What's the Best Cancer Insurance Policy?

A cancer diagnosis can be shocking and life-changing. Your first concern is obviously your health, and whether you’ll survive. Your second worry will be how or whether you can afford your treatment and stay out of poverty. With nearly 2 million new cancer cases every year and the high, ongoing cost of care, a cancer insurance policy can be a critical part of your insurance plan. With a variety of options, let’s figure out the best cancer insurance policy for you.

Cancer is Covered By Health Insurance

Cancer treatments are usually covered by your main health insurance policy. Affordable Care Act (ACA) plans and Medicare plans include cancer coverage by law. If you have private insurance, through your employment or your spouse, cancer coverage is usually included, with a few rare exceptions. Review your existing policy to understand your benefits, deductible, copayment rates, and maximum coverage limits.

Cancer coverage in your health insurance has its limits, however. Traditional health insurance plans don’t cover experimental treatment, which may include stem cell transplants, or genome sequencing, which can help you choose the most effective path to improving your health. And of course, there’s the co-pays and deductibles.

Some may say that the best cancer insurance policy is the one you get with your standard health insurance. But money from a separate cancer insurance policy can cover your deductible, for example, or other out-of-pocket expenses that occur during the course of your treatment.

Cancer Costs

Cancer treatment is expensive. In the first year alone, the average expense is around $43,000. The years in between are around $5,000 each, and the final year of care is often around $100,000.

The average diagnosis happens at 66. Patients at that age have about a 6-year life expectancy once they survive the first year. If you fit the average profile, here’s a cost breakdown:

Year 1: $43,000

Year 2-5: $5,000 x 4= $20,000

Year 6: $100,000

Total out of pocket: $163,000

Medicare Cancer Coverage and Out-of-Pocket Costs

If you fit the average profile, you’ll be under Medicare when you’re diagnosed. Medicare covers chemotherapy, radiation therapy, bone marrow transplants, and other traditional cancer treatments. If you receive treatment in the hospital and your care falls under Medicare Part A, there’s no charge to you.

If your care happens in a doctor’s office, at home, or otherwise outside of a hospital, then it falls under Part B. Your Part B deductible every year is $257 as of 2025. After you meet the deductible, you pay a 20% copayment on all charges afterwards.

Here’s a rough calculation of an average cancer patient lifetime expenses with Medicare Part B applied:

Year 1: $43,000 – $250 = $42,750. $42,750 * 20% = $8,550 + $250 = $8,800 due

Year 2-5: $5000 – $250 = $4,750. $4,750 * 20% * 4 = $950 + $250 = $1200 due per year

Year 6: $100,000 – $250 = $99,750. $99,750 * 20% = $19,950 + $250 = $20,200 due

Total out of pocket: $33,800

These standards may be different on a Medicare Advantage Plan. Please refer to your plan documents for your deductible and copay rates. Note that neither Medicare nor Medicare Advantage covers experimental treatments. You’ll need the best cancer insurance policy for that.

Cancer in Younger Patients

Cancer can appear in people of any age, gender, race, or economic status. While most cancers appear in adults over age 50, in the last few years, cancer has been diagnosed in younger people more often. New technologies mean that we can diagnose cancer earlier and improve health outcomes.

ACA Cancer Coverage Example

ACA plans have different levels of deductibles and copays. They all cover traditional therapy practices as well. At the bronze level, your deductible will be high, and you pay about 40% of care costs. Plans also have an out-of-pocket maximum. Let’s assume a $10,000 deductible and 40% copay, with a $20,000 out-of-pocket maximum for a worst-case scenario.

Year 1: $43,000 – $10,000 = $33,000. $33,000 * 40% = $13,200 copay. Total = $23,200, capped at $20,000.

Year 2-5: $5000 – Deductible not met, you pay in full each year.

Year 6: $100,000 – $10,000 = $90,000. $90,000 * 40% = $36,000 copay. Total = $46,000, capped at $20,000.

Total out of pocket: $60,000.

