Does Medicare Part B cover my cancer screening and treatment? How about chemotherapy and radiation therapy? How much will I have to pay for my cancer treatment? Does Medicare cover the rest? How can I get help paying my medical bills?
From a purely financial perspective, most people with original Medicare and a supplement (Medigap) plan will not have to worry about how they will pay for the cost of cancer treatment. Most Medigap plans cover 100% of your hospital inpatient (Medicare Part A) expenses and the bulk of your Part B outpatient care.
That’s not the case with Medicare Advantage.
Medicare Cover Cancer Treatment?
Your out of pocket costs for cancer treatment with an Advantage plan can run several hundred or even thousands of dollars each year. If your treatment includes chemotherapy, you are generally responsible for 20% of the cost. Your plan picks up the balance.
If you are turning 65 and going on Medicare, this may be your only chance to pick a Medigap plan. Choose wisely.
Your information is NEVER sold. We are happy to discuss options by phone and will give you an
instant quote for the absolute lowest Medigap rate in your area. There is never any pressure to buy.
Post summary.
How common is cancer?
Will Medicare pay for treatment from ANY doctor?
How much will I pay for chemo?
Is cancer screening covered by Medicare?
Medicare Advantage or original Medicare and a supplement plan? Which is better?
Medicare Coverage for Cancer Treatment
The American Cancer Society tells us that more than half the 1.4 million new cancer diagnoses occur in people age 65 and older. Roughly 20% of retiree deaths are a result of cancer. Medicare pays for almost half of the $74 billion spent on cancer treatment. The elderly account for 70% of cancer deaths each year.
Original Medicare covers about 80% of your cost of care. Most Medigap plans will pick up the remainder. You can pick your own doctor(s), hospital and treatment center and a referral is never required.
Not all cancers require or even respond to chemotherapy, but there are some things you should know about the cost of chemo.
One screening mammogram every 12 months is fully covered for all women with Medicare age 40 and older. You can get one baseline mammogram between ages 35 and 39, too. Medicare also covers newer digital mammograms.
Original Medicare coverage for cervical cancer testing
Medicare covers one Pap test and pelvic exam every 24 months if you are at average risk for cervical cancer. If you’re at high risk for cervical or vaginal cancer or are of childbearing age and have had an abnormal Pap test in the last 3 years, the tests are covered every 12 months.
You pay nothing for the Pap lab test or for collecting the Pap test and the pelvic exam, as long as your doctor accepts assignment from Medicare. As part of the pelvic exam, Medicare covers a clinical breast exam to check for breast cancer.
Medicare coverage for colorectal cancer testing
Medicare covers colorectal screening tests in people 50 and older to help find colon or rectal cancer and/or pre-cancerous polyps (growths in the colon) so they can be removed before they turn into cancer. Coverage for these tests depends on the person’s risk for colorectal cancer, when they had their last test, and whether something is found that needs to be removed during the test.
Medicare coverage for prostate cancer testing
For men over age 50 with Medicare, one digital rectal exam (DRE) and one prostate-specific antigen (PSA) blood test are covered every 12 months. This coverage starts the day after your 50th birthday.
Medicare coverage for lung cancer testing
Medicare covers lung cancer screening with a low dose CT scan once per year if you have Medicare, are 55-77 years old, have a tobacco smoking history of at least 30 pack years*, and you either continue to smoke or you have quit smoking within the last 15 years.
Need Help Paying Medical Bills?
There are several resources that can help cover the gaps when it comes to paying medical bills.
This list is by no means complete. If you know of a resource that should be added, please let us know.
Cancer Treatment, the Final Word
I enrolled in Medicare in September, 2015. Cancer is a word I know too well. My mothers twin sister and older sister died of cancer. My wife’s father and mother died because of cancer. All 5 of my father-in-laws siblings died of cancer. Two of my mother-in-laws siblings died of cancer.
I have seen what cancer can do to the human body and the misery that accompanies this dread illness. If you are diagnosed with cancer, the last thing on your mind should not be “How will I pay for my treatment?”
Currently my health is good. That has been true for most of my life. No chronic illness, not even high blood pressure or cholesterol.
