A cancer diagnosis can be scary for anyone. Between screenings and treatments the average cost of treatment is around $150,000. The big question is can Medicare help? Yes, Medicare can make watching for and treating cancer much more affordable.
How Cancer Treatment is Covered by Original Medicare
Original Medicare, or Medicare Parts A and B, often provides beneficiaries in need of cancer treatment or screenings a decent coverage option. Which part of Original Medicare that can provide insurance coverage for cancer screenings or treatment depends on whether you’re an inpatient or outpatient.
Medicare Part A
If you’re an inpatient (e.g., in a hospital or health care facility), Medicare Part A can help cover your stay at the hospital, as well as other inpatient services. Part A may also cover your time at a skilled nursing facility, chemotherapy in an inpatient setting, inpatient mental health services, and hospice care.
Medicare Part B
If you’re not staying at an inpatient facility, Medicare Part B may help cover your cancer treatment. Common service such as: doctors’ visits, outpatient chemotherapy and radiation treatments, outpatient mental health services (if part of your cancer treatment), outpatient diagnostic tests, and preventative screenings (mammograms & prostate cancer screenings).
Both Medicare Part A and B have costs associated with them that can change each year. Keep in mind, it’s possible to be treated in a hospital or health care facility and be considered outpatient if you’re in observation status. For this reason, it can pay to verify what part of Medicare you’ll be covered under ahead of time if you can.
Medicare Part D and Cancer Treatment Coverage
When discussing cancer treatment, it is important to discuss prescription drugs. A few common medications in cancer treatment are chemotherapy, anti-nausea, or pain-management drugs, If you’re a Medicare beneficiary with a Medicare Part D plan, your prescriptions drugs may be covered in some way. It’s important for you to ask questions and check for specific costs when it comes to your prescription drug needs.
Medicare Part D has a initial coverage limit which then falls into the coverage gap where you pay a certain percentage of the cost of your prescriptions. Once you’ve spent enough on prescriptions you’ll reach your true out of pocket limit and enter into the catastrophic phase of coverage. While in catastrophic coverage, your plan covers all but a small portion of your coinsurance and copayment for covered drugs. T
Other Medicare Coverage for Cancer Treatment
Medicare Part A, B, and D aren’t the only options for coverage. In fact, Medicare Part C, can offer extra help for cancer treatment. Medicare Part C is the federally-approved, privately-offered Original Medicare alternative. This means, it’s required to offer you the same coverage as Original Medicare, at the very least. In many cases, Medicare Advantage plans will offer prescription drug coverage in the plan, along with coverage for additional services. Check your own Part C plan for specifics on what benefits are offered.
Another option - Medigap plans. Medigap plans can help cover some out of pocket costs associated with Original Medicare.
If you or someone you love receive a cancer diagnosis, the last thing on your mind should be finances. Getting back to good health is most important and Medicare can be a wonderful way to help with costs so that you can focus on your health. We provide current, clear, and trustworthy information to help make Medicare easier to understand. Let us help you so that you can focus on more important things.
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