What is cancer?
Cancer is a sickness where some cells in your body change and start growing too fast. They can form a lump called a tumor or spread to other parts of the body. Some examples are breast cancer and lung cancer.
If cancer is untreated, it usually keeps growing and can spread to other parts of the body. This spread is called metastasis. When it spreads, it can damage organs and become much harder to treat.
How is cancer treated?
A doctor who treats cancer is called an oncologist. Oncologists use different ways to help stop cancer cells from growing.
Chemotherapy: This is strong medicine that can help kill cancer cells. It can be given in these ways:
- Into a vein (IV): This is the most common way. Sometimes the medicine goes in through a small device under your skin (called a port), so you don’t need a new IV each time.
- By mouth (oral chemo): You take pills, capsules or liquid that you swallow at home.
Radiation therapy: This treatment uses strong energy beams (like X-rays) aimed at one spot on your body to kill cancer cells or make a tumor smaller.
What parts of Medicare cover cancer services?
Each part of Medicare helps pay for certain cancer services:
- Part A (hospital insurance): This helps pay for care when you stay in the hospital. For example, it can help pay if you are in the hospital to get cancer treatment, like chemotherapy or radiation.
- Part B (medical insurance): This helps pay for doctor visits and care when you don’t stay overnight at the hospital. This can include visits with a cancer doctor (called an oncologist), chemotherapy in a clinic, radiation treatments and some cancer drugs.
- Part C (Medicare Advantage plans): These plans cover the same cancer care and drugs that Medicare Part A and Part B cover. Part C plans allow you to get your care and your medicines in one plan. Medicare Advantage (MA) plans may help lower some health care costs or give you added coverage.
- Part D (drug coverage): This helps pay for prescription drugs you get at a pharmacy and take at home. It often includes coverage for cancer drugs like oral chemotherapy pills you swallow. Part D may also cover other drugs you need during treatment.
What Aetna® Medicare plans cover cancer treatment?
The Aetna Medicare plans that may help cover cancer medication and treatments are Medicare Advantage prescription drug (MAPD) plans. These plans include medical care and prescription drug coverage. They help pay for cancer doctors, hospital care and covered medications. Learn more about MAPD plans.
Some MAPD plans are called Special Needs Plans, or SNPs. A SNP is for people who meet certain rules. Having cancer doesn’t mean you can enroll in a SNP. But if you qualify for a SNP, your cancer care will be covered.
There are three kinds of SNPs:
- A Chronic Condition Special Needs Plan (C-SNP) is for people with certain long-term health conditions.
- A Dual Eligible Special Needs Plan (D-SNP) is for people who have both Medicare and Medicaid.
- An Institutional Special Needs Plan (I-SNP) is for people who live in a nursing home.
What coverage choices do I have for Aetna Medicare Advantage plans?
There are three plan options for Aetna Medicare Advantage plans.
HMO
You need to use the plan’s doctors and hospitals in the plan’s network. Generally, if you go out of network the plan won’t pay for your care.
HMO-POS
You usually need to stay in the plan’s network when you get care from doctors, hospitals or urgent care centers. You can sometimes go out of network, but it costs more.
PPO
You can use any doctors and places to get care, like hospitals or urgent care centers. If you stay in network, you’ll pay less. If you go out of network, you’ll pay more.
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Aetna Medicare plans can help cover important parts of your cancer care:
- Doctor visits: Your plan will help pay for visits with your cancer doctor (oncologist) and other in-network providers.
- Treatment: Your plan will help pay for covered cancer treatment like chemotherapy and radiation.
- Cancer medication: Your plan may include drug coverage for cancer drugs (like oral chemotherapy pills you swallow) and other medications. You can check the plan’s formulary (drug list) to be sure.
Care management
If you qualify for an Aetna Medicare plan, you will be given a care management team. They’ll help you:
- Understand your care plan
- Set up appointments and follow-up visits
- Manage your medications
- Make sure your doctors share information
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Medicare usually does not pay for a routine skin cancer screening if you do not have any skin changes. But Medicare may pay for a skin check if you have a new or changing mole, a sore that will not heal, or a spot that looks unusual.
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Before you enroll in a plan, make sure your cancer doctor and treatment center are in network. Being in network means the plan works with them. This can help you save money.
- Start with your ZIP code to see plans near you. Compare plans and enroll
- Check the plan provider list to see if your cancer doctor and chemotherapy center are in network. Find providers
- If you’re not sure, call your doctor’s office and ask what Medicare plans they take.
Ready to shop Aetna Medicare plans?
Enter your ZIP code to find Aetna Medicare plans in your area. Compare benefits, costs and drug coverage and see if your providers are in our network.
Already a member?
If you already have a plan:
- Log in to your secure member website
- Check your plan details to see what help is included.
- Contact Member Services if you have questions about your benefits.
You can also learn more about switching plans.
Find more helpful information
Disclaimer
The Aetna C-SNP is available to Medicare members who have at least one of the qualifying chronic conditions. To ensure a successful enrollment process, we’ll confirm with your healthcare provider that you have one of these eligible conditions. If verification of eligible condition is not received, involuntary disenrollment will occur.
This material is for informational purposes only and is not medical advice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Contact a health care professional with any questions or concerns about specific health care needs. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna is not a provider of health care services and, therefore, cannot guarantee any results or outcomes. The availability of any particular provider cannot be guaranteed and is subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to our website.