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- Approximately 50 percent of Americans will be diagnosed with cancer in their lifetime
- Most policies will cover at least some cancer costs, but there will always be limitations
- HMO policies will require that treatments be received at pre-approved health institutions that may not specialize in certain treatments
It’s estimated that nearly 50 percent of Americans will be diagnosed with cancer in their lifetimes. Cancer can be extremely costly due to the long duration of the illness and ongoing expensive of treatments.
Insurance coverage varies tremendously in regards to paying for cancer care, leaving many patients with an impossibly high medical bill or reduced access to care.
Some companies provide cancer insurance, but this may not be a viable option for everyone. How do you know if your health insurance will cover cancer treatments?
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Does My Insurance Cover Cancer Treatment?
The good news is that the majority of insurance coverage does not exclude cancer treatment. Most insurance plans will cover medication, chemotherapy, surgery, hospitalization, and diagnostic treatments.
Different types of insurance policies will have different limitations for coverage
Most policies will cover at least some cancer costs, but there will always be limitations. For example, HMO policies will require that treatments be received at pre-approved health institutions that may not specialize in certain treatments.
In other situations, treatments must be proven effective before a health insurance company will pay for them. This means that experimental treatment or new medications may not be covered by insurance, especially under HMO plans.
Another major concern cancer patients face is the maximum benefit provided by the insurance company. Most insurance policies will have either a per-period or lifetime benefit cap, after which point the insured will have to pay.
In addition, once you have been diagnosed with cancer, purchasing additional insurance is extremely difficult, if not impossible. Insurance companies will often refuse to cover a pre-existing condition.
Once the policy has met its lifetime maximum, obtaining additional insurance may be impossible, leaving the patient with huge medical bills that may persist even after his death leaving a financial burden on the family.
Additional Costs from Chronic Illness
In addition to the high cost of care, cancer comes with many additional costs shared by all chronic illness. The patient may be unable to work, which could be devastating if he is the primary income in the household.
Medical costs are compounded by loss of work, leaving many individuals in deep financial trouble or unable to continue receiving the treatments they need.
Some companies such as Aflac provide cancer insurance, which is designed to offset some of the costs of cancer care as well as helping with loss of income due to treatments. Monthly premiums may be expensive and might not be available to all individuals.
Even if you do not have insurance coverage for cancer treatments, there are several things you can do to try and get the help you need. For example, if a specific treatment isn’t covered, there may other types of treatment possible at a lower cost.
If your insurance claim is denied, you can file an appeal through the state department of insurance. Appeals usually favor the patient and one in three appeals is usually granted if the argument behind it is sound.
You can also consider participating in a clinical trial. If you qualify for an experimental medication or procedure, you may be able to receive treatment paid for by the researchers.
By learning what your health insurance covers before a medical condition arises, you can make important choices that will impact you and your family’s future.
Speak with your insurance company about your yearly or lifetime benefit maximum and decide whether cancer insurance or other extended benefits would be a worthwhile investment.
In the event that you are diagnosed with cancer, however, there are many organizations that can help provide you support and make sure that you have as much opportunity as possible to get the care you need.
Good health is a gift. Use our FREE tool to find affordable health insurance in your area today!
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