10 Things People With Cancer Should Know About Health Insurance

To a person who isn’t an insurance industry insider, the ins and outs of health insurance can be confusing. Throw a diagnosis of a chronic condition like cancer into the mix and the confusion can easily turn into frustration. The good news is that with the right resources and knowledge, it doesn’t have to be.

1. What Type of Coverage Do You Have and What Does It Cover?

Do you know what type of insurance plan you are covered under? Is it an HMO, PPO, or POS? Knowing what kind of plan you are under and what that entails is one of the most important things to know when you have been diagnosed with a chronic disease, like cancer. Knowing about your health insurance plan is the first rule in being a responsible, empowered patient. Understanding managed care plans like HMOs and PPOs, which most Americans have, is the first step in knowing the details of your personal plan. What’s the Difference Between an HMO and PPO? 

2. There is Help for the Uninsured

Cancer doesn’t discriminate — it affects the uninsured just as often as the insured. Unfortunately, our insurance status greatly dictates what type of treatments we receive. Without insurance, this could mean no treatment. If you have cancer and don’t have health insurance, there is hope. Options for People Who Are Uninsured

3. What To Do If Your Insurance Doesn’t Cover a Test or Procedure

If you have been told that your insurance will not cover a specific test or procedure, wait before you reach your hand into your pocket. Out of pocket expenses for tests and procedures can be costly. Many people don’t realize that there are many things you can do as an alternative to paying out of pocket. Here’s what to do if your insurance won’t cover a needed test or procedure. 

4. What If Your Claim is Denied?

Finding out that your insurance claim has been denied can be emotionally and financially devastating. We invest a lot of hope and confidence into our health insurance providers, and when our claims are denied, the blow can certainly damage the patient-provider relationship.The good news is that the denial is not a case of “end-all, be-all” — you can fight the decision. You would be surprised how many denials are reversed. Learn what to do if your health insurance claim is denied.

5. If You Have Cancer, Welcome to the ‘Pre-Existing Condition Club’

Once you are diagnosed with the big “C”, you are automatically labeled as having a pre-existing condition. This means that that you have been diagnosed with a disease or condition prior to applying for insurance coverage. Should you choose to shop around for a new policy in the near future, this will greatly affect your premium and even the possibility of obtaining health insurance. How Will Having a Pre-Existing Condition Like Cancer Affect Me In The Future? 

6. Is Supplemental Health Insurance Right For You?

Advertisements for supplemental insurance make us think it’s a good idea. A plan that would pay for the services and treatments that my primary plan won’t cover? Sounds too good to be true and for some people it is. Is Supplemental Health Insurance Right For You? 

7. Know About Your State’s High Risk Pool

High risk pools are groups of people who cannot cannot obtain adequate, affordable insurance because of pre-exisisting conditions. Did you know that most states have a program that allow people in this high risk category to obtain health insurance, even if they have been denied in the past? Understanding Your State’s High Risk Pool

8. How to Avoid Errors on Your Explanation of Benefits

It’s always relieving to know that you insurance company has paid a claim. Sometimes we become so elated that we toss our Explanation of Benefits statement in the trash. Think all you need to know is that the claim was paid? Think again. You can be robbed of your benefits because of errors in billing that were paid. Check out these ways to avoid errors on your EOB.

9. Government Programs Can Help Save You Money on Prescription Drugs

Did you know that there are government programs that can help you pay for your prescription drugs, even if you have a pharmacy plan? If your drugs are not on your providers formulary or you have reached your cap for the year, don’t despair. There are programs that can help you. Government Programs For Prescription Drug Assistance

10. How Will Health Reform Affect You?

If you have cancer or are a survivor, you know how important it is to have affordable, quality medical care. One of the reasons that made health care reform necessary is that too many people were getting denied coverage because of a pre-existing condition or the costs to be insured were astronomical. Health care reform affects us all and if you have cancer, it especially affects you. How Will Health Reform Affect You? 


By Lisa Fayed
About.com Cancer Guide
May, 2010