But having spent the last 40 years in the health insurance business I know how quickly things can change. When my health changes I want to control the direction of my care. Insurance carriers are not going to give me a list of doctors and tell me this year I can only use these, and next year the list may change.
Beware of Excess Charges
I am in original Medicare plus Medigap plan N.
You may not know it, but the Mayo Clinic does not participate in MOST Medicare Advantage plans.
M D Anderson is another cancer treatment facility that does not accept MOST Medicare Advantage plans.
A study from the Medicare Rights discovered the number one reason for disenrolling from a Medicare Advantage plan was “provider access problems”. Number 4 on the list was “cost sharing too high”.
You may never receive a cancer diagnosis. I hope you don’t. But one thing I can tell you with certainty is this. Original Medicare and a supplement plan provides assurance the funds will be there to pay for almost all of your care.
We have rates on over 240 different Medigap plans in Georgia. We will quote you a rate over the phone and tell you who has the lowest rate.
More than that, there is no charge for our advice. No pressure. No “up-selling”.
You don’t need a separate cancer insurance plan or a hospital plan. You can sleep well at night knowing the cost of your cancer treatment is covered in full.
Your 2016 Medicare Part B premiums are going up. A lot. So are deductibles. Oh, and Medigap plan F will be retired in 2020. The same year the Part D donut hole closes and you pay more in premiums, copay’s and out of pocket.
What does this mean to you? How will this impact you? What will happen to Medicare supplement plans? If you bought plan F plan your exit strategy.
Shop and compare Medigap rates.
Instant online quote.
Your information is never sold.
Post summary
Part B deductible to rise in 2016
Part B premiums rise for 2016
Changes to deductibles and premiums not finalized yet
No Social Security COLA for 2016
Medicare supplement plan F to be retired
Instant online Medigap quotes
Medicare Part B Changes in 2016
Hold on to your wallet. Next year is going to be costly for many Georgia retirees on Medicare.
Medicare Part B premiums will rise 52% in 2016 from $104.90 to $159.30. If you are receiving Social Security your check will be lower.
Think the increase will be offset by your COLA increase?
Nope.
COLA increases are not in the cards for next year.
No COLA for you.
Medicare Trustee Report
For those who want to go straight to the source, here is a link to the Trustee Report.
The summary from Kaiser Health News distills it down to something mere mortals can understand. Kind of.
The report warned that several million Medicare beneficiaries could see their Medicare Part B monthly premiums skyrocket by 52 percent in January — from $104.90 to $159.30. Medicare Part B, which is paid for by a combination of federal funds and beneficiary premiums, generally covers physician and outpatient costs.
The huge rate hike is predicted because of a confluence of two factors: Medicare Part B costs increased more than expected last year, and Social Security is not expected to have a cost of living increase next year. By law, the cost of higher Medicare Part B premiums can’t be passed on to most Medicare beneficiaries when they don’t get a Social Security raise. As a result, the higher Medicare costs have to be covered by just 30 percent of Medicare beneficiaries. This includes the 2.8 million Medicare enrollees new to the program next year, 3.1 million Medicare beneficiaries with incomes higher than $85,000 a year and 1.6 million Medicare beneficiaries who pay their premium directly instead of having it deducted from Social Security. – Kaiser Health News
But wait, there’s more.
Medicare Part B Deductibles Increase in 2016
If you manage to escape the Part B premium increase you will still participate in the Part B deductible increase in 2016. One way or another, you will pay more.
The expected Part B deductible should be $223 in 2016
That is up from $147 in 2015.
If you have straight Medicare, you will pay more in out of pocket.
If you have a Medicare supplement plan F that pays your Part B deductible for you, expect to pay more. Plan F premiums will increase by $100 per year at a minimum.
Probably more in the order of $130 – $150+.
If you have a Medicare Advantage plan you will pay more. Higher premiums, higher copay’s, higher deductibles in any combination.
The only way to avoid paying more is to stay healthy and not incur any outpatient (Medicare Part B) charges.
Lock in lower premiums for plan G now. Shop and compare rates. We have access to over 170 different Medicare supplement plans in Georgia. One is right for you.
Georgia Medigap plans & Prices
What Happens in 2020?
