Best Cancer Treatment With Medicare: Best Medigap Plans for Cancer Patients, Medicare Coverage for Cancer Screening, and How to Pay for It
It seems like every day I’m hearing a new story about how people are struggling to pay their medical bills.
The costs of cancer treatment, especially with Medicare, can seem overwhelming for many people who don’t have a great health insurance provider or the finances to cover it themselves.
This blog post is meant as a guide for anyone facing this issue and hopefully helps them find out what options they do have available when making tough decisions around healthcare coverage and cost-sharing that work within their budget.
Table of Contents
What Are the Best Medicare Plans for Cancer Patients?
There are a variety of Medicare plans that cover cancer treatment. It’s important to choose the right plan for you, depending on your health and coverage needs.
If you are new to the Medicare health insurance program the best time to find a Medicare plan that will be light on your pocketbook is now. Far too often Medicare Beneficiaries sign up for a plan without considering all of the facts.
According to the American Cancer Society in 2022 there are 1,918,030 new cancer cases and 609,360 as of this article. In addition, according to the CDC more than two-thirds of all new cancers are diagnosed among adults aged 60 years and older.
For this reason, Medicare Beneficiaries need to consider which Medicare plan is best for treating cancer and provides the broadest coverage.
Based on our findings, we believe staying on Original Medicare with Medigap coverage is the best cancer treatment plan option available for the following reasons.
- Broadest access to Cancer Medical Facility
- Lowest out-of-pocket cost
- No limitations on access to specific cancer specialists that accepts Medicare assignment (If you have colorectal cancer you can go to the best doctor of your choice)
- Fixed healthcare budget with no surprise bills
If you are worried about the high costs of cancer we recommend you chose the best Medigap plan you can afford.
Best Medigap Plans for Cancer Treatment Services
Why Medicare Supplement Plans are the Best of the Best for your Cancer Treatment Insurance
Medicare Supplement Plans can provide important coverage gaps to your Original Medicare coverage.
Many people choose Medigap Plans because they offer more comprehensive coverage than traditional Medicare policies and Medicare Advantage plans. In fact, studies have shown that Medicare Supplemental Plans often provide better value than traditional Medicare options.
There are a number of different types of Medigap Plans available, so it’s important to choose the plan that best suits your needs.
When a Medicare Beneficiary signs up for Medicare Parts A and B they will be faced with choosing the right Medicare coverage. If you sign up for Medicare Supplement Plan G, it is cover all health care costs minus your annual Medicare Part B deductible.
This means cancer patients with Medicare Supplement Plan G in 2022 would have a total bill of $233. All other remaining costs would be covered at 100 percent.
How Do Medigap Plans Work for obtaining Medicare Cancer Treatment Coverage?
A Medigap insurance policy helps cover medical expenses not covered by Original Medicare. There are 10 different plan options to choose from, each providing a different level of benefits.
Medigap can be very helpful for people who have expensive healthcare needs but don’t want to worry about covering those costs themselves. By purchasing a Medigap policy, you can rest assured that your costs will be covered in the event of an accident, illness, or other health crisis.
Medigap plan G premiums provide older adults with an affordable option and provide comprehensive health care coverage.
Medigap Plan F
Medigap plans vary in terms of their coverage and premiums, but they all have one thing in common: They help pay for medical expenses that aren’t covered by Original Medicare. That means that you can use them to cover things like copays, deductibles, and out-of-pocket costs.
Medicare Plan F provides the most comprehensive health insurance coverage of all Medigap plan options. Medigap Plan F also covers the Part B deductible which no other plan is allowed to do.
This plan is not available to new enrollees who qualify for Medicare after January 1, 2020.
Medigap Plan G
In order to qualify for a Medigap plan, you must meet certain eligibility requirements, including having Medicare Part A and Part B coverage. Medicare Supplement Plan G provides the exact same benefits as Plan F minus the Part B deductible is not covered by Plan G. Medigap Plan G is the most popular supplemental plan option.
