The most important thing for adults with cancer is having a health insurance plan that covers necessary cancer treatments. It’s vital to keep your health insurance coverage with no coverage gaps. After getting a cancer diagnosis, speaking with your health care providers, and reviewing your current Medicare coverage, you may want to look at other health coverage options based on your specific needs. However, it’s important to remember that there are certain limitations on what changes you can make and when. Each year, you have a chance to make changes during open enrollment, to your private insurance or your Medicare health and prescription drug coverage for the following year. Each year, plans can change in cost and coverage. It is advisable to compare the plans available in your area each year to ensure you have the plan that best meets your specific needs. While facing cancer can be overwhelming, rest assured that your Medicare benefits for cancer treatment are strong! In fact, Medicare paired with the right Medigap plan can provide 100% coverage for many services which might include: inpatient hospital cancer care, surgeries related to cancer, oncologist office visits, chemotherapy, radiation, medications to ease side effects such as nausea, skilled nursing for cancer recovery, home health services, durable medical equipment, physical therapy and rehabilitation, short term nursing home care, and/or Hospice or end of life care. Learning which parts of Medicare cover certain services and how to access those services is the first step. It also doesn’t matter if you have cancer before you age into Medicare. There are open enrollment windows which you can use so that your pre-existing conditions won’t affect your coverage.
As far as prescription drug coverage, it’s important to determine how it is to be paid under Medicare. Enrollment choices can determine how and if your medications are paid for at the time they are needed. If you have other insurance that supplements Original Medicare, like a Medigap (Medicare Supplement Insurance) policy or a group health plan, it may pay some of the costs for the necessary supplies and services. Medigap policies are sold by private companies and help pay certain out-of-pocket costs, like deductibles, coinsurance, and copayments. Remember, open enrollment is from October 15 through December 7 with changes effective on January 1, 2022.
Have questions about open enrollment and your health insurance? Need financial assistance?
Call Ashley Hahn, LCSW Oncology Social Worker in Santa Maria 805-346-3402 or Jenni Davis, Patient Advocate in Arroyo Grande 805-474-5303