Navigating the Health Insurance Process for Cancer Patients

Wheelhouse
July 15, 2022
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Unfortunately, when you’re ill you can’t just worry about getting better as you should. There are other stresses in your life that you’ll still have to keep track of as you face the trials associated with cancer treatment. Navigating health insurance can be one of the biggest stressors while receiving treatment. Different individuals will have varying amounts of support from friends and family. Resources vary across the nation for helping people with cancer pay for their treatment.

Understanding the health insurance options available is the first step to taking advantage of these resources if you need help paying for your medical expenses. This article will cover the major kinds of insurance and how they can help someone in your situation.

Finding the Right Kind of Insurance

Now you are facing the costs of cancer treatment, unsure of how you’ll pay for it or what will be covered by your insurance. Discovering this information can be confusing as coverage changes depending on the company you work with and the policy you’re under.

Below are simple explanations of all the major insurance types that are available.

Identifying Private Insurance Options

Private insurance comes in two different care models that you may fall under.

Health Maintenance Organizations

Health maintenance organizations (HMOs) have an agreement with a network of hospitals, doctors, and health clinics where costs can be covered by the insurance agency. As long as the doctor you choose is in this designated network, any appointments should be covered by the HMO.

What you should watch out for with an HMO and looking to get treatment:

Some services may not be covered, be sure to check with your provider if some treatments you’ll be receiving fall under this category
The facilities you receive coverage at may be limited
You may need a doctor referral to get specialist appointments covered
You may need to get HMO approval before getting treatment in some circumstances

Preferred Provider Organizations

This kind of private insurance is slightly different than an HMO. A preferred provider organization (PPO) offers contracts to health care facilities and providers that negotiate a lower service price. A PPO often has more facilities in its network of hospitals, doctors, and services, than HMOs do.

PPOs often follow a co-pay payment method as well. When you receive care, you just have to pay a lower flat fee to the insurance provider. Like HMOs however, there are some things you should be aware of when you use this insurance type while you’re receiving cancer treatment.

You won’t need a referral to see a specialist or doctor
PPOs allow you to get care from non-aligned facilities, however, you may have to pay a larger portion of the care cost
Check to see if your treatments need pre-approval by the insurance agency
Know that not all health services will be covered

Going with Savings Accounts

If you’ve been a forward thinker, you may have invested in an insurance-focused saving account. These special accounts help you prepare for unexpected medical costs and also come with several tax benefits.

If you didn’t directly invest in one of these savings accounts, look over your employee insurance. Your employer might offer this service through a third-party private insurance agency.

Flexible Savings Accounts

Also called FSAs, flexible savings accounts take out a portion of your paycheck (pre-tax) and set it aside for any medical expense you have to directly pay for later.

Each year you can decide on the amount of your paycheck you want to set aside for this fund. However, any funds left in the account at the end of the year expire. This makes it impractical for long-term savings.

Health Savings Accounts

An HSA works similarly to the FSA. The most important difference, however, is that funds added to an HSA will never expire. Whatever capital remaining in the account carries over year after year. This account remains accessible even if you leave the employer that offered this insurance option.

Be aware. Often, only high-deductible insurance agencies offer this kind of account. In essence, this means that before you hit a total deductible amount, you’ll be responsible for all health-related expenses you accrue each year. That is until you hit the deductible amount. After that, the insurance will completely cover the rest of your medical expenses.

Government-Funded Health Insurances

Medicare

If you’re retired, above the age of 65, or already disabled, you may already receive Medicare. There are four levels of Medicare, Parts A-D. Each part offers different coverage, but none will cover all your expenses.

If you already have Medicare and certain parts of your cancer treatment don’t fall under Medicaid assistance it is possible to buy additional private “Medigap” supplemental insurance that will cover these extra costs.

Medicaid

Medicaid is more variable than Medicare, as it’s funded in part by both the federal government and the state, while each Medicaid plan is crafted by each state. If you currently have Medicaid, reach out to your local Public Service Department or a local Medicaid expert to see if it will cover your treatment costs.

If you have more questions about either of these government services, consider exploring the CMS or Medicare websites.

Other Various Kinds of Insurance

Doing more research can open you up to other insurance options that don’t fall within these major categories. These may be great options for cancer patients looking for innovative ways to cover expenses.

Look for long-term care insurance, disability insurance, or even supplemental insurance options to see if they can help you cover your expenses.

Other nonprofits and charitable organizations can help, or at least assist you through this process even if they cannot financially support you directly.

Save the Most on Medical Treatment

After finding the right insurance plan, you can start focusing on feeling better instead of crunching numbers and worrying about money.

While you’re working with an insurance agency, consider other ways that you can save yourself some money while receiving cancer treatments by getting in contact with a tax advisor. Many people don’t know this, but many medical expenses can be deducted from federal income taxes. If insurance does not cover some of your medical expenses, consider deducting these expenses from your taxes instead to save money.