Patients with only Medicare coverage face significant out-of-pocket costs following a cancer diagnosis, according to a new study.
For the study, researchers at Baltimore-based Johns Hopkins University examined data for 18,166 Medicare beneficiaries who participated in the January 1, 2002, to December 31, 2012, waves of the Health and Retirement Study, a nationally representative panel study of US residents older than 50. More than 1,400 were diagnosed with cancer during that period. About 15 percent were covered by traditional Medicare only, according to The Washington Post.
Here are four things to know about the high out-of-pocket costs of cancer care for Medicare patients.
1. The study, published Wednesday in JAMA Oncology, found Medicare beneficiaries without supplemental insurance incurred out-of-pocket costs at a mean of 23.7 percent of their household income, with 10 percent incurring out-of-pocket costs that were 63.1 percent of their household income.
2. Researchers said hospitalizations may be a primary contributor to these high out-of-pocket costs. In fact, among the 10 percent of beneficiaries with cancer who encountered the highest OOP costs, hospitalization contributed to 41.6 percent of total out-of-pocket costs.
3. Additionally, among the 1,409 participants diagnosed with cancer during the study period, the type of supplementary insurance was significantly associated with mean annual out-of-pocket costs after a cancer diagnosis ($2,116 among those insured by Medicaid, $2,367 among those insured by the Veterans Health Administration, $5,976 among those insured by a Medicare health maintenance organization, $5,492 among those with employer-sponsored insurance, $5,670 among those with Medigap insurance coverage, and $8,115 among those insured by traditional fee-for-service Medicare but without supplemental insurance coverage), according to the study.
4. "Medicare beneficiaries without supplemental insurance incur significant OOP costs following a diagnosis of cancer. Costs associated with hospitalization may be a primary contributor to these high OOP costs," the researchers concluded. "Medicare reform proposals that restructure the benefit design for hospital-based services and incorporate an OOP maximum may help alleviate financial burden, as can interventions that reduce hospitalization in this population."
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