Proton Therapy Cost
The Maryland Proton Treatment Center (MPTC) is committed to providing excellent care and making proton therapy an affordable option for our patients. While proton therapy has a reputation for being an expensive treatment in other parts of the country, at MPTC the cost of proton therapy is similar to the cost of conventional radiation therapy. This pricing is based on a cost neutral model that ensures patients have access to the best radiation treatment for their cancer right here in Maryland.
The insurance coverage process
Throughout the process, our physicians as well as our dedicated team of patient representatives will work directly with your insurance provider to obtain authorization for coverage.
- We will begin with a consultation with our team to review your treatment plan, your health background and insurance plan.
- From there, we will reach out directly to your plan to establish coverage.
- Before you begin treatment, we will review with you your insurance coverage, co-pays and out-of-pocket expenses so you know what to expect.
MPTC accepts a variety of insurance types and will be happy to discuss your specific coverage at 410-369-5200.
General guidelines include:
General coverage: Proton therapy is generally covered by Medicare (non-HMO). In many cases, patients covered by Medicare supplemental insurance often incur few net-out-of-pocket expenses for treatment after deductibles, copays/coinsurance, and annual maximum payments are met.
Treatment-based coverage: Some private insurance companies cover proton therapy for specific disease sites (cancer types) or on a case-by-case basis. We will work on your behalf to obtain coverage including communicating the facts and clinical recommendation for proton therapy, providing comparative treatment plans and setting up physician-to-physician consultations between our team and your insurance provider.
We also work with insurance providers from around the country.
Self-pay: If you do not have insurance or if you are coming from outside the U.S., MPTC also has self-pay options and payment plans.
Coverage denials: Should your insurance carrier deny your coverage for proton therapy, we will first appeal on your behalf. If the appeal is denied, we can also recommend some actions to take, recommend a different treatment option or work with you on a self-pay basis.