What Are the Best Medicare Plans for Cancer Patients?
The best Medicare plans for cancer patients are a Medigap Plan G from AARP and a Medicare Part D plan from Wellcare.
Alternatively, if your cancer diagnosis means you can't qualify for Medigap, choose a Medicare Advantage plan from Aetna. In both cases, you'll first need to sign up for the Medicare program through the government. If you have a low income, enroll in both Medicare and Medicaid, which will reduce how much you pay for cancer treatment.
Best coverage combination
Best if you can't get Medigap
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Cost of cancer treatment and chemotherapy with Medicare
The total cost of cancer treatment and a Medicare plan is between $4,361 and $10,872 per year, based 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 | $257 | $4,104 | $4,361 |
| Medicare Advantage | $5,854 | $2,556 | $8,410 |
| Original Medicare only | $8,652 | $2,220 | $10,872 |
| 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 about $4,400 for the year, including the plan.
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 $8,074 per year.
Choosing coverage for cancer care
The rule of thumb for cancer coverage (or another expensive medical treatment) is that it's nearly always worth it to pay more for a plan with better benefits.
There are usually high costs for cancer treatment such as chemotherapy or radiation, and paying for better coverage can usually help you save thousands of dollars per year. For example, if you paid an extra $30 per month ($360 per year) for better coverage that lowered your medical costs by $3,000, you'd save $2,640 overall.
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Best cancer coverage: Medigap Plan G + 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) are expensive, with costs of more than $100 per month. But Medigap Plan G will pay for nearly all of your medical costs, except for $257 for the Medicare Part B deductible.
Plan G is the best coverage that's available to new enrollees. 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.
Medications are an important part of cancer treatment, so it's important to have good prescription coverage. Prescriptions you take at home are typically under your Part D prescription plan. However, medications administered at a doctor's office, hospital or medical facility would be a part of your Medigap coverage.
Best Medigap for cancer: AARP/UnitedHealthcare
AARP/UnitedHealthcare is the best Medigap provider for cancer patients because of its high customer satisfaction and cheap rates.
The coverage you get with Medigap Plan G is the same no matter which company you choose. However, rates can differ significantly between companies.
AARP/UnitedHealthcare is a good deal, with the cheapest average rates for Plan G. And 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, which shows plans are likely high-quality.
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, which has high-quality plans but includes fewer extra benefits than AARP/UnitedHealthcare.
Comparing Medigap plans for cancer patients
Company | Plan G cost | ||
|---|---|---|---|
| AARP/UHC | $157 | |
| Mutual of Omaha | $183 | |
| BCBS | $174 | |
| Cigna | $150 | |
Average monthly rates for a 65-year-old female nonsmoker.
Avoid Humana's Medigap plans, which have a very high rate of complaints. Even though Humana gives some enrollees a cancer support hotline, this extra benefit is not worth it if you can't count on all of your medical benefits.
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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At age 65, you'll get the best rates for a Medigap plan. You also can't be denied coverage because of a medical condition because you'll have Medigap guaranteed issue rights.
- You can be eligible for 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 without the protections of Medigap guaranteed issues. 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 for low-deductible plans.
Medicare Part D covers the prescription drugs you take at home. So while Medigap will help you pay for chemotherapy, Part D covers things like anti-nausea medicine and antibiotics.
Wellcare Medicare Part D plans are the best overall choice for affordable prescription coverage when you need many expensive drugs.
When you have cancer, you'll probably need expensive prescriptions. It can make a big difference if you pay 25% of the drug cost versus 40% of the drug cost.
All companies offer a wide range of coverage options. Keep your costs low by choosing a Medicare Part D plan that has a low deductible and low costs for specialty and brand-name drugs.
All Part D plans must cover drugs in each category of medicine. But the company 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 request 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: You should also consider Humana, which has high ratings for its mail-order prescription drugs, and higher average rates than Wellcare.
Comparing Medicare Part D plans for cancer patients
Monthly average costs are for Part D plans that have a deductible of $590. Ratings are the average Part D rating on Medicare.gov. Note that star ratings for Part D plans tend to be lower, and 98% of enrollees have a plan with 3.5 stars or less.
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Good 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 out-of-pocket maximum.
Medicare Advantage plans have more restrictions than a Medigap plan.
