MEDICARE AND CANCER
A cancer diagnosis is always stressful, but navigating Medicare can add to your struggle. Read on to learn about Medigap insurance and how it can impact the out-of-pocket costs you’ll pay for cancer treatment.
A cancer diagnosis can cause significant stress in your life, and you don’t want unnecessary healthcare bills to wreak any additional havoc. Unfortunately, retirees and Original Medicare beneficiaries don’t always know what to expect from their insurance coverage, nor do they realize that Medigap insurance can help.
Medigap plans are extra insurance policies that cover some of the gaps in treatment coverage that Medicare doesn’t. Even if you have Medicare Parts A and B, you might want Medigap insurance to help offset the costs related to cancer treatment and other healthcare services.
Before you make any decisions, let’s look at how Medicare handles cancer treatments and what you can get from Medigap insurance.
WHAT CANCER TREATMENTS WILL MEDICARE COVER?
Medicare Parts A and B cover many different types of cancer treatments, including chemotherapy and radiation. It might also pay for certain prescription drugs you receive at a hospital or doctor’s office.
You can expect Medicare on its own to cover part or all of the costs incurred through diagnosing cancer, mental health services, outpatient and inpatient surgeries, and more. Medicare pays for durable medical equipment as well as rehabilitation you might need, such as at a skilled nursing facility.
That doesn’t mean you won’t have out-of-pocket costs, though.
Medicare comes with certain deductibles, copayments, and coinsurance costs. While you’ll have the advantage of reduced costs for cancer treatments, some will still come out of your pocket.
WHAT CANCER TREATMENTS WILL MEDICARE NOT COVER?
Medicare won’t cover any nutritional supplements you might need to continue fighting your cancer, nor will it cover nursing home care or any at-home care that doesn’t demand a skilled nursing professional. Additionally, Medicare won’t pay for wigs if you lose your hair or for non-durable medical equipment.
In many cases, the reality of what Medicare will cover depends on the circumstance. For instance, Medicare Parts A and B don’t cover prescription drugs. However, if you need an oral medication during an outpatient treatment, Medicare might cover it as part of the overall service.
The important thing is to talk to your doctors about what costs you might incur and what treatments they recommend. You can then research those specific details to figure out what you might pay out-of-pocket.
DO YOU NEED MEDIGAP INSURANCE?
Medigap insurance can be critical for people who have received a cancer diagnosis. As mentioned above, you have to pay out-of-pocket for certain services because Medicare gives you financial responsibility in the form of deductibles, copayments, and coinsurance.
There are 10 Medigap plans, each of which covers a different subset of those out-of-pocket expenses. The goal is to use Medigap insurance to cover a greater percentage of your out-of-pocket costs so you don’t have to worry about money while you care for yourself.
Cancer can take as much of a psychological toll as a physical one. Between scheduling doctors’ appointments, enduring treatment, and living your everyday life, you might feel overwhelmed at times. Medigap insurance can take at least one stressor off your plate so you don’t have to worry constantly about what your cancer diagnosis is costing you.
You absolutely need Medigap insurance if you’re enrolled in Original Medicare. It’s the best way to gain more control over your budget. You’ll pay an extra premium every month, but if you choose the right Medigap insurance plan for your needs, the premium cost will matter less than what you would have paid for healthcare services.
Unfortunately, even insured patients often spend more money on cancer treatments than they first anticipated. The respondents to an oncology study who were surprised by their out-of-pocket expenses reported a median expenditure of just over $700, or about 11 percent of their average household budgets.
That’s tough for cancer patients who must take care of themselves mentally, physically, and emotionally. You might need to eat specific foods, for instance, based on your body’s ability to digest them. Medicare doesn’t cover special foods except under specific circumstances.
By reducing your out-of-pocket healthcare costs, you can allocate more money to things that Medicare doesn’t cover at all. Research shows that psychological stress negatively impacts the quality of life for patients with cancer. Since a cancer diagnosis causes stress by itself, you’ll want to eliminate as many other sources of stress as possible — including those that are related to finances.
CAN YOU GET MEDIGAP INSURANCE WHEN YOU HAVE CANCER?
If you’re applying for Medigap plans while you’re still in your initial enrollment period, you don’t have to worry about pre-existing conditions, including cancer. Companies have to offer you the desired Medigap insurance plan.
The same is true if you have guaranteed issue, though you might have fewer choices in terms of plan letters. Additionally, if you have guaranteed issue, some companies will institute a waiting period of up to six months. You’ll still be covered for treatment of issues unrelated to the pre-existing condition.
This is why it’s so important to apply for Medigap plans early. When you’re still in your initial enrollment period, you can’t be denied coverage.
WHAT MEDIGAP PLANS ARE BEST?
You can choose from 10 Medigap plans, each of which is different. There’s no “perfect” Medigap insurance plan for everyone; research them all to figure out what will fit best with your budget and healthcare needs.
For instance, if you want the broadest coverage possible, you might choose Medigap plan F, G, or C. They cover most or all of your deductibles, coinsurance fees, and copayments, but you’ll pay more for them every month.
Handling a cancer diagnosis is stressful, but you don’t have to worry as much about the cost of treatment if you have Medigap insurance. It’s one of the best ways to ensure that you don’t skip treatments because of their cost or cause yourself unnecessary stress.
Medigap insurance comes in 10 distinct forms, so you can choose what works best for you. Check out Ensurem’s Medigap Quoter to get quotes from multiple insurance companies. Each plan is the same regardless of which insurance carrier you select, so you can focus on getting the lowest possible premium.
Learning as much as you can about Medigap insurance now will make you more capable of selecting the right plan when the time comes. Medicare Supplement insurance helps ease your financial burden, so don’t wait until your initial enrollment period ends to act.