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.
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.
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.
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.
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.)
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.