Medicare and Cancer Care
Cancer is one of the costliest medical conditions to treat. While typical cancer drugs can cost $10,000 per month, some run many times that. And the single greatest risk for developing cancer is age. In fact, half of all cancer diagnoses occur at age 66 or above. So how does Medicare cover cancer treatments?
Part A covers 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, 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 typically covers oral drugs, 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.
Medicare beneficiaries with Parts A, B, and D often purchase a Medigap supplement policy to limit out-of-pocket costs. Coverage varies from plan to plan. Most doctors accept regular Medicare, and providers who do are required to accept any Medigap plan. The best time to purchase a Medigap policy is during your six-month open enrollment period, which starts the first month you’re 65 and enrolled in Medicare Part B. At that time, you can purchase any policy sold in your state, even if you have health problems.
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 (lower cost) network of doctors and providers, which may limit the specialists you can see during cancer care. Advantage plans have maximum out-of-pocket limits.
Planning for potential health care expenses 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.