Choosing Health Insurance Plans as a Cancer Survivor

Tuesday, October 27, 2015
As a 9-year testicular cancer survivor, I know the value of health insurance coverage and I choose my plan very carefully. When I was diagnosed, I was fortunate to have great health insurance and only had to spend a few hundred dollars out of pocket. Today, a cancer diagnosis can deliver a fatal dose of financial toxicity.

Lack of insurance is one of the greatest barriers to access to healthcare. The good news is that thanks to the Affordable Care Act (ACA or Obama Care), we no longer have to worry about being denied health insurance because of preexisting conditions or that we will lose our coverage because the total cost of our care has reached spending limits.

Open enrollment for the Health Insurance Marketplace begins on November 1st and it’s a time for those who don’t have insurance to get covered and for those that have plans through the marketplace to stay covered.

As a cancer survivor there are two important things I consider when selecting a health insurance plan.

Access to Healthcare

A story from 2014 indicated that only 4 of 19 nationally recognized cancer centers are covered by all of the insurance plans offered in their state.

The 19 hospitals surveyed are all part of the National Comprehensive Cancer Network (NCCN), an alliance of 25 of the top cancer centers in the world. The NCCN creates numerous guidelines that help physicians around the world care for oncology patients but evidently they may not be good enough for your insurance company.

Before signing up I make sure that Dr. Einhorn and Indiana University are on the list of providers. Dr. Einhorn and his team at Indiana University (IU) discovered the cure for testicular cancer over 40 years ago and are considered by many as the top place in the world for testicular cancer. Should I relapse, I want to make sure I can travel to IU to be treated and not have to deal with the delay of insurance appeals to get approval to go out of network.

Affordability

A 2011 report indicated that almost 50% of Americans would have difficulty coming up with $2,000 within 30 days in the event of an emergency, such as a medical condition. If you decide to go with a high deductible plan to save money on your monthly premiums then be sure that you are able to cover the deductible.

If most people can’t afford $2,000, then getting a $6,000 deductible plan may not really be affordable as you have to pay the first $6,000 before your insurance company starts helping pay any potion of your bills.

I look for a plan with a deductible under $1000, even if it costs $100 more a month. Compared to a $6,000 deductible plan this means that should I need treatments I can save $5,000. If I don’t need treatments and I am paying $100 more a month then I will only lose money if I am healthy for 50 months. With my luck, I’m going to break something and need fixing before the next 50 months pass.

External Resources

MJH Associates
American Journal of Managed Care
Cure
MD Magazine
Pharmacy Times
Physicians' Education Resource
Specialty Pharmacy Times
TargetedOnc
OncNurse Resources

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