Health Insurance Guidance & Tips for Survivors
Everyone needs dependable health-insurance coverage, but it’s especially important for cancer survivors. Not only do you need to have health insurance,, it is important that you maintain continuous coverage. A lapse can result in refusal of a new policy to cover pre-existing conditions. You need to understand your insurance policy and know your rights. The current health care reform has changed the way a person can obtain coverage. Because there are so many healthcare reform changes, it is impossible to cover all of them here. A great resource to learn about the new healthcare reform is www.healthcare.gov which outlines many of the provisions passed in legislation. In addition to the current reforms, the following types of health insurance are available to you:
Employer Provided Insurance
Most health insurance provided by employers is a form of managed care. This approach provides healthcare services in the most cost-effective manner. Below are some of the more common managed-care models:
If your employer does not offer healthcare coverage, or if you are self-employed, investigate group health care policies through other organizations, such as labor unions, fraternal organizations, professional or business organizations, student associations, religious groups, or other special-interest groups. The Encyclopedia of Associations, found at most public libraries, includes information on groups that offer insurance coverage. Be sure to investigate any insurance carrier with your state’s regulatory office; as in any industry, beware of fraudulent insurance providers.
State and Federal Programs
In addition, you may qualify for state or federal health insurance. Currently, state and federal laws offer cancer survivors very limited help in obtaining health insurance, but advocates are working toward improving this situation.
Listed below are government-sponsored programs you may qualify for:
The NCCS offers a free discount prescription drug card that also generates donations for the organization. The NCCS card provides users significant discounts on prescription medications at over 57,000 participating pharmacies nationwide and is designed for those who have limited or no prescription drug coverage. Click here to get your free card and find a participating pharmacy near you.
It is important that you check on your current health insurance and investigate that you are receiving the proper coverage based on the current legislation.
Making the Most of Your Health Insurance
Throughout your life you will need to understand the ins and outs of your insurance policy. Here are some specific questions you should be able to answer:
To be an effective advocate for yourself, you should keep the following information for your records:
If your insurance company denies a claim, investigate the reason. Many denials are due to errors. For example, the doctor’s office may have miscoded an item, or the bill may have been sent out late. If you see a problem, contact the provider’s billing office or the insurance company. When the mistake is corrected, the insurance company will reverse its denial.
Understand your insurance coverage and track your appointments, authorizations, communications and EOBs. The paperwork may seem overwhelming, but it’s essential for battling erroneous denials.
If you receive a denial that isn’t the result of a billing error, you may still want to appeal the decision. Make sure you know the insurance company’s time frame for appeal, and take the following steps. If you need help, contact the Patient Advocate Foundation or a similar organization. Steps to take:
If your insurance company persists in issuing what you consider an unjust denial, consider contacting a third party, such as the Patient Advocate Foundation or your state insurance commissioner.
Understanding your health-insurance policy may be a challenge. If you have questions, contact your state insurance commissioner’s office or the U.S. Department of Labor, which regulates health plans offered by many large employers. In addition, you can get a free review of your policy by contacting the Patient Advocate Foundation at 1-800-532-5274.