Understanding Your Health Insurance: A How-To Guide

Health insurance for cancer patients can be one of the most significant factors that determines a person’s prognosis. It is an unfortunate reality that cancer is costly; even with a good insurance plan, cancer patients can face steep co-pays, treatment costs, and medication prices. However, health insurance can defray exorbitant out-of-pocket expenses to a degree. Research has shown that financial concerns can discourage some patients from seeking proper care, or cause them to be non-adherent to their medication regimen, putting their health and recovery at risk.

While it’s a necessary part of care, understanding health insurance can seem like yet another challenge for cancer patients who already have so many other decisions and details to sort through. To ease that burden, here is a rundown of the steps cancer patients should take to ensure they’re making the most of insurance.

Get insured: If you don’t have health insurance, the very first action you need to take after a diagnosis is to enroll in a plan. Visit the federal healthcare site to learn about the private and public plans that are available. If your or your spouse’s employer offers insurance, a cancer diagnosis typically will be considered a qualifying life event, so you can enroll in a plan outside of typical enrollment periods. Other options include Medicare, generally applicable to those over 65, and Medicaid, for low-income or disabled individuals.

Stay insured: Cancer treatments may necessitate your taking time off of work or could even result in the loss of a job. Prepare ahead of time. The COBRA program provides temporary insurance coverage, often used by those whose employers discontinue coverage during a leave.

Get informed: Learn about your coverage by having a consult with a plan representative. It’s best to know ahead of time what’s covered and what’s not; even if that doesn’t alter your treatment plan, being prepared for medical bills can save some sticker shock and future stress. Make sure to learn what treatments, or how much of them, are covered; what you’ll encounter in the way of co-pays; and potential cost-savings programs the company offers.

Be persistent: If your company denies coverage for a certain treatment or medication, that doesn’t have to be the final word. Patients can appeal decisions; if the company still denies the claim, take the appeal to a third-party investigator, which all insurance companies now work with for external appeals.

Health insurance for cancer patients is an unfortunate step along the road to recovery. Learning about your options, and being your own advocate, can go a long way toward putting you one step closer to a clean bill of health.

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