Fair Square Medicare Wordmark

Does Medicare pay for Opdivo?

Model of the lungs with the diseased part. Cancer or Ground glass opacity GGO. stock photo

By Daniel Petkevich

Nov 23, 2022

You're covered on Medicare

For Medicare beneficiaries seeking treatment for cancer, knowing that you have coverage can offer peace of mind amidst very challenging times. Medicare will offer coverage for Opdivo, but there are some plans that will lead to more out-of-pocket costs than others. Let's talk through your Medicare coverage options.

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

What is Opdivo?

Opdivo is a prescription medication used to treat certain types of cancer. It works by blocking the activity of an enzyme called PD-1 which helps the body’s immune system recognize and attack cancer cells. By blocking this enzyme, Opdivo can help the body’s own immune system fight off cancer.

Doctor's may prescribe Opdivo to treat the following conditions:

  • Melanoma

  • Non-small cell lung cancer (NSCLC)

  • Urothelial carcinoma

  • Kidney cancer

  • Head and neck squamous cell carcinoma

Opdivo is administered intravenously and may be given in combination with other treatments such as chemotherapy or radiation.

How does Medicare cover Opdivo?

If you are receiving Opdivo in an in-patient setting, Medicare Part A will cover your treatment costs. In this instance, you will be responsible for paying the Part A deductible for each benefit period.

If you are receiving Opdivo in an out-patient setting, then Medicare Part B will cover the costs of your treatment. In this instance, you will be responsible for 20% coinsurance, and potentially copays as well.

Opdivo is not covered by Part D, because it is only administered intravenously. However, Part D covers some medications that may be related to your cancer treatment and can help reduce out-of-pocket costs.

To get the most protection against out-of-pocket expenses when paying for a treatment option like Opdivo, you should probably be on

Medicare Supplement Plan G

. With other plans, you might have to worry about 20% of the cost of Opdivo, which could quickly climb to thousands of dollars. Or you might have copayments on a Medicare Advantage plan that could pile up to your out-of-pocket maximum of around $6,000.

What are the side effects of Opdivo?

Opdivo can cause some side effects when used in the treatment of cancer. These may include nausea, fatigue, rash, diarrhea, fever, and chills. Other more serious side effects can occur, including an increased risk for lung inflammation or pneumonitis.

Conclusion

When it comes to Medicare coverage, it's important to know your options. With the right plan, you can get the most protection against out-of-pocket expenses associated with treatments like Opdivo. Be sure to speak with your doctor when considering treatment options. This content is for informational purposes only. And if you need to speak with a Medicare expert, give us a call at 888-376-2028.

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

Recommended Articles

senior couple doing yoga stock image

13 Best Ways for Seniors to Stay Active in Columbus

Mar 8, 2023

Heart on Heart Rhythm Background Concept stock photo

Does Medicare Cover the WATCHMAN Procedure?

Dec 1, 2022

Cover image

Fair Square Client Newsletter: AEP Edition

Oct 2, 2023

Model of the lungs with the diseased part stock photo

Does Medicare Cover Ofev?

Dec 2, 2022

Diagnosis overactive bladder stock image

Does Medicare Cover PTNS?

Dec 9, 2022

Cover image

2025 Medicare Price Changes

Oct 30, 2023

Senior couple working at a computer stock image

Do I Need Medicare If My Spouse Has Insurance?

Dec 19, 2022

Caucasian nurse holding spine model against the patients backs. Clinic interior. stock photo

Does Medicare Cover SI Joint Fusion?

Nov 28, 2022

Plastic surgeon handles a silicon implant

Does Medicare Cover Breast Implant Removal?

Jan 5, 2023

cartoon hospital and male doctor stock image

Can I Have Two Primary Care Physicians?

Oct 3, 2022

Senior woman receiving an ear exam stock photo

Does Medicare Require a Referral for Audiology Exams?

Nov 22, 2022

Cover image

What To Do If Your Medicare Advantage Plan Is Discontinued

Feb 26, 2024

senior african american man feeling pain in his knees from arthritis while on a couch stock photo

How Much Does Xeljanz Cost with Medicare?

Jan 25, 2023

Sinusitis. stock illustration

Is Balloon Sinuplasty Covered by Medicare?

