Original Medicare vs. Medicare Advantage for Cancer Care
Choosing between Original Medicare (with a Medigap policy) and a Medicare Advantage plan during cancer treatment is one of the most critical health insurance decisions an older adult will make.
Key Differences at a Glance
| Feature | Original Medicare + Medigap | Medicare Advantage (HMO/PPO) |
|---|---|---|
| Doctor & Hospital Choice | Any provider in the US accepting Medicare | Restricted network (HMO/PPO) |
| Prior Authorization | Rarely required for cancer care | Frequently required for scans, chemo, radiation |
| Out-of-Pocket Cap | Comprehensive protection with Medigap | Annual MOOP limit ($3,200 to $8,850+) |
| Out-of-State Care | Covered nationwide | Emergency care only (unless PPO allows out-of-network) |
When to Consult a Free SHIP Counselor
Before changing from Original Medicare to Medicare Advantage—or attempting to switch back—always discuss medical underwriting rules and Medigap guaranteed-issue rights with a SHIP counselor.
Free & Independent Counseling
Speak With a State Health Insurance Counselor (SHIP)
HIICAP (Health Insurance Information, Counseling and Assistance Program) provides free, unbiased, one-on-one Medicare counseling. SHIP counselors do not sell insurance or receive commissions.