They're usually cheap and include lots of benefits. But you will have to use a doctor in the plan's network and will often need to ask for permission from your insurance company before you get expensive medical care, called prior authorization. Plus, your costs can differ widely based on the amount of medical care you need, which will be a key consideration if you are comparing Medicare Advantage and Medigap.
There are a wide variety of Medicare Advantage plans offered, and choosing the best cancer coverage can save you thousands of dollars per year.
Your portion of costs for cancer treatment will usually reach the plan's cap, called the out-of-pocket maximum. Choosing a lower spending cap can reduce your medical costs and save you money.
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. A company with a high star rating could mean you'll face fewer issues or delays when you're getting cancer treatment.
In nearly all cases, you can't add on a Medicare Part D plan for prescription coverage if you're enrolled in Medicare Advantage. So be sure that the plan you choose will cover prescriptions, unless you already have a prescription plan through a former employer or union.
A 2019 policy change now allows a Medicare Advantage plan to first require patients to try a cheaper version of a Medicare Part B-covered drug before it will cover a more expensive prescription. Called step therapy, it's 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 most effective treatment methods.
Best Medicare Advantage companies for cancer
Aetna is the best Medicare Advantage company for cancer patients because its high-coverage plans are affordable and high quality.
Among national insurance companies, coverage options can vary widely depending on where you live. That's why it's a good idea to look closely at the plans offered in your area to find companies that offer low out-of-pocket maximums.
You may also have access to regional insurance companies that offer better benefits than large, national insurance companies. For example, smaller North Carolina Medicare companies like Alignment Health have high-quality plans that cost $0 per month with an average spending cap of $3,524 per year, which is a very good value.
Alternative to Aetna Medicare Advantage: Also consider AARP/UnitedHealthcare Medicare Advantage, which has high-quality plans with good coverage. Be careful to not let AARP advertisements about included benefits, like eye exams, prevent you from choosing a plan with good medical benefits that could save you thousands of dollars per year.
Comparing Medicare Advantage plans for cancer patients
Averages are based on Medicare Advantage plans that include prescription drug coverage and a cap on your medical costs of $4,000 or less. The monthly cost is only for the Medicare Advantage plan and doesn't include the $185 that all enrollees pay to the government for Medicare Part B. Ratings are the overall star rating on Medicare.gov for both medical and prescription benefits.
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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 dual enrollment in Medicare and Medicaid.
When facing the high cost of cancer treatment, enrolling in both Medicaid and Medicare can reduce or eliminate your costs for medical care, prescriptions and insurance.
There are two ways to qualify for Medicaid.
- Because of only your income: Most people qualify for Medicaid because of their income. Medicaid eligibility varies by state, and in most states you qualify if you earn less than about $21,000 per year (roughly $44,000 for a family of four).
- Because of your income after subtracting medical spending: The high cost of cancer treatment can make it easier to qualify for Medicaid through the Medicaid spend-down program. Rules vary by state, but generally you subtract your medical and insurance costs from your income, and use this adjusted number to see if you qualify for 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 be used to qualify for Medicaid.
Even if you don't qualify for full Medicaid eligibility, your Medicaid application may qualify for partial Medicaid benefits or other programs like 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, no matter what age you are. Whether you have a bundled Medicare Advantage plan or a combination of Medigap and Medicare Part D, most cancer care is considered medically necessary and is covered.
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
Frequently asked questions
What is the best Medicare plan for someone with cancer?
Cancer patients have the best coverage with a combination of Medigap Plan G to reduce medical costs and Medicare Part D for prescription drugs. If you don't qualify for Medigap and need Medicare Advantage, choose a plan with a low cap on your medical spending from Humana. In both cases, you'll need to first enroll in Original Medicare through the government.
Can you get a Medicare Supplement plan if you have cancer?
If you have cancer, you can still enroll in a Medicare Supplement plan if it's your open enrollment period at age 65 or if your situation otherwise qualifies you for guaranteed issue. In both cases, you can't be denied enrollment because of a preexisting condition.
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 $257 for the year. With a Medicare Advantage plan, your typical cost for cancer treatment is $5,854, and with Original Medicare and no other plans, the cost is $8,652.
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.
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Medicare Advantage and Part D plans and benefits are offered by these carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare, Wellcare and WellPoint.
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