What Are the Best Medicare Plans for Cancer Patients?
Medigap Plan G from AARP/UnitedHealthcare and a Medicare Part D plan from Wellcare are the best Medicare plans for cancer patients.
If you can't get Medigap because of your cancer diagnosis, consider a Medicare Advantage plan from Blue Cross Blue Shield or Kaiser Permanente if you can get one in your area.
If you have a low income, you can enroll in both Medicare and Medicaid to drastically lower your cancer treatment costs.
Best coverage combination
Best if you can't get Medigap
Compare Medicare Plans in Your Area
Best cancer coverage: Medigap Plan G and Medicare Part D
Medigap Plan G and a Medicare Part D prescription plan give you the best coverage for cancer treatment.
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Medigap plans (also called Medicare Supplement plans) help cover the leftover costs you're responsible for paying with Original Medicare (Parts A and B). These plans tend to have higher monthly costs than Medicare Advantage plans, but you pay significantly less when you get medical treatment. That makes Medigap a better choice for cancer patients, because procedures and care are usually expensive.
Medigap Plan G is the best option for cancer patients because the plan covers almost all of your costs with Original Medicare (Parts A and B). except for your $202.90 Part B deductible. . Plus, Medigap plans are accepted by nearly all doctors and hospitals in the country, giving you flexibility about where you can get cancer treatment.
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Medicare Part D is a prescription plan that you add on to Medigap.
It's important to have good prescription coverage because medications are an essential part of cancer treatment. Prescriptions you take at home are typically under your Part D prescription drug plan. However, medications you take at a doctor's office, hospital or clinic are covered by your Medigap plan, not Part D.
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Best Medigap for cancer: AARP/UnitedHealthcare
AARP/UnitedHealthcare is the best Medigap company for cancer patients because of its high customer satisfaction and cheap rates.
AARP/UnitedHealthcare is a good deal because of its affordable rates for Medigap Plan G and the company's strong reputation for customer satisfaction. Plus, AARP/UnitedHealthcare Medigap plans include benefits such as a 24/7 nurse line for questions about your treatment plan, drugs and health concerns.
AARP/UnitedHealthcare has few customer complaints for its Medigap plans. Customer satisfaction and complaints are important when choosing a plan. Cancer treatment means frequent medical care, and you want to feel confident that you won't have problems with your coverage.
Alternative to AARP/UnitedHealthcare Medigap: If you're shopping around, also get quotes from Mutual of Omaha. The company has high-quality plans but expensive average rates.
Comparing Medigap plans for cancer patients
Company | Plan G cost | ||
|---|---|---|---|
| AARP/UHC | $177 | |
| Mutual of Omaha | $207 | |
| BCBS | $189 | |
| HealthSpring (Cigna) | $166 | |
Average monthly rates for a 65-year-old female nonsmoker.
Avoid Medigap plans from Humana and HealthSpring (Cigna). Both companies get significantly more complaints than an average company their size.
The coverage you get with Medigap Plan G is the same no matter which company you choose. That means cost and customer service are the two most important factors to consider when shopping for a Medigap plan.
If you want a Medigap plan, the best time to enroll is usually during your initial enrollment period when you turn 65.
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You'll get the best rates for a Medigap plan if you get one during the six months around your 65th birthday, called your Medigap open enrollment period. Companies can't deny you coverage or charge you higher rates because of your medical history during this period.
- You can buy a Medigap plan without having to worry about getting charged a higher rate or getting denied coverage altogether because of your medical history, called "guaranteed issue rights," at other times, depending on your situation and where you live.
- However, your Medigap application will usually be denied if you have cancer and apply for a plan outside of a "guaranteed issue right" period. In this situation, enroll in a Medicare Advantage plan with good coverage for cancer during the fall open enrollment period.
Best Medicare Part D prescription plan for cancer: Wellcare
Wellcare has the best Medicare Part D drug plans for cancer patients because of its cheap rates and good customer service.
