The American Cancer Society predicted that in 2020, an estimated 1.8 million new cancer cases would be diagnosed. And treatments for cancer are not cheap, with the 2017 national expenditure upwards of $147.3 billion. In short, cancer is a friend to no one. Thankfully though, Medicare has your back!
Preventing cancer and detecting it early are key. To aid you in preventing cancer, Medicare Part B provides access to 8 smoking cessation counseling visits per year. Nutritional counseling is also provided if you have diabetes or kidney disease as both conditions increase your risk of developing cancers.
Below are some examples of how Medicare covers preventative screenings:
- Mammograms (even the newer digital ones!) are covered at 100% every 12 months and cervical cancer screenings every 2 years. Both screenings can be covered more often under Part B at 80%.
- Prostate cancer screenings such as the PSA (prostate-specific antigen) blood test are covered yearly. However, the DRE (digital rectal exam) is only covered at 80% yearly.
- There are multiple ways to screen for colorectal cancers. The occult blood test can be completed every year. Colonoscopies are covered every 2 years if you are considered high risk or every 6 years. These screenings can be covered more often under Part B at 80%.
Treatments are going to be the largest expense as they include any items to help you fight your cancer.
Diagnostic tests like X-rays and CT scans are covered at 80% by Part B.
Durable medical equipment (DME), such as wheelchairs and walkers are also covered at 80% by Part B. DME feeding pumps may be fully covered by Part B.
Chemotherapy is covered under Part A or Part B depending on if you are in a hospital or doctor office setting. Some oral chemotherapy treatments are also covered by Part B. Most oral chemotherapy is covered under Part D, so expect to pay copays and/or coinsurance.
Medicare will also cover second and possibly third opinions for non-emergency surgeries.
Surgeries & Hospital Stays
Inpatient surgeries and hospital stays are covered 80% by Part A. This includes other treatments you may receive while admitted, such as medications. While you may be in a hospital, make sure to double check your status with the hospital staff as you could still be considered an outpatient (aka under observation). Read our article here (https://www.planmedigap.com/observation-vs-admitted/) to learn more about the importance of your status.
After a 3-day hospital stay, Part A will also cover skilled nursing facility care or home health care services. These mainly include rehabilitation centered services such as physical therapy, speech-language pathology therapy, occupational therapy, and skilled nursing care (i.e. rebandaging wounds or administering shots).
Medicare Part A & B may cover 80% of your bill when you participate in clinical research studies (aka clinical trials). These studies may include diagnostic tests, surgical treatments, medicine, and/or other new types of care.
A subject no one wants to discuss, but it is good to know that hospice care in a hospital setting is covered 100% by Medicare. Copayment for medications is no more than $5, but this is covered by a Medicare Supplement plan. Grief and loss counseling for you and your family is also covered by Medicare.
What Insurance Plans Can Help Me?
Having a Medicare Supplement plan can help pay the 20% of costs not covered automatically by your Part A & B. These plans can also aid in drastically reducing your medical bills if you need to have any major surgeries such as tumor removal or reconstruction.
However, there are many other costs that need to be considered such as:
- Transportation (for follow up visits, physical therapy sessions, etc.)
- Hotel stays for you and your family
- Going out to eat when away from home for treatments
- Cost of a wig
- Co-pays or coinsurance for prescription medications
- Loss of income
- Long-term nursing home care
- Medical food or nutritional supplements
- Experimental treatments
- Other expenses not covered by Medicare
The best way to protect yourself from these unforeseen costs is with a Cancer Insurance plan. These plans will provide you a lump sum benefit from $5,000 – $100,000 (in $5,000 increments) when you are diagnosed with cancer.