Does Medicare Cover Cancer Treatment?

Medicare cancer Coverage, First let us put your mind at ease from the start by letting you know that, yes, Medicare does cover treatments for cancer, and this post will explain to you the basics of coverage whether you’ve got just Original Medicare or if you’ve added on Part C, Part D, or Medigap.  If you would like to discuss this call 844-528-8688.

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The National Institute of Health predicts that more than one and a half million cases of cancer will have been diagnosed in U.S. by the end of 2018, and approximately 50% of those will be in citizens age 65 or older.

While a cancer diagnosis is emotionally devastating to any family or individual, the financial costs can also create a lot of worry. You may wonder how does Medicare cover cancer treatment?

Medicare Part A Coverage for Cancer Treatment

When it comes to Medicare Cancer Coverage with parts A and B, your coverage for cancer treatment obviously depends on the type of care being received. Part A is reserved primarily for inpatient services, so any cancer treatment you receive while admitted to the hospital will fall under Part A.

Before Part A will kick in, you have to pay the deductible ($1,340 in 2018). This deductible must be met every benefit period. A benefit period starts when you are admitted and ends after you have not received inpatient care for 60 days in a row.

After you meet the deductible, you may be charged coinsurance if your stay is longer than 60 days at a hospital or 20 days at a skilled nursing facility (SNF).

Medicare Part B Coverage for Cancer Treatment

With Medicare cancer coverage, Part B will cover the outpatient cancer treatments that you receive at your doctor’s office or a separate clinic. There is a small deductible of $183 (in 2018) that you’ll have to meet before your benefits kick in. Unlike Part A, this is an annual deductible that you will only ever pay once per year.

Part B covers 100% of the charges for cancer screenings (according to your Medicare preventive services)

Chemotherapy or radiation treatment received as an outpatient are covered up to 80%, the remainder of which you must pay as coinsurance. With just original Medicare cancer coverage there is no limit to the out-of-pocket expenses you might be charged in a year, which is why if you are looking for the best way to avoid costs for cancer treatment, you should consider enrolling in a Medigap plan.

Medicare cancer Coverage with a Medicare Supplement Plan

As you can see, Original Medicare will cover your cancer treatments, but can still leave you with a lot of very hefty charges that can really add up given the long term nature of fighting cancer. Namely, you’ve got these three charges to worry about:

  • Part A Deductible of $1,340, potentially multiple times per year.
  • Part A coinsurance for hospital stays beyond 60 days (or 20 days at a SNF)
  • 20% coinsurance on all treatments that fall under Part B.

The good news is that many of the Medigap plans cover all three of these expenses for your Medicare cancer coverage. Medicare Supplements C, D, F, and G leave you with zero out-of-pocket expenses for the Part A deductible, as well as the coinsurance for Parts A and B. Plan N will also cover these charges, though you’ll pay a small copay for some Part B services.

So, needless to say, if you are worried of the risk of being bankrupt by a cancer diagnosis, enrolling in one of these Medigap plans can put you mind at ease

Medicare Coverage for Cancer Medications

How your Medicare covers cancer medications can be a little bit tricky to figure out because it sometimes falls under Part B and sometimes Part D.

Cancer medications fall under Part B if you receive them at your doctor’s office. These are usually IV treatments, but may include pills as well. These medications cost you the usual 20% Part B coinsurance.

Cancer medications fall under Part D if you fill the prescription at a pharmacy. If you have Part D, the cost will depend on which tier the drug falls under in your plan.

Cancer medications can really add up. Some prescriptions can cost as much as $5,000 per month or more if you have no coverage. That’s why enrolling in Part D is especially important if you are trying to avoid unexpected costs for medication.

In addition to protecting you from the full out-of-pocket cost for medication, Part D also includes a catastrophic coverage limit to ensure you never spend too much on prescriptions

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Medicare Advantage Plans and Cancer Treatment

Coverage for cancer treatments on a Medicare Advantage Plan can vary a lot depending on your specific plan.

While the benefits will be identical to Original Medicare, your providers are allowed to charge different out-of-pocket expenses. Additionally, many Advantage Plans require you to work within a specific network of doctors in order to avoid higher fees.

Finally, because you cannot have Medigap with a Medicare Advantage Plan, your out-of-pocket expenses for cancer treatments are likely to be higher.  For most plans you will pay 20% of the Medicare approved amount for your chemotherapy.

In the end, a Medicare Advantage Plan provides some safety net when it comes to a cancer diagnosis, but you should probably be prepared for an expensive journey if your treatment is long term.

The Best Way to Prepare for Medicare Coverage of Cancer Treatment

When it comes to enrolling in Medicare, there are a lot of aspects to consider. Seeing as more than half of all new cancer diagnoses every year are in the 65 and older population, it’s important for new enrollees to consider the potential expenses.

The best possible way to avoid being bankrupted by cancer treatment is by enrolling in a Medicare Supplement (Medigap) that will cover the most expensive costs at 100%. It’s important to make this decision when you can enroll without underwriting.

If you wait until you receive a cancer diagnosis to change plans, you will probably not be able to change and will be hit with thousands of dollars of medical expenses.

If you are ready to find the right Medigap plan for you, email us or call 844-528-8688 and let us help every step of the way.

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