Medicare and Cancer Care

Medicare and Cancer Care

March 18, 2021

While we all hope its something that will never affect us personally, cancer is a worry to all who are impacted by it. Along with the anguish of being diagnosed with cancer, many patients are also hit with major medical bills for cancer treatment. The single greatest risk for developing cancer is age, with half of all cancer diagnoses occurring above the age of 65. Age and cost are critical to keep in mind when creating a secure retirement strategy and healthcare plan.  And, with Medicare being the primary source of healthcare in retirement, it’s vital to understand the cancer treatment options and plans available through Medicare.

Parts A & B: Medicare Part A includes hospital stays after the $1,408 deductible for each benefit period. Patients hospitalized longer than 60 days pay $352 coinsurance per day. After 90 days, it’s $704 per each lifetime reserve day. Once the 60 lifetime reserve days are used, the patient pays all costs. Because many chemotherapy drugs are administered in a clinic or treatment center, Medicare Part B usually covers 80 percent of their costs after a $203 deductible. If you have Medicare Parts A and B alone, there is no out-of-pocket maximum for these expenses.

Part D: This plan typically covers oral cancer drugs, those which can’t be given through an IV – after a deductible that can’t exceed $445. Standard plans have either copayments or coinsurance charges and a coverage gap after $4,130 when patients pay higher percentages until they reach catastrophic coverage once prescriptions total $6,550. There is no maximum out-of-pocket under Part D.

Medigap: Medicare beneficiaries with Parts A, B and D often purchase a Medigap supplement policy to limit out-of-pocket costs. Gaps such as deductibles, coinsurance, and copayments can total in tens of thousands of dollars each year for a cancer patient. Medigap plans cover the cost-sharing gaps of Original Medicare (Parts A & B). While coverage varies from plan to plan, most doctors accept regular Medicare, and providers who do are required to accept any Medigap plan.

Medicare Advantage: Other beneficiaries choose a Medicare Advantage plan, referred to as Part C, which combines Parts A and B and usually a drug plan in a private policy. Many plans have a required or a preferred network of doctors and providers, which may limit the specialists you can see during cancer care. Advantage plans have maximum out-of-pocket limits.

While it’s not a pleasant topic to prepare for, planning for potential health care expenses including cancer treatment, has never been more important. Whether you’re retired or still working, we can help you find the best vehicles to put money aside for health care.