Medicare for Mesothelioma Treatment

Mesothelioma is a rare internal cancer often found in lung tissue. Commonly associated with asbestos exposure, this type of cancer develops slowly.

Usually, mesothelioma is not diagnosed for many years after exposure. Due to its slow development, mesothelioma diagnosis typically presents at a late stage in growth. So, this makes it difficult to find an effective treatment.

With the average age of a mesothelioma diagnosis being 72, it is not uncommon to have questions about how Medicare covers the effects of this type of cancer. Below, we discuss how Medicare can protect you against the costs of mesothelioma treatment.

When utilizing Part A (hospital insurance) for mesothelioma treatment, you will be subject to the Part A deductible. This is a per-occurrence deductible that is the beneficiary’s responsibility during each period of care.

When using Part B (medical insurance) for coverage of mesothelioma, you are responsible for the calendar year Part B deductible before coverage begins. Once the deductible is met, you are responsible for a 20% coinsurance. So, this means Medicare covers 80%, and you cover 20% of any costs accrued after the deductible.

With Medicare Advantage, each plan has a different set of deductibles and coinsurances. You are responsible for meeting these limits before the full extent of the plan’s coverage. It is best to refer to your plan’s specific outline of coverage to determine your out-of-pocket costs.

When using Part D to cover drugs related to a mesothelioma diagnosis, you can be responsible for a copayment when you pick the prescription up at your pharmacy. You’ll also need to meet your plan’s deductible before you reach the initial coverage phase. With Medicare Part D, the individual plan’s formulary will determine the copayment. These formularies change annually, so reviewing your Part D plan with a licensed agent during the Annual Enrollment Period is essential.

Medigap and Mesothelioma

To reduce the cost-sharing of Medicare, many seniors enroll in a Medicare Supplement (Medigap) Plans policy. These plans pick up the remaining costs. With a Medigap plan in place, you will only pay a fraction of the out-of-pocket expenses you are responsible for when using Original Medicare.

The Medigap plan you choose to enroll in ultimately dictates your annual medicare spending. The best Medicare Supplement plans are Medigap Plan F, Medigap Plan G, and Medigap Plan N.

Each of these Medigap plans allows beneficiaries to pay very little or no out-of-pocket costs when utilizing medically necessary services. This also helps policyholders avoid high unexpected medical costs.

Treatments Covered by Medigap

When seeking treatment for mesothelioma, it is important to speak with your doctor to understand which form of treatment is best for you. Not all treatment is acceptable for all diagnoses.

When a doctor deems treatment medically necessary, the following mesothelioma treatments receive coverage from Medicare:

• Surgery
• Tests and Scans
• Chemotherapy
• Inpatient care, nursing home care, or hospice care
• Radiation
• Home health care services
• IV Medications
• Ambulance Services
• Labwork
• Medical Equipment

Unfortunately, Medicare will not cover the costs of immunotherapy treatments because they are only available through clinical trials.

Mesothelioma Settlements and Medicare

We have all heard the commercials stating, if you or a loved one has been diagnosed with mesothelioma, you may be entitled to financial compensation. For many with the diagnosis, this is true.

If you have Medicare coverage and receive a mesothelioma settlement, you may be subject to a Medicare lien on that settlement amount. If Medicare has paid for any treatment related to the diagnosis, you could be responsible for repaying the Medicare-covered costs.

It is crucial to work with a mesothelioma lawyer who can educate you on the legalities of the lien and negotiate a lien amount with Medicare.

FAQs

How to Use a Medigap Plan to Offset Mesothelioma Costs

Mesothelioma diagnosis and treatment can be a very expensive path to venture down. To keep your costs as low as possible, a Medigap plan is essential to ensuring that you do not overpay for the necessary treatment you need to fight this rare form of cancer.

To speak with a licensed agent about enrolling in a Medigap plan, complete our rates form or call the number above to receive help immediately. Our Medicare experts are available to serve as an educational resource for Medicare beneficiaries and their families.

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