The good news is, the Medicare Part D drug plan donut hole will go away. About 93% of Medicare beneficiaries never hit the donut hole but in 2020 no one will find themselves there.
The bad news is, between now and 2020 your Part D premiums will rise as will your copay’s and deductibles. In other words, funding the closure of the donut hole means EVERYONE pays more, including those that would have otherwise hit the donut hole at one point during the year.
There is no free lunch.
The donut hole was included in the plan design to keep costs affordable. Eliminating the donut hole, billed as a benefit of Obamacare, makes your Part D premiums and out of pocket less affordable.
Also, the folks in Congress believe retirees go to the doctor too much and are encouraging them to stop going so much by retiring plan F.
In the interim plan F premiums will skyrocket.
There are two types of people that buy plan F.
Those that just want to budget for premiums and not have to pay Medicare Part B deductibles and coinsurance. For them, it is easier to pre-pay those expenses by paying a higher premium for plan F.
Then there are retirees that have never been told about anything other than plan F. The salesman or the carrier pushed plan F on them without showing them how they could save $300 per year or more with plan G. Why did they push plan F?
Because the higher premium means the agent and the carrier make more money.
But you won’t have to worry about that much longer. In 2020 Medigap plan F will be retired.
As a result of legislation just passed by Congress, starting in 2020 Medigap plans will no longer be allowed to offer coverage of the Medicare Part B deductible, which is currently $147 (in 2015). However, current Medigap policyholders and those buying policies before 2020 will still be eligible for the deductible coverage after that date. – Elder Law Answers
If you have plan F now, you can keep it.
But understand that plan F premiums that are already overpriced will become even more so when the plan is no longer an option for new entrants.
Lock in lower premiums for plan G now. Shop and compare rates. We have access to over 170 different Medicare supplement plans in Georgia. One is right for you.
Save money on your Medicare drug plan with simple changes. Avoid the donut hole. Turning 65? The drug plan with the lowest premium may cost you the most. Medicare Advantage may be your worst enemy if you want to save on prescription medications. Save even more by substituting OTC for prescription medications. Change your pharmacy, save big. Finding places that offer free prescription drugs. Take advantage of Medicare Extra Help. Lower your drug costs by ordering medications from Canada.
Georgia Medicare Plans is more than your best resource for low cost Medigap plans. In addition to over 170 different Medicare supplement plans in Georgia there are more than 40 different drug plans.
Sadly, too many people focus on the monthly premium and fail to look at how much the plan REALLY costs. Every year when the new drug plans are introduced there is always one carrier that tries to capture as much of the market by offering a drug plan with the lowest premium. Some years it is Humana. Others the AARP plan from United Healthcare will have the rock bottom premium.
What’s wrong with that?
Dee has the low premium drug plan from Humana, and thought it was fine. I always offer a free drug plan review to my Medigap clients but she only took a few low cost generics and felt the Humana Walmart plan was best.
This year she decided to take me up on my offer and ask for a comparison of her Humana Part D plan with the other 40+ plans available in her zip code. Dee sent me a list of her medications (exact name, dosage, number of refills, preferred pharmacy) and I entered them into the Medicare Plan Finder.
The results surprised her.
If she simply renewed her Humana drug plan for next year the annual cost of her medications would be over $3,000. Switching to a different Part D plan with a slightly higher premium drops her drug costs to $1300.
That’s a savings of $1700 per year!
For the last 3 years she has saved over $500 per year with the Medicare supplement plan I suggested vs. the plan she picked on her own. Putting $500+ per year in Dee’s pocket vs. the insurance carrier certainly helped, but how much more could she have saved over that time if she had allowed me to help?
Generics, the key to savings
It is common knowledge that generic drugs can save you money, but not everyone can tolerate the fillers in generics. But did you know that some medications you are filling by prescription are available in the same strength as your prescription brand?
Barb has been taking a prescription dose of Niacin ER for years at the insistence of her doctor. Every month for the last several years she fills the prescription and pays $109 for 30 pills. Her existing drug plan won’t cover the prescription version since there is an OTC alternative so Barb pays the regular retail price.
A little research turned up the same dosage over the counter was available from Amazon at a cost of $45 for 500 capsules. She could have been getting almost a years supply from Amazon for about the same price as she is paying for a 30 day supply from the pharmacy.
