Paying for Healthcare after Childhood Cancer


Healthcare costs a lot and people who have had a serious illness often face many hurdles when trying to find health insurance coverage. Here's what you need to know about getting and keeping health insurance.

How Do I Find Health Insurance?

You should be able to find health insurance, even with your cancer history. Explore the following resources and contact social service organizations (such as the American Cancer Society) or your hospital or clinic social worker if you need help:

  • Check to see if you can get coverage through your parents or spouse.
  • Find out if your college or employer offers health insurance.
  • Get a list of insurance providers in your state through your state insurance office.
  • Call your county department of human services to find out if you qualify for healthcare through state or federal public assistance programs for people with low income or disability (Medicare and Medicaid).

Make sure to complete and follow through with any applications for healthcare insurance. Ask your healthcare provider to write a letter that documents your long-term remission to the insurance company to which you are applying. Milestones of five, seven, and ten years from the end of treatment seem to be important to insurers. If you are denied insurance, make an appeal with letters of support from your healthcare providers.

What Kind of Policy Should I Get?

When looking for healthcare insurance, be sure to think through what you need in a policy. Ask yourself these questions:

  • Do I mainly need a healthcare provider for general check-ups?
  • Do I have chronic health problems that require frequent medical visits?
  • Do I have problems that need to be monitored by a specialist?
  • Am I on expensive prescription drugs?
  • Do I need prosthetic or rehab services?

What Should I Do If I Can't Afford Healthcare Services?

If you can't afford to pay for medical care, talk with your primary care doctor about setting up a payment plan for services. If you need lab work, you might be able to have it done for a lower cost at your county or city health department. If you need to see a specialist or have an expensive test, ask if you can be referred to a doctor or facility that offers discounted rates or payment plans for people who don't have insurance.

Other ways to lower your costs include the following:

  • Look for free or discounted healthcare through health department clinics or church-based programs.
  • Contact the pharmaceutical companies who make your medicines to find out if they provide them at a low cost or for free for people with low incomes.
  • Research services offered by national nonprofit organizations, such as the Lions Club for ocular prostheses.

Once I Have Insurance, What Do I Need to Know About It?

Health insurance policies can be complex and hard to understand. But there are certain things that you need to know to avoid unexpected costs.

Understand Your Coverage Benefits 

If you are unclear about the specifics of your health insurance benefits, ask family members, friends, hospital or clinic insurance managers, or your insurance company's customer representatives to explain them to you.

You should know these facts about your policy:

  • What services are covered
  • What your payment responsibilities are
  • If and how your plan covers prescription drugs
  • If referrals to specialists must be made by your primary care doctor
  • If your coverage is limited by pre-existing condition clause
  • If your coverage is in effect only while you are a full-time student
  • If your coverage ends when you reach a certain age

Avoid Lapses in Coverage 

When you have health insurance it's important to avoid lapses in coverage, which can make it hard to get a new insurance plan. Plan for transitions in health insurance coverage that occur with college graduation and job changes. Two laws, called COBRA and HIPAA, help you keep your insurance benefits.

COBRA (Consolidated Omnibus Budget Reconciliation Act) requires employers or larger businesses to make insurance available for alimited time to employees and their dependents who are fired or laid off.

HIPAA (Health Insurance Portability and Accountability Act) helps people with pre-existing conditions get and keep health insurance when they are changing insurance plans or jobs. Certain conditions apply that may limit the help available to you under HIPAA. Contact your social worker, insurance provider, or state insurance department with questions. Learn more about HIPAA at https://www.cms.gov/hipaageninfo/.

Where Can I Learn More about Paying for Healthcare?

Many cancer groups have created websites that include information and tools for cancer survivors on how to find financial assistance or affordable healthcare. Here are just a few:

 

Childhood Cancer

Medical Information

Research

Coping with Cancer

Get Involved

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