Can a Medicare Supplement Plan Help Pay for Cancer Treatments?
When you’re facing a cancer diagnosis, costs can quickly add up. Depending on the type of cancer you have and your prognosis, your doctor may recommend several treatment options, such as chemotherapy, surgery, or radiation. In addition to doctor visits, your medical costs could also include services like lab tests, imaging tests, or home health care. According to the American Cancer Society, chemotherapy drugs alone can cost thousands of dollars a month.
Here’s an overview of how Medicare Supplement plans may help with cancer treatment costs.
How Medicare Supplement plans work
Medicare Supplement plans are not stand-alone plans, and you’ll need to stay enrolled in Original Medicare (Part A and Part B) for your hospital and medical care and Part D for prescription coverage.
Medicare Supplement plans help “fill the gaps” in certain costs that Original Medicare doesn’t cover. This includes cost sharing (such as copayments and deductibles), as well as services or items you’d normally pay out of pocket, like Part B excess charges and overseas travel coverage.
There are 10 Medicare Supplement plans available, labeled A through N, and benefits are standardized across each plan type. Medicare Supplement plans help with out-of-pocket costs like:
- Part A coinsurance and hospital costs for another year after Medicare benefits are used up
- Part B coinsurance or copayment
- First three pints of blood
- Part A hospice copayment or coinsurance
- Part A skilled nursing facility coinsurance
- Part A deductible
- Part B deductible*
- Part B excess charges
- Overseas foreign travel coverage
*Medicare Supplement Plans C and F currently cover the Part B deductible. However, please note that starting January 1, 2020, new Medicare Supplement plans will not cover the Part B deductible or be available to beneficiaries new to Medicare. Those already enrolled in a Medicare Supplement Plan C or F may keep their plan.
A new high-deductible Plan G might be available starting January 1, 2020.
For more information, this chart comparing Medicare Supplement plan benefits may be helpful.
What Original Medicare covers and how Medicare Supplement plans help
If you’re diagnosed with cancer, Medicare Part A covers inpatient care like hospital stays, skilled nursing facility stays, home health care, and hospice care. Part B covers outpatient services like doctor visits, durable medical equipment, and chemotherapy or radiation treatments administered in a doctor’s office or outpatient clinic. Part B-covered medications are usually the kind you can’t give yourself, such as infusion drugs. For all other prescription drug coverage, you’ll need to enroll in Medicare Part D.
Keep in mind that Medicare Supplement plans don’t cover prescription drugs or help with Part D prescription drug costs. So, if you’re taking chemotherapy medications by mouth (also known as targeted therapy), you’d be covered through Part D. Medicare Supplement plan wouldn’t help with these costs. However, if you’re getting chemotherapy drugs intravenously in a doctor’s office, you’d be covered under Part B, and a Medicare Supplement plan may help with any related copayment or coinsurance costs. If you already had a Medicare Supplement Plan C or Plan F prior to January 1, 2020, or if you qualify to buy one, your Medicare Part B deductible might also be covered.
For those who’d like an annual cap on medical costs, Medicare Supplement Plans K and L both have an out-of-pocket limit. It’s not uncommon for cancer treatment costs to quickly add up, particularly if you have an advanced type of cancer or your cancer battle is prolonged. With these two options, the Medicare Supplement plan covers all Medicare-covered services for the rest of the year after you’ve met the yearly limit as well as your annual Part B deductible.
How Medicare Supplement plans help with inpatient vs. outpatient costs
A big factor affecting your costs is whether you’re getting your cancer treatment as an inpatient (covered through Medicare Part A) or an outpatient (covered by Medicare Part B).
For example, if you’re getting radiation therapy as an inpatient, your share of costs will include the Part A deductible and, once met, a coinsurance (if your inpatient stay is longer than 60 days). If you’re getting radiation therapy as an outpatient through a freestanding clinic, you’ll pay 20% of the Medicare-approved amount, after reaching the Part B deductible.
In the above scenario, a Medicare Supplement plan could help cover your Part A deductible and any applicable coinsurance costs for an extra 365 days once you’ve exhausted your Medicare benefits. This could help with costs if you’re hospitalized for a long period. Or, if you’re getting the treatment through an outpatient clinic, a Medicare Supplement plan could cover the cost of your Part B copayment or coinsurance, and the Part B deductible.
For more information on Medicare Supplement plans
When you’re facing cancer, there can be many unknowns. Knowing you’re financially able to handle medical costs can help you feel more prepared so that you can focus on your treatment. If you’d like to look for Medicare Supplement plans that may help with costs, enter your zip code into the plan finder tool to get started.
This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.