Home InsuranceMedicare Medicare Coverage for Mesothelioma Cancer 2021

Medicare Coverage for Mesothelioma Cancer 2021

by EG
medicare coverage for mesothelioma feature

Mesothelioma is a rare form of cancer associated with asbestos exposure. Many older victims wonder what Medicare coverage for Mesothelioma looks like.

Certain occupations have a higher than average chance of long-term exposure, including electricians, plumbers, insulators, demolition workers, service members, and construction workers. Mesothelioma is a slow-developing cancer and may not be diagnosed for 70 years after asbestos exposure. As a result, the average age of someone with mesothelioma is 72.

Mesothelioma is an aggressive cancer with no cure. Diagnosis is often made after the cancer has reached an advanced stage. If you or a loved one has been diagnosed with mesothelioma, you may need to investigate thoroughly options that will help cover the expenses associated with treatment.

Treatment for Mesothelioma

Mesothelioma is most often treated with a combination of radiation, surgery, and chemotherapy. Other treatments can relieve symptoms. Chemotherapy often involves pemetrexed, cisplatin, bevacizumab, carboplatin, gemcitabine, or vinorelbine. 

Surgeries may include pleurectomy/decortication, extrapleural pneumonectomy, and mediastinal node dissection. However, not all mesothelioma patients are eligible for surgery, nor does this type of cancer act the same as some less aggressive varieties. Radiation therapy can be used to prevent recurrence after surgery or for palliative care. 

The cost of these treatments averages out to be about the same as lung cancer treatment, more than $60,000 the first year. Your out-of-pocket costs may vary but consulting a mesothelioma specialist will increase the expense. You could pay up to $12,000 a month for mesothelioma treatment.

Types of Coverage for Mesothelioma Treatments

You can think outside just Medicare coverage for Mesothelioma. There are other types of insurance coverage, however. But, let’s start with the main focus of this article…

Medicare Coverage

Medicare will cover certain Mesothelioma treatments, including chemotherapy, medications, clinical research trials, and hospice care. Part A will cover inpatient chemotherapy, while Part B covers outpatient treatment. There is a 20% co-payment for outpatient chemotherapy. 

Some oral cancer drugs are covered by Medicare Part B if the same medication is also available as an injectable drug or a prodrug (oral medication that breaks down the same as an injectable medicine). Anti-nausea drugs are covered when they are part of chemotherapy. Other medications may be covered under Part D, but you’ll need to check with your plan to find out more information. 

Many mesothelioma immunotherapy treatments are available as clinical trialsMedicare will cover some of the costs of participation, including office visits, tests, and medication. There’s a 20% copayment for clinical trials. 

When the time comes, Medicare will also cover hospice care. In this case, you agree not to receive any more curative treatment. Medicare will cover palliative care. There is no copayment. Pain relief and symptom control medications will cost you no more than $5. If you are receiving hospice care in a nursing home, Medicare does not cover room and board. 

Medicaid Coverage

If your income is below a certain threshold, you may qualify for Medicaid. Coverage varies from state to state, and not all health care providers will accept it. It’s worth looking into if your state’s plan will cover mesothelioma treatment.

Health Insurance Coverage

Health insurance through your employer may pay for some aspects of mesothelioma treatment. Contact your agent for more information. 

Private insurance is another option to consider. Some insurance companies will not insure you after a mesothelioma diagnosis. You may need to look at high-risk pool plans offered by some state governments. They have higher premiums, but this type of coverage could be a good way to keep out-of-pocket expenses low. 

Department of Veteran’s Affairs Coverage

U.S. military veterans make up more than 30 percent of all mesothelioma patients. During WWII and the Korean War, many enlisted service members in the Navy were exposed to asbestos fibers as machinists, firefighters, and boiler tenders. Spouses of service members also were exposed as a result. If you are a veteran, you may be able to take advantage of reduced cost or free treatment through the Department of Veteran’s Affairs. If you were exposed to asbestos as a part of your active duty, you could receive VA disability benefits and health care. 

Mesothelioma Compensation Settlements

It may be that you are entitled to compensation from your employer. Many asbestos exposure incidents can be traced back to negligence. Compensation may also be granted from the asbestos manufacturer. Asbestos companies have established trust funds that you may draw from for your mesothelioma treatment over the years. You can find out more information about submitting a claim here

The statute of limitations varies from state to state, so you should look into this option immediately after your diagnosis. You may be able to receive some compensation for lost wages and treatment costs. The average settlement is over $1 million. You will need to contact a competent lawyer that specializes in mesothelioma compensation cases for more information. 

Non-Profit Organizations

Several non-profit cancer support groups offer counseling on treatment options and paying for treatment. There may be funds available to you as well. The American Cancer Society has chapters throughout the country. 

The Pacific Mesothelioma Center is part of The Pacific Heart, Lung & Blood Institute. It focuses on treatments for Mesothelioma and may have clinical trials you can participate in. The Mesothelioma Applied Research Foundation may also have funding options you can apply for. 

Be sure to ask your local hospital social worker or mesothelioma patient advocate for other options that may be available to you. 

Medicare Coverage for Mesothelioma Conclusion

Treatment is costly, so any victim older than 65 will wonder what Medicare coverage for Mesothelioma means for them. Because it takes so long to present, proper diagnosis may be a late-stage event. This means more aggressive treatment is necessary. Because it is considered a rare form of cancer, clinical trials are ongoing. If you qualify for participation in clinical trials, Medicare and other organizations may pay for your treatment. 

If you are a veteran, then be sure to contact your local Department of Veteran’s Affairs for information about treatment. They have access to some of the best doctors in the country who specialize in mesothelioma treatment in Boston and Los Angeles. 

Filing a lawsuit for compensation from your employer or the asbestos company is another option that may help finance your treatment. Since the statute of limitations varies from state to state, you should consult a lawyer about your claim as soon as you receive a mesothelioma diagnosis. 

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