Cancer and Health Insurance

Where can I find out more about health insurance?
For more information about health insurance, including suggestions for taking action and a list of resources, visit the Lance Armstrong Foundation.

Why is knowing about health insurance important to being affected by cancer?
Health insurance plans provide coverage to pay medical expenses when you are ill or injured. Most plans also pay for examinations, diagnostic tests and other preventive care services to keep you well. Each health plan defines what is covered and the benefits that are available under their individual policy. Good health insurance is very important for cancer survivors. Without health insurance coverage, you will be responsible for the full costs of medical procedures, visits with your health care team and prescribed medications. In addition, without coverage you may have difficulty accessing needed care. Health insurance helps make the medical care you need affordable and obtainable.

What do I need to know about health insurance?
If you already have health insurance coverage, start by reviewing your existing health plan. Next, make a list of all your current and projected health care needs for services and treatments. Compare your present plan benefits to your anticipated medical needs to decide whether you have the right type of coverage.
Keep in mind that you must continue to pay all of your policy premiums in full and on time to keep your health plan coverage. An insurance company cannot deny payment for covered medical services when a policy is active and if you have followed all of the administrative rules of the insurance policy, such as getting pre-authorization for coverage when the plan requires it. However, if you do not make the required premium payment for your plan coverage on time, your plan will lapse and your health coverage will end.

If your health insurance policy is canceled, finding good coverage with a new health insurance plan is likely to be very challenging for someone with a medical history, such as cancer. In addition, a new individual policy could include higher premiums, extended waiting periods for coverage, and waived or excluded insurance benefits due to your medical history.

If you have no health insurance at this time, a review of your medical needs will help you identify the type of insurance coverage to get. You will need to make certain the plan you select will cover your health care providers, including doctors, hospitals, diagnostic services and therapists. It is also important to find out if your prescribed medications will be covered at the level that you need.

Many people are able to obtain health insurance coverage as an employment benefit. However, if you are not working for someone else, or if your employer does not offer a health plan, you will need to find health coverage in other ways. For example, you may be able to get coverage through membership in another group or by purchasing an individual health insurance policy. Health coverage can often be obtained through a spouse or dependent option offered through a family member's plan.

What steps should I take to address health insurance?
Choosing the right health plan for your situation is very important. There are many health insurance plans to choose from and the quality of plans is varied. Your health plan will directly affect which medical providers will care for you and what kind of care you will receive. In addition, your plan will also affect when you receive medical care, how you will be cared for and how much the medical care will cost you.
If your health insurance is provided by your employer, and more than one plan is offered, compare the different plans to see which best meets your medical needs. The same is true if you are looking for individual insurance. Learn about a variety of health plans to select the one that will best meet your needs.

Review and compare factors such as the following during the process of making your choice:
• Are the plan benefits rated highly by its members?
• Does the plan provide the health care benefits you need?
• Will the plan cover medical services provided by your current physician, hospital, lab, diagnostic facility and your other health care providers?
• Are covered medical services accessible and located near you?
• Does the plan cover your prescribed medications?
• Is the insurance company accredited and rated highly by industry standards?
• It there an administrative process to appeal denials and access prescribed medical care?

Survivors also need answers to the following questions about a health plan:
• Is there a pre-existing condition exclusion period?
• Do physician appointments, treatments and prescribed drugs require prior approval from the insurance company?
• Does the plan exclude any coverage or specific medical services?
• What is the process for appealing a denial decision made by the insurer?
• What are the deductible and co-payment requirements for the plan?
• Is the plan affordable?