Medicare already offers quite a bit of coverage for cancer patients and treatments, and depending on which Medicare Supplement plan you go with, if eligible, 100% of the costs can be covered. However, there are still certain services that may not be covered at all and will have to come out-of-pocket.
What does Medicare cover?
Each part of Medicare covers a specific amount of treatments and services.
Medicare Part A covers:
- Hospital stays, clinical studies, surgically-implanted breast prostheses as an inpatient
- Care at a skilled nursing facility
- Physical therapy, skilled nursing care, and other home healthcare services
- Hospice care
Medicare Part B covers:
- Doctor visits
- Majority of chemotherapy drugs given in an outpatient setting or in a doctor’s office, and given through the vein
- Certain oral chemotherapy treatments
- Radiation treatments in an outpatient setting
- Diagnostic tests
- Surgeries given as an outpatient
- Mental health services both outside a hospital and in an outpatient setting
- Nutritional counseling and enteral nutrition equipment
- Certain screenings
- Breast prostheses
- Some clinical studies
- Multiple opinions for a surgery if it’s not an emergency
Medicare Part C covers:
- Same coverage as Medicare Parts A and B
- Some coverage from Medicare Part D
Medicare Part D covers:
- Most prescription medications
- Certain chemotherapy treatments
Make sure to check the formulary list with the plan you already have or are currently looking at to see which drugs are covered. Usually, Part D will cover whatever Part B doesn’t.
Medicare Supplement Plans:
- Other out-of-pocket costs
What do I have to pay?
Despite all the coverage Medicare does offer, there are still certain costs that aren’t covered. Services that are not covered include:
- Room and board in assisted living facilities or for you and your family if traveling for treatment
- Adult day care
- Long-term care (short-term care is covered up to 100 days)
- Services to help with daily living but don’t require skilled care
- Medical food/nutritional supplements
If you do not have any Medicare Supplement plans to help with the costs of deductibles, coinsurance, or copayments, those will also be out-of-pocket.
If there are any services that you feel should be covered or you received coverage for services that are no longer covered by Medicare, you have the right to file an appeal. An appeal allows a request to be reviewed by Medicare to determine if you should receive the coverage for that specific service.
By speaking with an insurance professional, you can be aware of all the options available to you and what coverage you’ll receive. At Reichardt Insurance, we can help you decide on the
Medicare plan that’s right for you. Give us a call at (870) 698-2928 and r eceive a quote.