Medicare and Cancer Care
Cancer is the second leading cause of death in the United States, according to the Center for Disease Control. And cases of the most common cancers, breast, kidney, lung, melanoma, and prostate, are on the rise. If you are in treatment for cancer now, or want assurance you’ll be covered for a possible cancer in the future, here’s what you can expect once you’re part of Medicare.
As an enrollee of Medicare Part A and B, you’ll get coverage for doctor-approved cancer treatments and services, including skilled nursing facility care, blood work, home health care, breast prosthesis after an inpatient mastectomy, intravenous chemotherapy drugs, diagnostic exams, outpatient surgeries, preventative and screening services, and more. What’s not covered is room and board in an assisted living facility, long-term nursing home care, adult day care, unskilled home care, and medical food or nutritional supplements. Since Medicare Part D is strong on coverage for cancer medications, we recommend you enroll in Part D when you first join Medicare. Original Medicare also covers immunotherapy, the advanced treatment that recruits your immune system to fight cancerous cells. In terms of out-of-pocket costs, you may be responsible for copayments, coinsurance, and deductibles. Costs vary with the type and location of facility, and whether you have additional insurance. There may be payment limits on certain services, and some may not be covered. medigapcoverage.com powered by pollen is here to answer any questions you have about cancer and Medicare coverage, including supplemental insurance to fill the gaps in Medicare. Call us at 1-833-245-0614
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I’m in cancer treatment now and will need help with costs for my care from Medicare. What can I expect?
Medicare Part A and B will help you pay for doctor-approved cancer treatments and services, including skilled nursing facility care, blood work, home health care, breast prosthesis after an inpatient mastectomy, intravenous chemotherapy drugs, diagnostic exams, outpatient surgeries, preventative and screening services, and more.
I’m going to need help paying for prescription medication for my cancer treatment once I join Medicare. Does basic Medicare provide for this?
Original Medicare (Part A and Part B) do not offer prescription drug benefits, but Medicare Part D does have very good benefits for cancer medications.
- Best overall Medicare supplement for new enrollees: Plan G.
- Best overall Medicare supplement before 2020: Plan F.
- Best low cost Medicare supplement: Plan K.
- Best alternative to Plan G Medicare supplement: Plan N.
Medicare Supplement policies are private health insurance designed to cover gaps in Original Medicare. They are also known as Medigap plans. These take care of costs such as copays, coinsurance, and deductibles which can become expensive if you need regular care from a doctor or hospital. If you need medical care while traveling outside the U.S., you can buy Medigap policies to help cover those costs. As a supplement to Original Medicare, you’re required to have Part A and Part B before you canget a Medigap policy. This way, Medicare is responsible for the Medicare-approved costs of the covered care, and the remainder is covered by your Medigap plan.
Optimal coverage comes with higher costs, making Plan F the most expensive Medigap plan. Plan F is known as “first-dollar coverage” and it takes care of everything provided during a doctor or hospital visit. Your only responsibility is for dental, vision, medications, and equipment, such as hearing aids.
The Federal government ended the Plan F option for new enrollees last year to keep the healthcare system from being overused by patients who had their deductibles covered. The next best coverage after Plan F is Plan G.
Medigap Plan G offers every advantage of Plan F except for the deductible, which you have to cover. Because it isn’t as comprehensive as Plan F, Plan G is more affordable.
For people who don’t go to the doctor often, Plan K is worth considering. It is the most affordable because it provides just 50% of Medicare Part B coinsurance, the Part A deductible, blood, skilled nursing, and Part A hospice costs. For comparison, Plan G and others offer full coverage of these expenses, and more.
It’s hard to argue against plans which cut your traditional Medicare costs. For most people, having the extra coverage these supplemental plans provide is common sense, unless they want the specific features of a Medicare Advantage plan.
Most people would benefit from not having to pay out-of-pocket to stay healthy. Medicare supplement insurance or a Medicare Advantage plan offer vital savings now, but are indispensable should a catastrophic health issue occur.
Of the 10 Medicare-approved Medigap plans, Plan G and Plan N are the most popular. Plan F is no longer available to new Medicare enrollees as of 2020, but it is still popular among people who bought this plan prior to 2020.
- Plan F$128–$342
- Plan F (high deductible)$22–$88
- Plan G$106–$325
- Plan G (high deductible)$29–$58
Before getting a Medicare supplement plan, you need to be enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance). People with Medicare Advantage Plans who want to go back to Original Medicare can buy a Medigap policy prior to switching.
The security of having lower or no out-of-pocket healthcare costs can offset the premiums you’ll have to pay for whichever Medigap plan you choose, which vary depending on the benefits offered.
The national average cost for Medicare Supplement Plan F is $1,824 annually, which is $152/month; Medigap Plan G will cost you around $143 per month.
Since Plan F was discontinued for new enrollees as of 2020, Plan G offers the most coverage for people 65 and older. It has a lower premium than Plan F and duplicates its benefits, except for the Part B deductible.
It depends on your specific needs, but for most people a Medigap plan is very useful in supplementing the coverage of Medicare Part A and Part B. A Medicare Advantage plan is an affordable way to get healthcare coverage not offered by Original Medicare.
Historically, Plan F has been the most popular because it covers all the out-of-pocket costs Medicare does’t pay for. This includes the 15% extra charge billed by providers who do not take Medicare as full payment.