Wellcare Medicare Part D plans are the best overall choice for affordable prescription coverage when you need many expensive drugs.
All Medicare Part D plans cap your annual costs at $2,100, called an out-of-pocket maximum. You'll never pay more than this amount in a single year when you buy drugs using your Part D plan, regardless of which company you choose.
Choosing a Medicare Part D plan that has cheap rates can help you save money if you think you'll hit your $2,100 out-of-pocket maximum. If your doctor has only prescribed a few cheap drugs, you may want to consider a plan with a higher monthly rate, but a lower deductible and costs you're responsible for paying when you get your prescription filled, called copays and coinsurance.
Medicare Part D covers the prescription drugs you take at home. So while Medigap will help you pay for drugs you take at the hospital, such as chemotherapy, Part D covers things like anti-nausea medicine and antibiotics.
All Part D plans must cover drugs in each category of medicine. But the company and plan you choose will determine the exact list of drugs that are covered.
If a prescription you need is not covered by your plan, you can ask for an exemption to get it covered. This process can require more paperwork, but it's a useful way to make sure your cancer drugs are cheap and easy to get.
Alternative to Wellcare Medicare drug plans: While Wellcare stands out for its low costs and quality coverage, you should also consider Aetna if you need to take less common specialty drugs as part of your cancer treatment.
Comparing Medicare Part D plans for cancer patients
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Good option for cancer coverage: Medicare Advantage plan with a low cap on your medical spending
If you can't get a Medigap plan, cover your cancer treatment by choosing a Medicare Advantage plan with a low cap on your annual spending and a good reputation for customer satisfaction.
Medicare Advantage plans have more restrictions than Medigap plans. For example, with a Medicare Advantage plan, you're typically restricted to a network of doctors and hospitals. With Original Medicare and Medigap, you can see any doctor who accepts Medicare nationwide.
Medicare Advantage plans usually have low monthly costs. Plus, most plans offer extra benefits, such as dental, vision and gym memberships.
The main downside to having a Medicare Advantage plan is that you have to use a doctor in the plan's network. You may also need to ask for permission from your insurance company before you get expensive medical care, called prior authorization. Also, you'll typically pay significantly more when you go to the hospital with a Medicare Advantage plan than you would with Medigap.
Cancer patients usually hit their Medicare Advantage plan's annual spending limit, called the out-of-pocket maximum. Choosing a lower spending cap can reduce your medical costs and save you thousands of dollars per year.
Medicare Advantage plans often require you to get approval from the insurance company before it will cover certain types of expensive medical care, which is called prior authorization. Choosing a company with a high star rating could mean you'll face fewer issues or delays when you're getting cancer treatment.
Most Medicare Advantage plans include drug coverage. It's important to check your plan details to make sure you can get the medications you need.
If your Medicare Advantage plan doesn't offer coverage for prescription drugs, you can sometimes buy a separate Part D policy. It almost always makes more sense to get a Medicare Advantage plan with drug coverage.
The average Medicare enrollee can choose from 32 Medicare Advantage plan options that include prescription drug coverage.
Some Medicare Advantage plans require patients to try a cheaper chemotherapy drug before the plan will cover a more expensive prescription, a process called "step therapy." This is often used to save insurance companies money on oral chemotherapies. However, it may mean worse outcomes for patients because they have to use cheaper drugs, which may not always be the best treatment methods.
Best Medicare Advantage company for cancer: Blue Cross Blue Shield
Blue Cross Blue Shield is the best Medicare Advantage company for cancer patients because its plans are affordable and high quality.
Blue Cross Blue Shield (BCBS) stands out for its strong reputation for cancer screening. Plus, enrollees report having an easy time getting the care and prescription drugs they need. As a BCBS customer, you'll also have access to a large network of doctors and hospitals. That's especially important for cancer patients who often need extensive specialty care.
