What Medicare Beneficiaries Pay Out-Of-Pocket For Cancer

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If you are a Medicare beneficiary with a new cancer diagnosis, you can expect to incur some steep out-of-pocket (OOP) costs, according to a study published recently by JAMA Oncology. And those costs vary depending on the type – if any – of supplemental insurance you have. Hospitalizations were a primary driver of these high OOP costs.

For instance, patients with only Medicare, and no additional health coverage, paid on average $8,115 a year (that’s 23.7 percent of their incomes) on out-of-pocket costs after a diagnosis of cancer.

Beneficiaries in private Medicare plans, which is part of Medicare Advantage, had costs of almost $6,000 a year.

The lowest out-of-pocket costs went to Medicare beneficiaries who also had coverage through Medicaid ($2,116 a year) or the Veterans Health Administration ($2,367 a year).

Seniors with additional coverage through employers had costs of almost $5,500, while those with private “Medigap” policies, which cover copays and deductibles not picked up by Medicare, had expenses of $5,670.

Among the 10 percent of beneficiaries with cancer who incurred the highest OOP costs, hospitalization contributed to 41.6 percent of total OOP costs.

Check out the study findings here.