Fluorouracil (5-FU) is a common chemotherapy treatment that circulates throughout the body to target and destroy cancer cells. Fluorouracil is particularly effective in treating specific types of cancer, such as those affecting the gastrointestinal tract. Original Medicare (parts A or B) should cover Fluorouracil when necessary to treat cancer.
Medicare will cover chemotherapy for treating cancer. Because doctors administer fluorouracil intravenously (via the veins), coverage falls under Part A or B. Part A covers it during a hospital stay, whereas Part B covers it when healthcare professionals administer it in a clinic or doctor’s office.
A person enrolled in Medicare Advantage (Part C) instead of Original Medicare should receive similar coverage.
That said, if someone needs topical fluorouracil to treat precancerous lesions known as actinic keratoses, they may have coverage from Medicare Part D or a Part C plan with drug coverage to help prevent skin cancer progression. Whether or not these plans will cover topical fluorouracil depends on the specific plan.
According to Optum Perks, without insurance, a generic solution of injectable fluorouracil costs between $65 and $145 for four 10-milliliter bottles. Depending on the dispensing pharmacy, fluorouracil cream costs between $35 and $75 per tube.
How much a person will pay out-of-pocket depends on the plan that covers the drug. In 2025, after a person meets the annual Part B deductible of $257, Part B will pay for 80% of any covered treatment or service. Most people do not pay a premium for Part A, but they must meet a $1,676 deductible. Once they do, Part A will cover their full hospital stay for up to 60 days. A person begins incurring an additional daily cost for any hospitalization or treatment they need after this period.
Under Medicare Part D, the amount a person pays depends on the drug tier classification within the plan’s formulary. In addition, because private companies administer Part D plans, each plan charges different premiums and deductibles. The national base beneficiary premium will be $36.78 in 2025.
Private insurers also manage Medicare Advantage (Part C) and offer different premiums, deductibles, and coinsurance. According to the Centers for Medicare & Medicaid Services (CMS), the average monthly premium for a Part C plan is around $17 in 2025.
Learn more: Does Medicare cover cancer treatment?
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