Fight Breast Cancer… Starting With Yourself

October is Breast Cancer Awareness Month—a time to focus on the importance of early detection, education, and support for those affected by breast cancer.

We’ve all known someone affected by this all-too-common disease. Too many of us mourn the loss of loved ones.

But the good news is, we’ve made some great strides in combating breast cancer––both in early detection and in successfully treating it once it’s identified. But early detection is still a hugely important factor in successfully defeating cancer.

First, let’s go through some of the basic statistics:

• Breast cancer is the leading cancer diagnosis among women, with 30% of patients being 70 years or older when first diagnosed. 
• About 43% of breast cancer cases are diagnosed in women ages 65 or older, and the risk continues to increase with age.
• While less common, breast cancer can occur in men also. Most at risk are obese men over 65 with a history of breast cancer in their family. 

Medicare offers robust coverage for preventive services, including mammograms, which are essential in catching breast cancer early when it’s most treatable.

Of course, the best way to beat cancer is prevention. In our April Newsletter, I wrote up some actionable things you can do to reduce your risk of developing cancer over time.

From Our Blog: How People on Medicare Can Protect Themselves Against the Financial Risk of Cancer

 The National Cancer Institute reports that 90.8% of women with breast cancer survive for 5 years after diagnosis. For men with localized breast cancer, the 5-year survival rate is 95%.

The American College of Radiography reports that mammography has helped reduce the breast cancer mortality rate by 40% since 1990. 

There are some special considerations for people over 70 diagnosed with breast cancer, and the treatment often has to be weighed against other health issues, especially for those who are older, frailer, or have heart conditions that are aggravated by chemotherapy. 

Finding cancer as early as possible allows for less invasive treatment options that are easier for older patients to tolerate. 

It’s important to talk to your doctor to make sure you are weighing all the potential risks and benefits before starting any course of treatment.

From Our Blog: Do People on Medicare need a Cancer Policy?

Use Your Medicare Benefits

Medicare makes preventative screening benefits free for a reason: They want you to use them! It saves the government money… and it saves patients’ lives.

That’s why Medicare covers several important cancer screenings:

Breast Cancer

• Annual screening mammograms for women age 40 and older
• Clinical breast exams as part of the “well-woman” pelvic exam
• Medicare Part B covers diagnostic mammograms for men if they are deemed medically necessary by a doctor. (For example, if a man has a lump that needs to be investigated.) 

Cervical/Vaginal Cancer

Medicare covers the following screenings:

• Pap test and pelvic exam every 24 months for most women
• Annual screening for high-risk women or those with abnormal Pap results

Colorectal Cancer

• Screening colonoscopy once every 24 months for high-risk individuals
• Screening colonoscopy once every 120 months (10 years) for average-risk individuals
• Annual fecal occult blood test for those 45 and older
• Multi-target stool DNA test every 3 years for those 45-85 at average risk.

Medicare also covers screening for these other common cancers, as well:

Lung Cancer

• Annual low-dose CT scan for high-risk individuals ages 50-77 who meet smoking history criteria

Prostate Cancer

• Annual digital rectal exam for men 50 and older
• Annual PSA blood test for men 50 and older

Most of these screenings are covered at 100% with no out-of-pocket costs when provided by a participating Medicare provider. But coverage may vary based on risk factors and medical necessity.

It’s important to discuss your individual cancer risk and appropriate screening schedule with your doctor. 

Medigap and MediShare 65+ can help cover any out-of-pocket expenses, such as co-pays and deductibles. But they don’t cover prescription drugs, which can be extremely expensive for cancer patients. For that, you need to combine them with a Medicare Part D policy, or enroll in a Medicare Advantage plan that includes prescription drug coverage as part of the package. 

If you need to add Part D coverage, contact your Personal Benefits Manager, who can help you compare plans and formularies and select the best one for your needs. 

And lastly, don’t be one of the 65% of Americans who neglects their recommended cancer screenings. Be proactive, and be well!

Here’s to your health and wealth,

Wiley P. Long, III
President – MediGap Advisors

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