Medicare for cancer coverage is complicated because there are several different categories of coverage it provides.
Prevention and screening for cancer is one major aspect of healthcare most people want to have figured out ahead of time, and if you have a Medicare plan you probably want to take advantage of these benefits.
Knowing what exactly is and isn’t covered can be tricky. Here is our guide to various types of preventative care Medicare covers:
1. Routine Screenings
Medicare Part B automatically covers regular screenings for the following cancers: breast cancer (mammogram) once a year, cervical cancer once every 2 years, colorectal once a year, prostate cancer once a year, and lung cancer low-dose tomography under certain risk factors like being a former smoker.
In addition to these regular screenings, if a doctor or provider requests more screenings such as for diagnostic purposes, it will generally be covered under Medicare Part B. This means all Medicare Supplement Insurance and Medicare Advantage plans are required to cover this type of care as well.
Colorectal cancer is one of the most treatable types of cancer if it’s caught early, so take advantage of the lifesaving colonoscopy Medicare Part B offers everyone one every two years. This is one type of Medicare for cancer that is almost always worthwhile to use.
The colonoscopy itself is fully covered under any Medicare Supplement Insurance or Medicare Advantage plan. However, sometimes polyps or other tissue is found and removed during a colonoscopy. If that occurs, you can be charged 20% of the out-of-pocket cost for the removal. To avoid that charge, enroll in a Medicare Supplement Insurance plan that pays for the remaining 20% charge, or enroll in a Medicare Advantage plan that covers colonoscopies including tissue removal in full.
3. Tobacco Cessation
If you’re looking to quit using tobacco, Medicare Part B has a built-in option to attend 8 counseling sessions per 12-month period of smoking. The counseling and smoking cessation information is fully covered under Medicare Supplement Insurance and Medicare Advantage plans.
Some people use pharmaceutical drugs such as nicotine patches to help with stopping smoking. To get those drugs covered, you will need either a Medicare Part D plan or to be enrolled in a Medicare Advantage plan that includes the drugs you want.
4. Hepatitis B Vaccine
Hepatitis B is a virus that can cause cancer and other detrimental liver diseases, so staying up-to-date on this vaccine is one of the easiest ways to lower your risk of cancer. The standard vaccine schedule for Medicare patients that includes the Hepatitis B vaccine should be fully covered for anyone with Medicare Part B or a Medicare Advantage plan.
5. Skin Cancer Screening for Concerned People
Medicare for cancer goes on an “as needed” basis for the most part, so it typically doesn’t doesn’t cover skin exams for people with no symptoms. However, it does cover a healthcare provider investigating a change to your skin such as a new mole appearing. If you have any type of plan that includes Medicare Part B, or a Medicare Advantage plan, you can go in to have any concerning changes to your skin examined by a healthcare provider.
In the event something concerning is found and further tests are needed, a referral to a dermatologist is also fully covered under Medicare Part B. If there is less evidence of a serious issue or if further tests are needed, you may in some cases have to pay 20% of the cost for this care. In that case, a Medicare Supplement Insurance plan can cover that 20%. Some Medicare Advantage plans offer more comprehensive coverage for this type of care as well, so check your local options for Medicare plans.