However, it's important to note that among national insurance companies, coverage options depend on where you live. In other words, BCBS might not always be the best option for those who need cancer treatment. That's why it's a good idea to look closely at the plans offered in your area to find companies with low annual spending caps and access to the best local doctors and hospitals for your cancer treatment.
You may also have access to regional insurance companies that offer better benefits than large, national insurance companies. For example, if you live in Florida, you may have access to a 5-star Medicare Advantage plan from Leon Health Plans. The company charges average rates of $0 per month, and you'll pay no more than $2,225 per year for medical care, on average.
Alternative to BCBS Medicare Advantage: If you live in Washington state, Oregon, California, Colorado, Hawaii, Georgia, Virginia, Maryland or the District of Columbia, consider Kaiser Permanente, which has high-quality plans with good coverage. The company's plans have high star ratings both overall and for cancer screening specifically. Plus, Kaiser Permanente has cheap rates and low out-of-pocket maximums, on average.
Comparing Medicare Advantage plans for cancer patients
Company | Monthly cost | ||
|---|---|---|---|
| Kaiser Permanente | $43 | |
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| BCBS | $36 | |
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| AARP/UHC | $20 | |
| HealthSpring (Cigna) | $4 | |
Averages are based on Medicare Advantage plans that include prescription drug coverage. The monthly cost is only for the Medicare Advantage plan and doesn't include the $202.90 that all enrollees pay to the government for Medicare Part B. Ratings are the combined star rating for breast and colorectal cancer screenings.
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If you have a low income: Medicare and Medicaid dual enrollment
If you earn a low income, you may qualify for both Medicare and Medicaid, called dual enrollment.
Enrolling in both Medicaid and Medicare can reduce or eliminate the high costs of cancer treatment.
There are two ways to qualify for Medicaid.
- Because of only your income: Most people qualify for Medicaid because their income is low enough. Medicaid eligibility differs by state. In most states, you qualify if you earn less than about $22,000 per year (roughly $44,000 for a family of four).
- Because of your income after taking out medical spending: The high cost of cancer treatment can make it easier to qualify for Medicaid through what's called the Medicaid spend-down program. The exact rules depend on where you live, but, generally, you subtract your medical and insurance costs from your income, and with the lower number, you might be able to get Medicaid.
For example, if you earn $25,000 per year and spend $5,000 for medical care and Medicare insurance plans, your adjusted income of $20,000 could allow you to get Medicaid.
Even if you're not eligible for normal Medicaid, you may get partial Medicaid benefits or you could qualify for other programs such as Medicare Savings Programs or Medicare Extra Help. This can help you reduce your costs for medical care, prescriptions or Medicare insurance, depending on the program.
What cancer costs are covered by Medicare?
Most cancer treatments are covered by Medicare.
Whether you have a bundled Medicare Advantage plan or a combination of Medigap and Medicare Part D, you should have coverage for most types of cancer care.
Medicare covers:
- Doctor visits
- Diagnostic tests
- Cancer surgery
- Hospital care
- Chemotherapy treatment
- Chemotherapy drugs
- Radiation treatment
- Proton therapy
- Immunotherapy
- Cancer drugs
- Skilled nursing facility care
- Transplants
- Wheelchairs and walkers
- Breast reconstruction after a mastectomy
- Mental health services
- Some clinical research costs
- Physical therapy
- Home health care
- Hospice
- Cancer screenings
Medicare does not cover:
- Experimental cancer treatment
- Medical marijuana
- Wigs
- Acupuncture
Cost of cancer treatment and chemotherapy with Medicare
The total cost of cancer treatment and a Medicare plan is between $4,878 and $11,421 per year, depending on the type of plan you choose.
Without insurance, the average cost of chemotherapy and cancer treatment is $43,516 for the first year after diagnosis.
Coverage type | Health care costs | Plan costs | Total |
|---|---|---|---|
| Medigap Plan G | $283 | $4,595 | $4,878 |
| Medicare Advantage | $6,347 | $2,759 | $9,106 |
| Original Medicare only | $8,986 | $2,435 | $11,421 |
| No insurance | $43,516 | $0 | $43,516 |
Average health care costs are for the first year after diagnosis, and plan costs are based on annual estimates. Calculations exclude oral prescription drug costs, which average $1,874 without a prescription drug plan.