Medigap Plan N
Medigap Plan N is a popular option for Medicare Beneficiaries who want to save money on their monthly premium and are willing to take on more of the financial costs when using their plan.
How to Choose the Best Providers Covered by Medicare for Cancer Patients
There are a variety of Medicare providers that offer cancer treatment coverage, and it’s important to choose the right doctors who can provide the most comprehensive cancer treatment options.
When choosing a Medicare provider, it’s important to consider what type of cancer you have. Depending on the type of Medicare plan you are enrolled in will depend on your available options.
If you have a Medicare Advantage plan, your only option is their approved doctors and medical facilities. Cancer treatment typically falls under your Part B coinsurance which is typically 20 percent up to your annual max out-of-pocket cost.
If you are enrolled in Original Medicare with a Medicare Supplement plan you will have no restrictions on which doctors or cancer facilities you can use.
The American Cancer Society has a worksheet to help you navigate this process as well.
It’s also important to find a provider that has a good track record in treating patients with cancer – this will help ensure that you receive high-quality care.
The most important thing to remember is if you are diagnosed with cancer after a prostate cancer screening, you will want to locate a top doctor who specializes in prostate cancer treatment. If at all possible do not use a generalist but an expert.
Costs of Breast Cancer Treatment and Chemotherapy with a Medicare Supplement Plan G?
There are many different types of cancers, and each has its own treatment plan that may or may not be covered by your Medicare plan. Some common treatments include chemotherapy and surgery; both can be expensive if you don’t have insurance coverage or a government health program like Medicare Supplement Plan G.
It’s important to speak with your doctor or a representative about your breast cancer treatment options. The great news is you signed up for a Medigap Plan G and remained on Original Medicare.
This means the sky is the limit on your available options. Based on your doctor’s recommendations of a treatment plan this will be the action plan that will take place. Your doctor is not limited to your plan’s prior authorization requirements, step therapy, and denials from the insurance company.
Medicare does cover many cancers and if you have a Medigap Plan G all costs minus your Part B deductible are covered. It is important to mention any Part D prescription drugs will have additional costs.
When Is the Best Time to Sign Up for a Medigap Plan?
The best time to enroll in a Medigap plan is during your Medigap initial enrollment period.
This window last 6 months from the date you first sign up for Medicare Part B. During this period you are guaranteed approval for any Medicare Supplement Plan you choose to enroll in without the need for medical underwriting.
If you have cancer already, the insurance company is prohibited from refusing to offer coverage during this enrollment period. They also must continue to renew your Medigap plan for as long as you continue to pay your monthly premiums.
Most Common Cancer-Related Expenses
Most common cancer-related expenses include medical bills, food, travel costs, and lost wages. When possible you may want to consider a cancer policy with a high payout for specific diagnoses. These policies help cover additional costs not covered by health insurance.
Do Medigap Plans Cover the Top Cancer Treatment Facilities?
MD Anderson Cancer Center
Located in Houston, TX is one of the top-rated cancer facilities in the nation. Many senior citizens are wondering if their Medigap plan will help cover the cost of treatment at MD Anderson.
The answer to this question is yes! Medigap plans can help cover the cost of treatment at MD Anderson.
Memorial Sloan-Kettering Cancer Center
This facility, located in New York, is one of the world’s leading cancer hospitals. If you are wondering if your Medigap plan will help cover the cost of treatment at Memorial Sloan-Kettering, the answer is yes!
Sidney Kimmel Comprehensive Cancer Center (Johns Hopkins Hospital)
The Sidney Kimmel Comprehensive Cancer Center is located in Baltimore, MD and is one of the top cancer hospitals in the nation. If you are wondering if your Medigap plan will help cover the cost of treatment at this facility, the answer is yes!
University of Washington Medical Center (Seattle)
Yes, your Medigap policy will cover this Medical center.
The University of Washington Medical Center is one of the most respected cancer treatment facilities in the country. They offer state-of-the-art treatments and have partnerships with some of the best hospitals in the world. If you’re looking for an exceptional cancer treatment facility, look no further than the University of Washington Medical Center.
