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LIVE YOUR LIFE WITH CANCER - PRACTICAL /// CHAPTER 78
Insurance
Being diagnosed with cancer means a sudden increase in medical bills
that not many of us would be prepared for. Let's start with insurance:
I have insurance:
» Become familiar with your insurance policy. This is easier said
than done. Usually, you can get it online once you log into your
" portal " on the insurance website. Or you can request a copy of
your policy from the company.
» Some insurance plans have helpful navigators or case managers
- definitely find out and use them if available. They can help you
through the processes of obtaining care, prior authorizations or
appealing denied care
Things to find out:
» What is my deductible (the amount I pay out of pocket before
the insurance company starts paying)?
» What is my out of pocket maximum (the maximum amount paid
by you annually before the insurance plan pays at 100%)?
» What are the details of the prescription plan?
» When does my policy end?
» What are the co-pays (upfront costs) for medical appointments,
procedures, surgeries or radiation?
Sometimes insurance covers costs related to treatment that aren't
usually talked about. In some plans, transportation is covered, which
means you may be able to get rides to or from treatment at no cost.
Additionally, Durable Medical Equipment (DME) - like walkers,
wheelchairs or hospital beds may be fully covered by your plan.
Think about plan B. What if you are unable to work and lose your
insurance through work? YOU DO NOT WANT TO HAVE A LAPSE IN
INSURANCE!
» You should be able to pay monthly premiums for COBRA, which
is a health insurance program that allows eligible employees
and their dependents the continued benefits of health insurance
coverage when an employee loses their job or experiences a
reduction of work hours. You are eligible to pay for this for at
least 18, up to 29 months. It's not cheap, but it's much better
than having a lapse in insurance and gives you time to get
another coverage.
» Losing job-based coverage also qualifies you for a Special
Enrollment Period. This means you have 60 days to enroll in
a health plan, even if it's outside the annual Open Enrollment
Period. See " I don't have insurance " below for options.
I don't have insurance:
» If you are low income, you may qualify for Medicaid
- www.medicaid.gov/ . Medicaid is a program
administered at the state level that provides free
or low-cost health coverage to eligible individuals,
such as low-income families, pregnant women, and
individuals receiving Supplemental Security Income.
» A rare few AYAs will qualify for Medicare, which is the
federal insurance program for the elderly OR those
with certain disabilities.
» You may be eligible to purchase a plan through
the healthcare marketplace -
www.healthcare.gov
» If you don't have insurance due to an inability to work,
you may look into applying for disability assistance
through the Social Security Administration. -
www.ssa.gov
* Social Security Disability Insurance (SSDI)
benefits: provides financial help if you/your parent
or spouse have worked long enough and you have
a severe medical condition that prevents you
from working for at least 6-12 months
* Social Security Income (SSI) - SSI provides
financial help to disabled individuals who ALSO
have limited income and assets.
» Most hospitals have some degree of a charity
program. You/your family will have to qualify based
on financial information you must share, but this can
help until you are able to get other coverage.
» Talk to your social worker, but know that they can't
do all this for you - unfortunately you will have to fill
out some forms and make some calls or answer calls
from the insurance or federal offices yourself.
RESOURCES
Triage Cancer
Oncolink
Cancer.org
Livestrong
http://www.medicaid.gov/ http://www.healthcare.gov http://www.ssa.gov https://www.triagecancer.org/ https://www.healthcare.gov/glossary/special-enrollment-period https://www.oncolink.org/support/insurance-legal-employment-financial-concerns/financial-concerns/financial-concerns-during-and-after-cancer-treatment https://www.healthcare.gov/glossary/special-enrollment-period https://www.cancer.org/treatment/finding-and-paying-for-treatment/understanding-health-insurance/managing-health-insurance/managing-health-insurance-when-someone-has-cancer.html https://www.healthcare.gov/glossary/open-enrollment-period https://www.livestrong.org/we-can-help/insurance-and-financial-assistance/health-care-assistance-for-uninsured https://www.healthcare.gov/glossary/open-enrollment-period https://fwaya.org/ https://www.fwaya.org/

What Do I Do Now?

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