The Best Medigap Plans for Cancer Patients

Medigap Plans for Cancer Patients

Cancer is one of the most expensive medical conditions in the U.S. This may cause older adults with cancer to face significant financial hardship. Researchers found that cancer patients on Original Medicare (Part A and Part B) without supplemental health coverage spent one-quarter of their income on out-of-pocket medical costs.2

Medigap (also known as Medicare Supplement Insurance) may be used to help offset the out-of-pocket costs associated with cancer treatment. New enrollees can choose from eight of the 10 standardized Medigap plans: A, B, D, G, K, L, M, and N.

Two Medigap plans offering comprehensive coverage to fill in the gaps, such as copayments, coinsurance, and deductibles, of Original Medicare stand out: Medigap Plan G and Plan N.

Medigap Plan G: Except for your Medicare Part B deductible, Medigap Plan G covers 100 percent of the costs for outpatient services, including doctor visits, medical supplies, and lab work. Medigap Plan G also covers blood transfusions, inpatient hospital fees, skilled nursing facility care, ambulance transportation, and hospice.

Medigap Plan N: Plan N is remarkably similar to Plan G’s coverage. However, with Plan N, you’ll be responsible for copayments up to $20 for office visits and $50 for emergency room visits that don't result in inpatient admission. Because of these copayments, Plan N’s premiums are lower than Plan G.

A key difference between Plan G and N is that Plan N does not cover the Medicare Part B excess charge. The excess charge is the amount a provider can charge over the Medicare-approved amount. All of the providers that made our list offer Plans G and N, along with prescription drug plans.

Prescription Drug Plans for Cancer Patients

In addition to a Medigap plan, it’s common for people with cancer to enroll in a Medicare Part D prescription drug plan (PDP). PDPs cover most prescription medications and some chemotherapy treatments and drugs. As with Medigap plans, Part D plans are sold by private insurance companies. As a cancer patient, your annual drug costs may be high, so it is imperative that you look at all of the available plans to find the one that best meets your needs.4

Our five best Medigap plans for seniors with cancer all offer the option to add a Medicare Part D prescription drug plan. Insurance bundling helps streamline communication with your insurance provider, make premium payments, and track coverage and claims.

How We Chose the Best Medigap Providers for Cancer Patients

We evaluated 12 of the top Medigap providers using the following criteria: Medigap plans offered, availability of adding a Medicare Part D prescription drug plan, and the insurance company’s longevity in the Medicare arena. From our research, we narrowed the list to five picks. We also investigated if the provider’s website offered straightforward and easy access to plan availability and costs.

When Is the Best Time to Sign Up for a Medigap Plan?

The month you turn 65, your Medigap six-month open enrollment period begins. During this time, you cannot be charged a higher premium or denied coverage due to a pre-existing health condition (including cancer).

Unfortunately, choosing to enroll after your six-month open enrollment period has ended may be a risk as your cancer diagnosis may negatively affect your Medigap application. You may face a late-enrollment penalty, a higher monthly premium, or be denied Medigap coverage altogether.

Do Cancer Patients Need a Medigap Plan?

A recent study reported that cancer patients with only Medicare coverage face hefty out-of-pocket costs for treatment, spending nearly one-quarter of their household incomes on average.6

While Medigap plans won’t completely eliminate treatment costs, they can ease the burden, covering out-of-pocket medical expenses not covered by Original Medicare. Before any cancer treatments, it’s crucial to verify that the doctor, clinician, or group accepts Medicare. This ensures your Medicare and Medicare supplemental insurance will be properly applied.

Sadly, unexpected medical expenses are one of the leading causes of personal bankruptcy. Research published in the American Journal of Public Health found that over 66 percent of personal bankruptcy is due to medical debt.7 If you’re worried about paying off debts, including mounting medical debt during your retirement years, watch the video featuring our editor-in-chief, Jeff Hoyt.

Common Cancer-Related Expenses

Cancer treatment comes with a range of medical expenses. It’s essential to have a firm understanding of how your Medicare, Medigap, and Medicare Part D Prescription Drug Plan work together to cover the costs of your cancer treatment. Knowing what is (and what is not) covered can help you avoid unexpected financial hardships.

Cancer-related medical expenses may include:

• Primary care and specialist office visits
• Laboratory testing
• Radiology imaging such as X-rays, ultrasounds, mammography, MRI, CT, and nuclear medicine scans
• Diagnosis-based procedures, such as biopsies
• Prescription medications
• Hospital and surgical costs
• Blood transfusions
• Radiation treatment
• Chemotherapy
• Physical therapy
• Transportation and lodging costs depending on where treatments are administered
• Home care, including home health care and durable medical equipment
• Operating room, anesthesia, and equipment expenses