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Being diagnosed with cancer is one of the most detrimental things that can happen to anyone. Not only do you have a battle to fight, but the medical bills that come with it are outrageous. According to AARP, the total cost of cancer treatment is in the $150,000 range but can certainly be higher. With that said, 63% of cancer patients and loved ones reported to have financial struggles following a cancer diagnosis, according to Asbestos.
Many cancer patients are Medicare beneficiaries. There are various amounts of Medicare parts and plans that you should consider when you age into Medicare because you never know what type of illness or disease you may be diagnosed with in the future. So, will Medicare cover skin cancer? Let’s take a look and see.
Original Medicare
Medicare is the United States federal healthcare program for seniors who are age 65+ or for people who have certain disabilities. Medicare will cover any service deemed medically necessary. Therefore, if your doctor deems your service, surgery, or screening for skin cancer to be medically necessary, Medicare will pay its share. Original Medicare comes with two parts: Part A and Part B, which both cover different types of cancer services.
Part A
Medicare Part A will cover most of the cancer treatments you receive as an inpatient in a hospital. Part A covers your room and board during your hospital stay, lab services, home health, and hospice care. In 2020, the Part A deductible is $1,408 per benefit period. Once you meet the deductible, you will not have any out-of-pocket costs with Part A for 60 days as an inpatient in the hospital.
If you receive cancer surgery, Medicare Part A will cover the first 20 days of your stay at a skilled nursing facility. After day 20, you will have a daily copay of $176 for days 21-100. Although Part A covers some most cancer treatments you receive as an inpatient, other types of cancer treatments can fall under Part B.
Part B
Part B covers outpatient services, such as doctor’s visits, durable medical equipment, preventative care, and more. If you are diagnosed with cancer, Medicare Part B will provide coverage for certain cancer screenings at 100% under your preventive care benefits.
However, after you meet the $198 Part B deductible, Medicare will only cover 80% for services like radiation, chemotherapy, diagnostic imaging, surgery, and injectable drugs. You will be responsible for the remaining 20% coinsurance for your cancer treatments with no out-of-pocket cap.
The remaining 20% can be a couple of thousand dollars for services like chemotherapy – which is why many Medicare beneficiaries enroll in a Medigap plan and why oncologists recommend it.
How does Medigap cover skin cancer?
Medigap plans work alongside Original Medicare, and many Medigap plans will cover that 20% coinsurance Medicare doesn’t pay. If you enroll in one of the comprehensive Medigap plans, your Medigap plan could possibly pay for 100% of your services. For new beneficiaries in 2020, Plan G is the most comprehensive Medigap plan on the market.
Medigap Plan G will cover your hospital deductible, copayments, coinsurance, excess charges, and more. The only out-of-pocket spending you will have with Plan G is the annual Part B deductible. So, if you receive chemotherapy for skin cancer, Medicare will pay 80%, and your Medigap Plan G will pay the 20% you are typically responsible for. Therefore, leaving you with no out-of-pocket spending.
Medication coverage
Cancer medications you receive are listed under Part Band Part D. Cancer medications you get in the doctor’s office will list under Part B. For example, IV infusion chemotherapy and anti-nausea medicines are listed under Part B. While oral cancer medications you receive at the pharmacy, such as Vismodegib, is covered by Part D.
Your Part D copay for medications will depend on the level of tier the drug is listed under on the Part D formulary. Most cancer drugs are brand name drugs and not generic. Therefore, your copay or coinsurance for your medications can be quite expensive. You will always want to verify with your doctor if your medications will fall under Part B or Part D and validate your cost-sharing.
Again, Medicare will cover skin cancer treatments, services, therapy, and more if the services are deemed medically necessary. Since Medigap plans work alongside Original Medicare, Medigap plans will always pay if Medicare pays, no matter the carrier or plan you are enrolled in. For more information over Medicare and skin cancer, visit Medicare.gov or contact a trusted Medicare broker.