While she was grateful for my advice she was not pleased that her doctor had her overpaying $1,000 per year for the exact same medication that was available on the shelf in the vitamin section.
These are just two examples out of many. How much can you save?
Medicare Advantage, one stop shopping
Many retiree’s flock to Medicare Advantage plans for the low monthly premium and convenience of having all their medical and drug needs in one package.
The low monthly Advantage premiums certainly are attractive, but like with everything else, the true cost is in what you pay for your health care. When you buy a Medicare Advantage plan you take the drug plan that is built in. Depending on your Georgia zip code, you may have anywhere from 2 or 3 Advantage plans to over a dozen.
But in that same area you could have 30 or more drug plans.
Toby had picked out a Gold Medicare Advantage plan based on the recommendation of some friends but at the last minute decided to compare his choice with original Medicare and a Medicare supplement plan. He had already checked and found his doctors were in the Advantage network and the hospitals in his area were as well. He was quite confident that the Advantage plan would work just fine.
We discussed the merits of each plan and while he was now leaning toward a Medigap plan he wasn’t completely ready to pull the trigger. I asked for, and received, a list of his medications and ran a drug plan report for him. Even though I normally only do this for existing clients, I felt Toby needed the “big picture” to finalize his decision.
The Medigap plan I suggested had a monthly premium of $112 plus another $30 for a drug plan. Comparing to his $40 Advantage plan that included prescription medications made him want to stay with his original choice and forgo the supplement plan.
But when I showed him the difference in his drug costs with a stand alone drug plan vs. the one built into his Advantage plan, going with original Medicare, a supplement plan and separate drug plan became the obvious choice.
His annual drug costs with the Advantage plan were almost $6,000 per year MORE than the stand alone Part D!
Too often retirees only look to see if their doctor is in network and fail to calculate the cost of prescription drugs.
Additional money saving tips
We have several ways to help you save money on your prescription drug needs. Combining a low cost Medicare supplement plan with the RIGHT drug plan is just one way.
Look for places that offer free and low cost prescription drugs. Your Publix pharmacy has a FREE medication list. Combining drugs from a reputable Canadian pharmacy with free prescription drugs can keep you out of the donut hole.
The key to saving money involves knowing where to look and how to understand your Medicare plan finder report.
Vera saved $550 per year. Bill will save over $1200. Sam saves over $900 every year.
I can’t guarantee you will save $300 to $1400 per year or more by switching drug plans any more than I can promise savings of $500+ by using one of our preferred Medigap plans over the one you have now.
The only way to know how much you can save, or could have saved, is to start with a free, no obligation Medigap quote. Compare plans side by side and see for yourself. We do have access to over 170 different Medicare supplement plans and can show you rates you won’t see anywhere else.
Then let us run a drug plan comparison.
This costs you nothing but a few minutes of your time, about 15 minutes on the phone to get a better idea of what YOU want, and then we email your report(s). Another 15 minute phone call after that and you can find out how much you can save with a better Medigap plan and drug plan.
What are the 4 mistakes you can make in choosing a Medicare plan? Do you understand the difference in original Medicare and private Medicare Advantage? Do you assume the plan your friends bought is best for you? Did you ask a knowledgeable agent to help or just shop online to find a plan? Have you budgeted for the total cost of health care? Don’t make the same mistake Tony made.
Many consumers start by shopping online, which is not a bad way to go as long as you understand the results. Others ask their friends about the kind of coverage they have. Nothing wrong with that as long as your friends researched and understood their options.
Sadly, too many end up repeating the same mistakes their friend made an only realize when it is too late to make a change.
You might be surprised at how many fail to understand the difference in original Medicare vs. a private Medicare Advantage plan. They think their Advantage plan is a supplement to Medicare.
It’s not.
Medicare annual open enrollment is when everyone can make changes in their plan.
Nope.
Medicare and a supplement is more expensive than Medicare Advantage.
It depends.
Original Medicare allows you to use any doctor, lab or hospital without penalty. You can travel anywhere in the country and have the same level of coverage as you have at home. You can keep the same plan, and doctor, from year to year.
