No. of Recommendations: 8
{{ How well does this work if you get cancer? I know two people with lymphoma and their medical costs topped $1 million each. If you’re planning for cancer, is a high deductible plan the right choice? }}
The deductible and annual maximum out-of-pocket is the most that you'll pay during the calendar year. That's true whether you have a $100,000 illness or a $1 MM cancer. The big worry is that your insurer may not approve the treatment your doctor recommends.
If you're on Medicare, the "Medicare reimbursement" is a fraction of what's billed. Something that's a $1 MM illness on your employer's health plan, might only be a $200,000 Medicare reimbursement. If the hospital bill is $150,000 and the doctor's bill and other out patient services are the remaining $50,000, your Medicare co-pay would be less than $12,000 for the year. People hear about the "20% that Medicare doesn't pay", and think that they'll be on the hook for $200,000 on a $1 MM illness. That's just not true.
A $1 MM hospital bill cost you just $1,676 in 2025 (that's the Part A deductible.) The non-hospital costs are the piece that gets the 20% co-pay, but it's 20% of the Medicare reimbursement, not the big number the hospital or doctor bills you.
I had about $400,000 in medical bills in 2025 after my leg was amputated. The hospital bill was $260,000, the Part B charges were $150,000 with a Medicare reimbursement of about $90,000. The total Medicare out-of-pocket for the year was about $20,000, but I had a high-deductible Medigap plan that capped that at $3,000/year.
https://retireearlyhomepage.com/medicare2025_prais...intercst