Medigap Plan G (also called Medicare Supplement Plan G) gives you the best coverage for cancer treatment, chemotherapy and other medical care. It's one of the most expensive Medicare Supplement plans. But it's worth it to pay the high monthly rates because it will bring your total costs to under $5,000 each year, including the plan, on average.
Medicare Advantage plans are usually cheaper but have less coverage. This means they're not the best deal if you get very sick or need expensive medical care. If you have Medicare Advantage, the cost of cancer treatment and insurance averages over $9,000 per year.
Frequently asked questions
What is the best Medicare plan for someone with cancer?
Cancer patients get the best coverage with a combination of Medigap Plan G to reduce medical costs and Medicare Part D for prescription drugs. If you can't get Medigap, choose a Medicare Advantage plan with a low annual spending cap, called an out-of-pocket maximum, and a good star rating for cancer screening.
Can you get a Medicare Supplement plan if you have cancer?
If you have cancer, you can still enroll in a Medicare Supplement plan during the six months around your 65th birthday, called an open enrollment period. Outside of your open enrollment period, companies may charge you higher rates or deny you coverage altogether because of your cancer diagnosis, unless you've recently moved, lost another type of coverage such as a Medicare Advantage plan or you otherwise qualify for what's called a guaranteed issue period.
Is Medicare good for cancer patients?
The cost of cancer treatment is about the same whether you have Medicare or health insurance through a job. However, choosing the Medicare plans with the best coverage can help you save thousands of dollars on cancer treatment.
How much does cancer treatment cost with Medicare?
With Medicare Supplement Plan G, most of your medical expenses for cancer treatment are fully covered. This reduces the $43,516 in medical bills down to $283 for the year. With a Medicare Advantage plan, your typical cost for cancer treatment is $6,347, and with Original Medicare and no other plans, the cost is $8,986.
Does Medicare cover cancer treatment and chemotherapy?
Yes, Medicare covers all types of standard cancer treatment, including chemotherapy and surgery. It does not cover experimental procedures.
Sources and methodology
Plan costs are based on rates came from the Centers for Medicare & Medicaid Services (CMS) and Medicare.gov.
The cost of cancer treatment is based on averages from the National Cancer Institute, and comparative out-of-pocket costs for employer insurance coverage are from research by the Johns Hopkins University School of Medicine.
Medicaid eligibility guidelines are based on current federal poverty levels from the U.S. Department of Health and Human Services.
Medigap costs are based on cost data for a 65-year-old woman who doesn't smoke and doesn't qualify for a household discount. Rates are also based on the preferred pricing of initial enrollment when shoppers don't have to answer medical questions. Averages exclude Select plans and plans in states that don't use national standardization.
Medicare Supplement customer satisfaction is a rating of up to five stars based on the National Association of Insurance Commissioners (NAIC) complaint index for a company's Medicare Supplement division. Higher scores mean better customer service and fewer complaints.
Senior Writer
Talon Abernathy is a ValuePenguin Senior Writer who specializes in health insurance, Medicare and Medicaid. He's also contributed to other insurance verticals including home, renters, auto, motorcycle and flood insurance.
Talon came to ValuePenguin in 2023. Since his arrival, he's helped to expand the site's health insurance-related content offerings. He enjoys helping readers understand the ins and outs of America's all too complicated health insurance landscape.
Before coming to ValuePenguin, Talon worked as a freelance writer. His prior work has touched on a broad range of personal finance-related topics including credit-building strategies, small business incorporation tactics and creative ways to save for retirement.
Insurance tip
In many parts of the country, you can qualify for a free Silver health insurance plan if you meet certain income requirements. Government subsidies in the form of premium tax credits and cost-sharing reductions may mean you'll pay nothing for coverage.
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