Three Clients
How a scary health problem was covered by three different insurance plans
The "C" word - Cancer
This past year, three of my Medicare clients were diagnosed with cancer. Each of them had a different insurance plans. Read below to see how well each of them were financially protected.
Medicare Advantage Plan
Client #1 has a Medicare Advantage plan. He came to me with this plan from a different broker, and was pleased with his coverage and low premiums ($0 per month) so we didn't make any changes. He'd been healthy and didn't need much in the way of doctor visits.
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In July he was diagnosed with an aggressive form of skin cancer and immediately wanted to switch to a Medicare Supplement plan. I had to inform him he could only switch during the Annual Enrollment Period (Oct 15 to Dec 7) and even then he would likely be declined due to his pre-existing condition.
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Client 1 has a $6,500 Out-Of-Pocket-Maximum that he will have to pay before the end of the year due to a 20% coinsurance for cancer treatments. Beginning in January, he will have a second $6,500 Out-Of-Pocket-Maximum to pay for 2024.
Client #2 has a Medicare Supplement Plan G, which costs $220 a month, plus $32.90 for a Part D Prescription Drug Plan. Although healthy, he preferred knowing his medical costs would be covered and was willing to pay the $3,034 a year in premiums for the best plan available to him.
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When Client #2 was diagnosed with leukemia, he paid the first $226 (the 2023 Part B deductible) and all his remaining cancer treatments were covered.
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Client #3 has a Medicare Advantage plan with a $0 monthly premium, and added a Hospital Indemnity Plan and a Cancer Plan to cover large expenses from a result of co-pays and coinsurance in his Medicare Advantage Plan. The cost for these two additional plans is $91.81 per month, ($1,101 per year.)
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When Client 3 was diagnosed with pancreatic cancer, he was admitted to the hospital for two days before being discharged to begin outpatient cancer treatments. Client 3 was charged $390 a day for the two days in the hospital, $250 for an MRI, and 20% of his cancer treatments. However, the Hospital Indemnity Plan reimbursed him $400 for each of the two days he spent in the hospital, $300 for the MRI, and the Cancer Plan paid him a one-time lump sum of $15,000 upon his diagnosis of invasive cancer, which he will use to offset all his cancer treatment expenses for more than two years.
Government Required Disclaimer:
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-medicare to get information on all your options.