Medicare and Cancer Treatments: What are my options?

If you have cancer or are concerned about receiving the best treatment in the unlikely event you are diagnosed with it, rest assured – you have options.

The cost of cancer treatment varies depending on your cancer type, how advanced it is and the treatment plan your care team recommends. Original Medicare and many Medicare plans offered by private insurance companies will cover many medically necessary procedures; however, the doctors and networks you can see may be limited, especially if they’re out-of-network.

Best Cancer Coverage: Medigap Plan G + Medicare Part D

Cancer treatments are costly, which can leave older adults undergoing treatments facing significant financial hardship. Original Medicare (Part A and Part B) covers a portion of some cancer treatment, but with no caps on out-of-pocket maximums, patients can find themselves with exorbitant out-of-pocket medical expenses.

That’s why people concerned with high out-of-pocket fees will opt to add a Medicare Supplement Insurance plan,
aka Medigap, to their Original Medicare coverage. Medigap Plan G is the most comprehensive Medicare Supplement Insurance plan available to new or recent Medicare enrollees. The primary exception is Medicare Part B deductible of $226 in 2023.¹

Because medications are often an important part of cancer treatment, you’ll also need a separate prescription coverage, known as a Medicare Part D plan. While costs for these two plans vary depending on your age and the plans you choose, the monthly premium costs may be hundreds of dollars combined. Even with those premiums,
a Medigap Plan G and Medicare Part D may provide you with the greatest level of coverage.

What About Medicare Advantage Plans?

Medicare Advantage Plans often include additional benefits that Original Medicare does not. It generally also offers out-of-pocket maximums to help offset the costs for certain services, which will vary depending on the amount of medical care you need. Some networks and hospitals, like Mayo Clinic, only cover in-network Medicare Advantage plans, so if you have a particular provider or location from which you would like to receive treatment, you must know what providers and plans they accept.

How Much Might Cancer Treatments Costs with Medicare?

The National Cancer Institute calculated the average cost of medical care and drugs over $42,000² with Original Medicare insurance. This total comes from Original Medicare (Part A and Part B), requiring you to pay 20% of the Medicare-approved amount after you meet your deductible. If you opt for a Medigap Plan G with Original Medicare, most of your medical expenses for cancer treatment are covered after you pay the $2,700 deductible.³ If the combined monthly premiums of Original Medicare plus a Medigap plan have you concerned with the month-to-month costs of keeping those plans, there are other options.

How Can I Cover My Out-of-Pocket Expenses While Undergoing Cancer Treatment?

To help lessen the impact of unforeseen expenses coupled with a cancer diagnosis, many people choose to purchase a Cancer Insurance Plan. This supplemental insurance policy that provides a lump-sum financial payment after the policyholder receives a cancer diagnosis. With a Cancer Insurance Plan and your health insurance plan, you can help combat high treatment costs and the indirect expenses associated with getting treatment.

What Can Cancer Insurance Pay For?

Anything! Cancer Insurance isn’t health insurance, so there are no limitations on how you spend your payment.
Most people use the funds to help pay for direct and indirect costs associated with treatment, such as:

• Copays/deductibles
• Prescription drugs
• Rehabilitation
• Transportation to cancer doctors/specialists
• Medical Supplies
• Loss of Income
• Rent/mortgage
• Childcare

Is Cancer Insurance the Same as Health Insurance?

No. Cancer Insurance is like other supplemental insurance plans like Hospital Indemnity insurance, which pays policyholders a lump sum if admitted to the hospital. It’s NOT recommended only to have a Cancer Insurance policy.

Conclusion

If you’re worried about potentially developing cancer or looking to ease your mind, then it may be worth exploring your Cancer Insurance options and selecting the right primary health insurance plan. Remember, there are other supplemental disease-specific insurance options, such as Heart and Stroke Insurance. Speak to an Ensurem licensed insurance agent to see if one is the right fit for your needs.