The day has come and the doctor says you have cancer. Out of the many thoughts racing through your mind is how will you pay for the cancer drugs. I get this question frequently. Cancer treatments including the cost for the drugs are completely unknown and different for each person.
With Medicare the cancer drugs that are made to be taken via your veins or by mouth are covered under Part B of Medicare. Drugs that are meant to only be taken by mouth are covered under your Part D plan. So for this article I want to discuss the drugs that would be covered by Part B of Medicare.
Assuming your have Parts A and Part B of Medicare active. Part B currently (2017) has a $183.00 annual deductible. After that deductible is paid for the year, Medicare will pay 80% of the cost of the drug, and you will be responsible for 20%.
Depending on your Medigap plan (Medicare Supplement) will determine how much you are left with. The majority of my clients have a Medigap Plan G. With Plan G, my clients are responsible for the Part B deductible on a yearly basis, however after that, the Plan G will pay that 20% that Medicare doesn’t pay for. Oh and by the way, cancer drugs start off with being expensive and go up from there.
If you have a Medicare Advantage plan, you’ll have to look at your summary of benefits under Part B drugs for your cost-share. The majority of the plans that I have seen say that you are responsible for 20% up until you reach your out of pocket maximum, but your plan may be different.
If you just have original Medicare, you will pay the Part B deductible and the 20% and Medicare will pay the remaining 80%.
My recommendation is to get into a Medigap plan (Medicare Supplement), to help minimize your out of pocket expenses created by your cancer treatments. The American Cancer Society agrees with this recommendation as well.
We are available to help you navigate Medicare and Medigap plans, at no charge to you. We just ask that you would purchase your plan through us.