Mayo Clinic Cancer Center
The Mayo Clinic Cancer Center is located in Rochester, Minnesota, and it’s one of the world’s best cancer hospitals. The answer is yes if you are wondering whether your Medigap plan will cover the cost of treatment at this institution.
These are just a few of the top cancer treatment facilities that accept Original Medicare with a Medigap plan. If you have any questions about whether your Medigap plan will cover the cost of treatment at a specific facility, we recommend that you contact the facility directly.
Do Medigap Plans Require Step Therapy?
No, Medigap plans do not require step therapy.
What is step therapy? Step therapy is a requirement that patients try certain medications before their insurance will cover a different, usually more expensive medication.
For example, if your doctor prescribed medication A as the best course of action for your cancer treatment but your insurance company requires step therapy (Medicare Advantage Plans), you would first have to try medication B.
If medication B is not effective, then you could move on to medication A unless the insurance company requires other medications before allowing you to take the originally prescribed cancer-fighting drug.
However, with a Medigap plan, you would not have to go through this process as Medigap plans do not require step therapy.
Will Medicare Advantage Plans Cover Cancer Treatment?
What is a Medicare Advantage Plan? (Medicare Part C)
A Medicare Advantage Plan is a health insurance plan offered by a private company that contracts with Medicare to provide all of your Part A and Part B benefits.
Medicare Advantage Plans typically include prescription drug coverage and oftentimes offer extra benefits that Original Medicare does not cover, such as basic dental, vision, and fitness programs.
Most Medicare Advantage Plans have monthly premiums in addition to your Part B premium, and some plans may require you to pay a copayment, deductibles, or coinsurance for services.
Enrolling in a Medicare Advantage Plan is optional – you can stay with Original Medicare and buy a Medigap plan if you prefer.
How does cancer treatment work with a Medicare Advantage Plan?
If you have a Medicare Advantage Plan, it is important to know that cancer treatment may be covered differently than it would be with Original Medicare with a Medicare Supplement plan.
For example, Medicare Advantage Plans may require you to get prior authorization from the insurance company before you can receive certain types of cancer treatment.
Additionally, Medicare Advantage Plans oftentimes have a network of doctors and hospitals that you must use in order for your treatment to be covered. Medicare Advantage plans often require step therapy which can extend the time of your treatment if the revised treatment plan is not as effective.
If you are receiving cancer treatment or are considering treatment, we recommend that you contact your Medicare Advantage Plan to see what coverage is available to you.
Can I go to the Best Cancer Facility in the Country with a Medicare Advantage Plan?
The answer to this question depends on your specific Medicare Advantage Plan. Most Medicare Advantage plans are Health Maintenance Organizations HMO plans which means this would not be an option.
If you have a Preferred Provider Organization PPO Medicare Advantage plan and you do choose to go out-of-network for cancer treatment, you will have to pay more out-of-pocket costs than if you had stayed in-network.
Some of the top cancer medical facilities do not accept any Medicare Advantage plans, so it is vital you call their billing department prior to scheduling an appointment.
Will Medicare Advantage Plans Require Step Therapy?
The answer to this question depends on your specific Medicare Advantage Plan. However, most will try to save money and will require step therapy.
If you are receiving treatment or are considering treatment, we recommend that you contact your Medicare Advantage Plan to find out what coverage is available to you.
What does Original Medicare Cover for Cancer Treatment without a Medigap Plan?
Original Medicare (Part A and Part B) does cover some cancer treatment, but there are some limits to what is covered.
If you have Original Medicare without a Medigap plan, you will have to pay for some of the costs of cancer treatment as Original Medicare will cover 80 percent of the costs.
This means you will be responsible for the remaining 20 percent.
This is why most Medicare Beneficiaries buy a Medigap plan to cover the 20 percent coinsurance, deductibles, and copays.
How can I Pay for Cancer Treatment if I have Medicare?