Medicare Advantage picks doctors for you. If you use someone that is not in network, you pay a penalty. Your doctor can be fired from the plan in the middle of the year. United Healthcare has made headlines because they told participating doctors they were no longer needed, leaving patients high and dry.
Can you afford to make that mistake?
Letting your friends pick a plan for you
Have you ever had a friend set you up for a blind date? Oh, they mean well, but most of the time you will smile and be pleasant while inside you are saying to yourself “What were they thinking?”.
One of the 4 mistakes many people make is buying the same plan a friend has. If you follow this philosophy you will probably buy a $0 premium Medicare Advantage plan or buy Medigap plan F from United Healthcare (AARP), Blue Cross or one of the current Mutual of Omaha companies.
What could be better than $0 premium? And your doctor(s) are in network so is there anything else to consider?
Or plan F pays 100% of my health care costs. It must be a great plan, right?
The $0 premium plan with $0 deductible might be just right, but did you estimate what your health care costs will be?
And about that plan F.
Depending on your age, gender and zip, Medicare supplement plan rates vary considerably. I recently ran a quote for a female, age 65, in Conyers. The United Healthcare (AARP) plan F was 19th on the list of plans ranked from lowest premium to highest. Blue Cross was 23rd.
If you are really sold on plan F you could have saved $350 a year (or more) if you had purchased from someone OTHER than the name brand carrier.
You would have saved even more, almost $600 a year, by choosing plan G ………. a plan not offered by United or Blue.
Shopping online
Amazon is the worlds largest retail shopping mall. You can find almost anything you want. Sometimes it is a good price, sometimes not. When the purchase arrives, if you don’t like it you can return it.
Buying a Medicare plan online isn’t the same thing.
Too often you won’t know if you like the plan until you actually use it. By then it may be too late to exchange it.
If you go to Medicare.gov there is a lot of information about Medicare Advantage and drug plans, but almost nothing usable when it comes to Medigap.
A common piece of advice on Medicare Advantage is to make sure your doctor is in network but how many times do you stop to check your medication list?
Most people don’t, especially the DIY crowd.
Big mistake.
The biggest hassle in online shopping is landing on a site that will sell your information to dozens of insurance agents. Your phone won’t stop ringing and your email will be stuffed with “buy me” notices.
Georgia Medicare Plans never sells your information to anyone. We call once. That’s it. You decide if you want more information.
Tony is turning 65. Like everyone else he is bombarded with information about available plans. And Tony has asked friends which plan they have and would recommend.
But Tony also likes to do his own research. That’s how he found me.
Most of his friends have a $0 premium Medicare Advantage plan. Tony has a chronic condition that is under control and he has doctors he trusts. He wants a plan that includes his current doctors.
Tony was proactive and asked his doctors which plans they accept.
“All of them”.
That’s when he found my site. And then he called.
We talked for a few minutes and discussed the differences in original Medicare and a supplement plan vs. Medicare Advantage. Tony was not aware that doctors can be dropped from an Advantage plan in mid year. He also was not aware of the out of network restrictions and penalties. We discussed out easy it is to slip out of network, especially with P.A.R.E. claims.
Then we talked out Medicare and Medigap plans. We also looked at his expected annual cost of health care.
Failing to consider your cost of health care is one of the 4 mistakes almost everyone makes.
But it was the discussion about his meds that brought things to a head.
Tony takes two specific medications to keep his health in control. One is relatively inexpensive, the other is not. He gave me a complete list of his medications and I ran a prescription drug report for him.
After looking over the list I decided to do something I rarely do. Medicare drug reports are quite detailed, and confusing. I normally just show clients the top two plans rather than sending them 20 or more to review.
I repeated the process for the $0 premium Advantage plan he said he wanted.
Then I compared the results.
The Medicare Part D plan with the lowest annual drug costs would result in $3,000 in out of pocket costs for his medications.
The $0 premium plan would have him spending almost $9,000 for the exact same medications.
If Tony had taken the advice of his friends and purchased the $0 premium Advantage plan he would have made a $6,000 mistake.
Can you afford to make that kind of error?
Give us a call to discuss plans that fit your needs AND budget. Or you can start the process by using our online instant quote engine.
