Cancer is a burden to all who are impacted by it. Along with the grief of being diagnosed with cancer, many patients are also hit with major medical bills associated to cancer treatment costs. According to the American Cancer Society Cancer Action Network (ACS CAN), in 2014 alone, nearly $88 billion was paid out by employers, insurance carriers, Medicare, Medicaid, patients and patient families on cancer-related care.
There is no question that the costs to treat cancer are astronomical. Cancer treatment centers and oncologists are aware of this and always breathe a little easier when a patient has excellent insurance for the treatment that is needed. For Medicare beneficiaries, Medicare supplement plans provide some of the most comprehensive coverage in general and even more so when it comes to cancer treatment.
There is one Medicare supplement plan that provides the most complete coverage for cancer treatment, making it a top recommendation among oncologists for their Medicare patients.
How Original Medicare Covers Cancer Treatment
Surgery, radiation, and pharmacological therapy such as chemotherapy, are three of the primary approaches to cancer treatment. The good news is that Medicare provides coverage for all three of these types of treatment.
Treatment received through surgery is covered by both Medicare Part A and Part B. Part A will provide you with your inpatient hospital coverage. Your room, meals and some inpatient surgeries will be covered under Part A after you meet a $1,300 plus deductible. Part B will cover pretty much every other medical service you receive while in and out of the hospital, such as doctor services, medications administered, X-rays, and lab work.
Radiation and chemotherapy also fall under Part B coverage. Cancer treatment that is covered by Part B is subject to the Part B annual deductible. Under Part B, you’ll also have a 20% coinsurance that you will pay for each service. Appallingly, chemotherapy alone can cost a couple thousand dollars a month. This could leave you responsible for thousands of dollars out-of-pocket each year.
The Medigap Plan That Your Oncologist Wants You to Have
Medicare supplement (Medigap) plans cover the cost-sharing gaps of Original Medicare. Gaps such as deductibles, coinsurance, and copayments can total in tens of thousands of dollars each year for a cancer patient.
Medigap Plan G will be the most comprehensive Medigap plan offered to new Medicare beneficiaries as of 2020. Plan G covers every gap in Original Medicare except for the small annual Part B deductible. So, with Medicare Plan G, you would be limited to paying only your Medicare premiums and Part B deductible each year for Medicare-covered services.
The Best Time to Enroll in Medigap Plan G
Every new Medicare beneficiary gets one chance to apply for a Medigap plan without having to answer any health questions. When applying for a Medigap plan without medical underwriting, you are guaranteed issue of that plan. This one-time chance is called your Medigap Open Enrollment window.
Everyone’s Medigap Open Enrollment window starts on the day their Part B becomes effective. From there, you have six months to apply for a Medigap plan without the worry of being denied coverage due to pre-existing conditions.
Not only are you guaranteed approval during this window, but this is usually the time when you’re quoted the lowest premium. This is because most plans are more expensive for older applicants.
Help for Cancer Treatment with Medicare from a Medigap Plan
The American Cancer Society conducted a case study on a Medicare beneficiary named Tom, who was diagnosed with colorectal cancer at the first of the year in 2016. Tom’s cancer diagnosis and treatment included a fecal immunochemical test, a colonoscopy, two polyp removals, a biopsied lesion, multiple blood tests, a CT scan, colectomy surgery, chemotherapy, oral drugs, and many follow-ups.
In 2016, Tom’s total costs for his cancer treatment were $124,425. Thankfully, Tom had a comprehensive Medigap plan. Tom’s Medicare Part A, Part B, Part D, and Medigap plan covered nearly 99% of his cancer treatment costs, leaving Tom with only $1,368 to pay out-of-pocket (not including his monthly premiums).
Tom’s Cancer Treatment Costs Without a Medigap Plan
Tom’s $1,368 in cost-sharing plus all of his monthly premiums (Part B, Part D, and Medigap) added up to $8,572 at the end of the year. His Medigap plan premium was on the higher end, which tells us that he likely wasn’t 65 at the time of his diagnosis.
If you were to get Medigap Plan G at age 65 during your Medigap Open Enrollment window, your premium would likely be much less than what Tom’s was at the time he was diagnosed. Therefore, your total out-of-pocket would likely be much less than $8,572.
Nevertheless, without that Medigap plan, Tom would have ended up paying $16,392 in premiums ($2,227) and cost-sharing ($14,165). That is nearly double what he was responsible for with his Medigap plan. So, as you can see, paying an extra premium each month can literally save you thousands in the end.
There Are No Identical Cancer Diagnoses
Tom’s experience is but one of millions. Undoubtedly, the cost of cancer treatment with Medicare alone can vary greatly. The purpose of this case study is to give you an idea of what cancer treatment is like with a Medigap plan and what it’s like without one.
Additionally, Medigap plan premiums vary by person. Premiums are based on things like age, gender, zip code, tobacco usage, plan, and carrier.
Because a Plan G is a Plan G no matter which carrier you get it from, you can focus on finding the lowest rate. Due to inflation, Medigap plan premiums generally go up every year. Therefore, you’ll want to look at the average rate increases as well to make sure you don’t choose a carrier who raises their premiums at a higher rate than normal.
Boomer Benefits can shop multiple carriers to help you get the most comprehensive cancer treatment with Medicare. Because we represent over 30 carriers, we can compare Medigap Plan G premiums and average rate increases from multiple carriers offered in your area. Once you’re enrolled, you’ll have completely free support from our legendary client service team to help with all of those issues you are likely to run into with Medicare.