As mentioned, the conditions here are some of the least favorable, and will depend highly on the insurance coverage you choose. We should also note that younger people recover better from cancer, on average, and your lifespan could be significantly longer, increasing your total expenses.

Private plans usually have better conditions, with lower deductibles, lower coinsurance rates, and lower out-of-pocket caps. This estimate is the high end of your potential costs if you’re privately insured through employment.

The Insurance Catch-22

Most Americans get their health insurance through their job. And as mentioned, most private insurance plans include cancer coverage. However, cancer treatments can be incredibly hard. You may not be able to perform at work as you’re used to.

If you lose your job, you also lose your employment-based health insurance. Having cancer insurance outside of your employer-provided insurance can provide a financial cushion, reducing stress and letting you focus on getting well.

About Cancer Insurance

Insurance specifically for cancer may be part of a critical illness insurance policy, or it may be an independent offering. It can be triggered independently of health insurance or Medicare Advantage benefits.

If you’re working, your work may offer cancer insurance as an part of your employee benefits. The best cancer insurance policy is one that lets you take it with you, regardless of your employment.

Most insurance payoffs are tax-free.

Lump Sum Payment vs Reimbursement

Critical illness insurance offerings pay directly to you, the policy holder. Some products only pay for specific items, while others offer a lump sum payment. Some benefits of lump sum payments include:

Don’t have to provide receipts or invoices for reimbursement
Can use the money for anything, like paying your mortgage or credit card bills
Get your full benefit at one time, not piecemeal
Less waiting to get your cash
Look for treatment outside the US, for example, in Mexico
Use the funds for advanced or experimental treatment, like stem cell transplants

On the other hand, a lump sum means that’s the maximum the plan will pay out. Defined benefit plans may pay weekly or monthly for a treatment, medication, surgery, or benefit with no limit.

You’re already fighting this disease and your standard health insurance company. You shouldn’t have to fight for your supplemental insurance as well. The best cancer insurance policy makes it easy for you to make a claim and get your funds.

Common Conditions and Requirements

Many cancer insurance policies have a waiting period, often 30 days. This means that you have to wait a month or more to claim your benefit. Starting early means that your benefits kick in as soon as you’re diagnosed.

As supplemental insurance, cancer insurance may have health requirements for you to be accepted. Some companies will not insure a cancer survivor against a re-occurence. Others require certain timeframes around the last instance of the disease. Aflac, for example, allows cancer survivors to be cancer-free for a decade before issuing new cancer insurance, but Mutual of Omaha only requires 5 years.

Genetic Sequencing: The Next Generation of Cancer Care

Traditional insurance companies like MetLife, Aflac, or Cigna offer coverage for standard treatments. Some may offer benefits for some experiemental treatments as well. But science is improving faster than most insurance companies can keep pace.

Genetic sequencing helps you beat cancer by:

GTL, an insurance company with over 80 years of experience, has partnered with TGen, a leading nonprofit medical research institute to deliver innovative health care solutions. GTL’s Precision Care covers genetic sequencing and one-on-one consultations with a TGen expert physician on top of lump sum cancer insurance.

Analyzing your tumor’s “fingerprint”
Matching you with the best care for the underlying biology of your specific cancer
Targets molecular structures to make medicine more rational, personal, and precise
Identifies whether targeted drugs that support your own immune system’s ability to fight cancer could be beneficial

Genetic sequencing could cost over $10,000 retail, and is not covered by any other insurance. With Precision Care, it’s included.

Genetic sequencing is easy with Precision Care. Inform your doctor that you have access to TGen genetic sequencing. Your doctor will send the biopsy to TGen.

The cost of the biopsy and the consultations are covered completely by GTL.

When the sequencing is complete, you and your doctor get one-on-one consultations with a TGen physician. This way, everyone on your treatment team can work together to find the best solutions to helping you improve your health.

Cancer is hard and painful enough. Leverage the power of the latest medical science to eliminate guesswork and find a treatment path personalized to your body. Choose Precision Care.