Why you Need to Buy a Cancer Policy prior to turning 65
If you are enrolling in Medicare for the first time, you may want to consider buying a cancer policy to supplement your coverage.
Cancer policies can help cover the costs of cancer treatment that Medicare does not cover, such as copayments, coinsurance, and deductibles.
Additionally, cancer policies can help pay for certain out-of-pocket costs, such as transportation and lodging costs associated with cancer treatment.
It is critical to buy a cancer insurance policy prior to turning 65 as most insurance companies will not offer them after turning 65 years old.
Factor in Hotel stays and Flight Costs for you and your spouse
If you or a loved one has cancer, you may have to travel for treatment. This can be costly, especially if you have to travel far from home.
When considering treatment options, be sure to factor in the cost of hotel stays and flights for you and your spouse.
You may also want to consider whether the treatment facility offers housing for patients and their families.
Some cancer treatment facilities offer free or reduced-cost housing for patients and their families. This can be a great way to save money on travel costs.
Does Medicare Part A or Medicare Part B provide Cancer Coverage?
Medicare covers cancer treatment in a number of different ways, and the cost of cancer treatment could be spread over different Medicare parts. It is vital to understand which part of Medicare will cover your medical bills so you do not have any unexpected bills.
Cancer coverage is provided by both Medicare Part A and Medicare Part B. Part A covers inpatient care, while Part B covers outpatient care. Depending on where you are receiving your treatment will change which part of Medicare pays.
You may also receive bills related to your Medicare Part D plan. Part D provides coverage for your prescription drug plan for medications received at your local pharmacy. Depending on the specific cancer drugs and how and where they are administered will impact which Part’s Medicare covers the cost of cancer treatment.
Does Medicare Covers Cancer Screening and Cancer Diagnosis?
Yes, Medicare covers cancer screening and cancer diagnosis. However, there are some exceptions and limitations to what is covered.
For example, certain types of cancer screenings (such as colonoscopies) may only be covered once every 10 years. Additionally, diagnostic tests (such as biopsies) may only be covered if they are ordered by a doctor.
Can you get a Medicare Supplement Plan if I have Cancer?
Medigap Initial Enrollment Period
If you have cancer and are enrolled in Medicare, you may be eligible for a Medicare Supplement Plan. Medicare Supplement Plans help pay for the costs of cancer treatment that Medicare does not cover, such as copayments, coinsurance, and deductibles. You can enroll in a Medicare Supplement Plan during your Medigap Initial Enrollment Period.
Your Medigap Initial Enrollment Period is the six-month period that begins on the first day of the month that you are both 65 years old and enrolled in Medicare Part B.
If you enroll in a Medicare Supplement Plan during your Medigap Initial Enrollment Period, you cannot be denied coverage due to your health.
If you wait to enroll in a Medicare Supplement Plan after your Medigap Initial Enrollment Period, you may be denied coverage or charged higher premiums due to your health.
Outside of your Guaranteed Open Enrollment Period
If you attempted to enroll in a Medigap plan outside of your guaranteed issue rights, you will likely have to undergo medical underwriting in order to qualify for a Medicare Supplement Plan.
Medical underwriting is the process by which health care insurance companies evaluate your health to determine if you are eligible for coverage.
Each insurance company has different underwriting requirements. For instance, AARP Medigap plans may restrict access for any hospitalizations within the past year, while Anthem Medigap plans may have a 2-year look-back period on hospitalizations.
One of our Medicare insurance agents will be able to review the underwriting guidelines to see if we can find a Medicare Supplement policy that would be the best fit.
How Integrity Now Insurance Brokers can set you up for Success with your Medigap Policy!
Integrity Now Insurance Brokers can help you set up a Medigap policy that will cover the costs of your cancer treatments.
How? By working with our network of insurance providers and brokers, we can find the best coverage for you and help you pay for it all in one fell swoop.
We also have years of experience helping clients understand their policies and use them to get the most out of their care. So whether you’re looking to start treatment or just make sure your medical expenses are covered, Integrity Now is here to help!
