Understand Your Cost &
Coverage Options for Proton Therapy
Dealing with a cancer diagnosis is difficult enough. We have a dedicated team in place to help you with the paperwork, work with your insurance provider, make a case for your treatment and even assist you with appeals, easing the burden of dealing with cost and coverage so that you can focus on becoming well.
What Is the Cost of Proton Therapy?
The cost of treatment varies by your insurance provider, condition, medical history and other factors such as the number of treatments. Keep in mind the cost per daily proton dose may be slightly more expensive than traditional radiation, but the long-term cost can be much less as patients tend to experience fewer side effects that require treatment or medication. In fact, recent studies have shown that the cost of proton therapy is lower than other treatment options.
Payment & Coverage Options
Full coverage: While proton beam therapy is covered by Medicare, private insurance coverage varies. Some companies do not reimburse for the service or only cover treatment for certain diagnoses. If your insurance carrier does pay for proton therapy, patients often incur little or no net out-of-pocket expenses after deductibles and annual maximum payments are met.
Case-by-case coverage: In this situation, our team of specialists and physicians will work directly with your insurance plan to seek authorization for care by providing appropriate documentation to support the medical necessity of treatment.
No coverage: For those whose insurance does not cover proton therapy, or Americans and foreign nationals without coverage in the U.S., we offer reduced self-pay options.
Insurance Coverage Assistance
We have a dedicated team of patient representatives and physicians who will work with any insurer on your behalf to facilitate authorization and reimbursement for care. They assist by:
- Responding to insurer questions
- Writing letters of medical necessity and submitting supporting documentation on your behalf
- Participating in peer-to-peer discussions regarding your treatment
- Providing comparative treatment plans as required
- Filing appeals on your behalf if your insurance denies coverage
- Confirming your eligibility, benefits, deductible amounts and co-payments/co-insurance requirements