A new diagnosis

Diagnostic imaging: CT scans, MRIs, PET scans, and biopsies ordered by a physician are covered under Part B with standard 20% coinsurance after the Part B deductible.

Chemotherapy: Intravenous chemotherapy administered in a hospital outpatient setting or physician office is covered under Part B. Oral chemotherapy is generally covered under Part D. The distinction matters because Part B and Part D have different cost-sharing structures.

Radiation therapy: Covered under Part B.

Surgery: Covered under Part A for inpatient procedures, Part B for outpatient procedures.

Oncology clinical trials: Medicare covers routine care costs for patients in Medicare-approved clinical trials. The experimental treatment itself may not be covered, but standard care costs associated with the trial are.

Oral cancer drugs: Covered under Part D if the drug has an IV equivalent that Medicare covers under Part B, or if the drug is otherwise on the formulary. Specialty tier cancer drugs can be very expensive - ask about prior authorization requirements and the plan's specialty drug cost-sharing before starting treatment.

Cardiac rehabilitation: Medicare covers cardiac rehabilitation programs for patients who have had a heart attack, coronary artery bypass surgery, stable angina, heart valve repair or replacement, coronary angioplasty, or heart transplant. The program typically involves supervised exercise, education, and counseling over 36 sessions.

Remote cardiac monitoring: Medicare covers remote physiological monitoring for heart failure patients including devices that track weight, blood pressure, and cardiac function and transmit data to the clinical team.

Home health: Heart failure patients who are homebound and have skilled nursing or therapy needs qualify for Medicare home health. This typically includes monitoring, medication management teaching, and care coordination.

Chronic care management: Patients with heart failure and another chronic condition qualify for Chronic Care Management services - non-face-to-face coordination services billed by the physician practice, covered under Part B.

Neurological evaluation and imaging: Neurologist consultations, MRI, and diagnostic testing are covered under Part B.

Outpatient therapy: Physical, occupational, and speech therapy are covered under Part B for neurological conditions as long as skilled care is needed and the patient is making progress. There is no annual cap.

Cognitive assessment: Medicare covers cognitive assessments during the Annual Wellness Visit and as ordered diagnostic tests when a physician suspects cognitive impairment. A formal neuropsychological evaluation ordered by a physician is covered under Part B.

Dementia - important limitation: Medicare does not cover custodial care for dementia patients who no longer have skilled care needs. When nursing, therapy, and medication management are no longer needed at a skilled level, Medicare coverage ends - even if the patient cannot safely care for themselves. This is one of the largest and most impactful coverage gaps in Medicare for families managing dementia.

PACE: For patients with neurological conditions who are Medicaid-eligible and require nursing home-level care, the Program of All-Inclusive Care for the Elderly (PACE) provides comprehensive coordinated care. PACE is available in most but not all states and requires both Medicare and Medicaid eligibility.

An advance directive records your treatment preferences if you are unable to speak for yourself. It typically includes a healthcare proxy designation (who makes decisions on your behalf) and a living will (what your preferences are for specific treatment scenarios).

Medicare covers advance care planning conversations as part of the Annual Wellness Visit and as a separately billed service. Ask your physician to initiate this conversation or to refer you to a social worker or palliative care specialist who can facilitate it.

The time to complete an advance directive is when you are healthy enough to think through your preferences clearly and articulate them fully. After a serious diagnosis, that window is still open - but it may not remain open indefinitely.

A POLST (Physician Orders for Life-Sustaining Treatment - called MOLST, POST, or MOST in some states) is a physician-signed medical order that specifies your preferences for resuscitation, hospitalization, and artificially administered nutrition. Unlike an advance directive, a POLST is a medical order that emergency responders are required to follow.

If a patient without a POLST goes into cardiac arrest at home and 911 is called, paramedics will attempt resuscitation regardless of any advance directive. A POLST specifying "do not resuscitate" is an order paramedics must follow. For patients with serious diagnoses who have clear preferences about resuscitation, a POLST is not optional - it is the document that ensures those preferences are honored in a crisis.

Ask your physician to complete a POLST together with you. It should be kept somewhere accessible at home and should travel with you to all medical appointments and any hospital or facility stay.

For diagnoses that carry a risk of cognitive decline - early Parkinson's, mild cognitive impairment, early Alzheimer's, or post-stroke changes - a formal neuropsychological evaluation at baseline establishes what current capacity looks like. This has two practical purposes: it creates a reference point for tracking change, and it documents that legal and planning decisions made now were made with full capacity.

Legal documents executed while a patient has documented capacity are far more difficult to challenge later. Power of attorney, advance directives, and estate planning completed now - with a neuropsychological evaluation in the record - protect both the patient's wishes and the family from future disputes.