

General coverage: Proton therapy is generally covered by Medicare (non-HMO). In many cases, patients covered by Medicare supplemental insurance often incur few net-out-of-pocket expenses for treatment after deductibles, copays/coinsurance, and annual maximum payments are met.

Treatment-based coverage: Some private insurance companies cover proton therapy for specific disease sites (cancer types) or on a case-by-case basis. We will work on your behalf to obtain coverage including communicating the facts and clinical recommendation for proton therapy, providing comparative treatment plans and setting up physician-to-physician consultations between our team and your insurance provider.

We also work with insurance providers from around the country.

Self-pay: If you do not have insurance or if you are coming from outside the U.S., MPTC also has self-pay options and payment plans.

Coverage denials: Should your insurance carrier deny your coverage for proton therapy, we will first appeal on your behalf. If the appeal is denied, we can also recommend some actions to take, recommend a different treatment option or work with you on a self-pay basis.

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