Cancer is an insidious disease and can spread to virtually any part of the body. Often, cancers will travel along bloodlines as it metastasizes, and this means that the bones can be affected. When this occurs, certain cancers can cause high levels of calcium to develop in the affected bone tissue.
Although calcium is good for bones as it strengthens them at normal levels, when calcium levels are higher than normal, the result can be damaging to the heart and brain as well as the kidneys. In fact, too much calcium can actually weaken bone structure and lead to pain and the potential for severe injury. Treatment for high calcium levels depends on the cause, but if abnormal levels of calcium are the result of cancer, prescription medications like Zometa may be added to a treatment plan that includes chemotherapy.
What is Zometa?
Zometa (zoledronic acid) is an injectable medication intended to treat high blood calcium levels. It works by reducing the effects of specific bone cells that eat away at bone tissue when activated due to cancer. By doing this, individuals suffering from cancer that has spread to the bones may see a reduction in bone weakness and a slowing of the progression of cancer. In tandem with chemotherapy drugs, Zometa potentially increasing the effectiveness of treatment to eliminate cancer.
Medicare Coverage of Zometa
Medicare benefits under Part D are usually the guidelines used to cover prescription drugs, but the stipulation when utilizing this part of Medicare is that the drugs have to be available for purchase at a retail pharmacy and self-administered. This often means that injectable drugs like Zometa are not covered under Part D. With this stated, Medicare Part B provides coverage for outpatient care, and in general, prescription drug injections that take place in a doctor’s office or Medicare-approved clinic are considered outpatient treatment. As a result, Zometa will likely be available to Medicare recipients under Part B.
The other possibility for Medicare benefits coverage is if Zometa is administered in a hospital setting after admittance or while staying in a skilled nursing facility. Under these circumstances, Medicare Part A would provide coverage since this part covers treatment while being cared for in a residential setting such as a hospital or skilled nursing facility. If you have a Medicare Advantage plan, you will still receive the same Part A and Part B benefits as Original Medicare, but you may have access to additional coverage.