Getting Started with Cancer Plans

60% of all newly diagnosed cancer cases are in those over age 65 and 70% of all cancer deaths are over age 65. By 2040, the number of new cancer cases per year is expected to rise to 29.5 million and the number of cancer-related deaths to 16.4 million.

Men Cancer Stats

1 in 2 men are expected to have some form of cancer in their lifetime

Women Cancer Stats

1 in 3 women are expected to have some form of cancer in their lifetime

Offer a Package Solution

Think of the fast food industry. No longer does anyone need to order a hamburger, fries, and a drink. They order a #1.

The same can be applied to offering cancer with a Medicare Supplement. Offer your clients a cancer benefit with their Medicare Supplement to provide them protection from the limitation of Medicare and unplanned costs.

Post Sale

Stand Along cancer plans cannot be sold at the same time as Medicare Advantage because they are not listed on the Scope of Appointment form. (Note the loop hole, check out our Hospital Indemnity Sales Tools for a way to offer a cancer rider during an MA appointment). This creates a great opportunity for a follow-up appointment to help give your clients added protection from not only co-payments in their plan, but also the unplanned, uncovered, non-medical costs.

Brand Awareness

Are you letting clients know you offer cancer benefits? Numerous carriers have cancer marketing materials, as well as the personalizable pieces offered through SMS’s Agent Marketing Portfolio (AMP).

Want to go the basic route? Simply hand write a post-it not and put it on the front of every policy you are delivering.

Uncovering the Need

While fact finding with your client, you can probe for cancer concerns and interest by asking:

Other than your current health plan, should you be diagnosed with cancer, what other funds do you have in place to help offset treatment costs?

Cancer Plans & Medicare Supplements

While many Medicare supplement plans will cover medical cancer costs, the non-medical, unplanned costs can easily go into the thousands and beyond (as mentioned previously). Remember, if Medicare does not cover the cost, neither will Medicare supplement.

Cancer Plans & Medicare Advantage

Beyond the non-medical costs, many Medicare Advantage plans cover chemotherapy at 80/20 (80% Medicare, 20 beneficiary) which can easily create high out of pocket costs for the client.

While your clients have a max-out-of-pocket stop loss, this resets in January. This means if your clients max out their out-of-pocket costs in November and they are still under treatment in January, they will start paying all over again.

Talking Points

A lot of my clients and their family have had very expensive out-of-pocket costs when it comes to treating cancer.

Medicare will only cover certain treatments, and does not pay for alternative treatments, additional home care, transportation, and other expenses if you need to travel for the best treatment.

I don’t want your treatment costs to add additional stress or limitations.

History of Cancer

Most people know someone who has battled cancer, and have seen the effects of cancer treatments, which can greatly alter the patients lifestyle for some time. Giving your clients additional fiscal resources can greatly improve their outcomes by reducing fiscal strains and stress. You can still review the cancer plans to clients who may not qualify as they may know others who can benefit from a plan.

Medicare and most other coverage will not pay for:

  • Travel for treatment or for family to visit
  • Lodging if travel is required
  • Extra help in the home
  • Time off work for the client or family / friends assisting
  • Alternative treatments

Plus your clients may have additional expenses for:

  • Additional prescription drug
  • Follow-up medical visits
  • Hospitalizations

Personalizable Client Facing Cancer Fact Sheet – download, fill in your info and click print. It really is that simple!

Personalized Client Coverage Option Sheet – download and fill in your info

Breast Cancer Awareness Media Kit

Cancer Plans Media Kit

SMS Agent Marketing Portfolio Order Form

Treatment Services

Medicare Publication # 11931 “Medicare Coverage of Cancer Treatment Services” is extremely helpful in determining how Medicare will be involved in cancer treatment.

Link: https://www.medicare.gov/Pubs/pdf/11931-Cancer-Treatment-Services.pdf

Cancer Medications

Questions often arise while comparing drug coverage plans if a drug is covered under Medicare Part B or Part D. This CMS tip sheet can answer those questions for you.

“Drug Coverage under Different Parts of Medicare”


Need training on cancer plans, the products, and how to offer it to your clients? Check out the Cancer Plan Courses on SMS-University.

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