Dec 1, 2022

Emergency section of a hospital exterior stock photo

How Does Medicare Pay for Emergency Room Visits?

Nov 21, 2022

Medicare Part A & Part B stock photo

How Much Does Medicare Part A Cost in 2025?

Nov 18, 2022

Fecal microbiota transplant from healthy in unhealthy intestine, FMT. Improvement intestinal microflora and normalization stool by introducing beneficial bacteria in bowel colon tract. Vector stock illustration

Does Medicare Cover an FMT?

Dec 2, 2022

Dripping medication stock photo

Does Medicare Cover Ketamine Infusion for Depression?

Nov 23, 2022

More of our articles

13 Best Ways for Seniors to Stay Active in Indianapolis

14 Best Ways for Seniors to Stay Active in Nashville

14 Best Ways for Seniors to Stay Active in Seattle

14 Best Ways for Seniors to Stay Active in Washington, D.C.

Building the Future of Senior Healthcare

Can I Change My Primary Care Provider with an Advantage Plan?

Can I Choose Marketplace Coverage Instead of Medicare?

Can I switch From Medicare Advantage to Medigap?

Can Medicare Advantage Plans be Used Out of State?

Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?

Can Medicare Help with the Cost of Tyrvaya?

Costco Pharmacy Partners with Fair Square

Denied Coverage? What to Do When Your Carrier Says No

Do Medicare Supplement Plans Cover Dental and Vision?

Does Medicare Cover a Spinal Cord Stimulator?

Does Medicare Cover Bariatric Surgery?

Does Medicare Cover Bladder Sling Surgery?

Does Medicare Cover Boniva?

Does Medicare Cover Cartiva Implants?

Does Medicare Cover Cataract Surgery?

Does Medicare Cover Disposable Underwear?

Does Medicare Cover Fosamax?

Does Medicare Cover Hearing Aids?

Does Medicare Cover Hoarding Cleanup?

Does Medicare Cover Ilumya?

Does Medicare Cover Incontinence Supplies?

Does Medicare Cover Iovera Treatment?

Does Medicare Cover Kidney Stone Removal?

Does Medicare Cover Kyphoplasty?

Does Medicare Cover Medical Marijuana?

Does Medicare Cover Mouth Guards for Sleep Apnea?

Does Medicare Cover Nexavar?

Does Medicare Cover Orthodontic Care?

Does Medicare Cover Ozempic?

Does Medicare Cover Qutenza?

Does Medicare Cover Robotic Surgery?

Does Medicare Cover TENS Units?

Does Medicare Cover Xiafaxan?

Does Medicare Have Limitations on Hospital Stays?

Does Medicare Pay for Bunion Surgery?

Does Your Medicare Plan Cover B12 Shots?

Estimating Prescription Drug Costs

Explaining the Different Enrollment Periods for Medicare

Finding the Best Dental Plans for Seniors

Finding the Best Vision Plans for Seniors

Gap Health Insurance: The Secret Sidekick to Your High-Deductible Plan

How Can I Get a Replacement Medicare Card?

How Do Medicare Agents Get Paid?

How Much Does a Medicare Coach Cost?

How to Apply for Medicare?

How to Become a Medicare Agent

How to Choose a Medigap Plan

Is Emsella Covered by Medicare?

Is Fair Square Medicare Legitimate?

Is HIFU Covered by Medicare?

Is PAE Covered by Medicare?

Medicare Advantage MSA Plans

Medicare Consulting Services

Medigap Plan N vs. Plan G — Which One Fits You in 2025?

Plan G vs. Plan N

Seeing the Value in Fair Square

Top 10 Physical Therapy Clinics in San Diego

Turning 65 and Thinking of Keeping COBRA? Here’s Why It Usually Backfires

Welcome to Fair Square's First Newsletter

What If I Don't Like My Plan?

What Is a Medicare Advantage POS Plan?

What is a Medicare Beneficiary Ombudsman?

What is the 8-Minute Rule on Medicare?

What is the Medicare ICEP?

What People Don't Realize About Medicare

What's the Difference Between HMO and PPO Plans?

Why Is Medicare So Confusing?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.

Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2025

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M

Fair Square Medicare

FSM symbol - 50