Your Supplemental Cancer Insurance Guide
According to the U.S. Centers for Disease Control and Prevention, almost 1.6 million Americans are diagnosed with cancer every year.
Cancer has a significant impact on people living with this disease. Many patients struggle to balance different areas in their lives while they undergo treatment. Many patients endure treatments and surgeries to help them fight the disease. They may also suffer from anxiety, depression and fear after a diagnosis. Additionally, they face the additional burden of handling the expectations and emotional reactions of well-meaning relatives. Another unexpected area that can affect cancer patients is their finances. Since some patients must take off work to recover, it can dramatically affect the income they earn every week. Expensive treatments can also pose a challenge to pay back.
Traditional insurance may not pay for all of these expenses associated with the disease. Many top insurers have developed supplemental cancer insurance policies to help with out-of-pocket costs that cancer patients may incur. In this article, you'll learn about the basics of these supplemental policies.
What Is Cancer?
According to the U.S. government’s National Cancer Institute, scientists define cancer as a collection of diseases that cause cells to divide without stopping.
Cancerous tumors are malignant, meaning they can spread into other tissues and or organs and invade them. These cells can separate and travel into distant areas within the body using the blood or lymphatic system. In these situations, new tumors form away from the original cancer source. Benign tumors differ from malignant ones. Although they can grow large, they don’t spread into nearby tissues. Once surgeons remove benign tumors, they generally don’t grow back, unlike malignant ones. In rare cases, they may become life-threatening when they grow inside the brain. Cancer falls into different cell categories. Here are four common types:
Carcinoma: This cancer is the most common. It is formed by epithelial cells that cover the inside and outer surfaces of the body. It includes adenocarcinomas (breast, colon and prostate); basal cell carcinomas (skin, epidermis); and squamous cell carcinomas (stomach, intestines, lungs and kidneys).
Sarcoma: These cancer cells form in the bone and soft tissues, including muscle, fat, fibrous tissue, blood and lymph vessels. Osteosarcoma is the most prevalent form. Soft-tissue sarcomas include leiomyosarcoma, Kaposi sarcoma, liposarcoma and others.
Leukemia: This cancer starts in the blood-forming tissue of the bone marrow. It does not form solid tumors. Instead, it increases the number of abnormal white blood cells (leukemia cells and leukemic blast cells). The disease builds up in the blood and bone marrow, crowding out normal cells. When normal blood cells decrease, the illness makes it harder for the body to control bleeding, fight infections and get oxygen.
Lymphoma: This cancer begins in the disease-fighting white blood cells called lymphocytes (T cells or B cells). They belong to the body’s immune system. There are two types of lymphoma: Hodgkin Lymphoma, which has abnormal lymphocytes called Reed-Sternberg cells, and Non-Hodgkin Lymphoma that develops from B or T cells.
For a full list of cancer categories, visit the federal government’s National Cancer Institute’s webpage.
Treatments for Cancer Patients
The American Cancer Society is a nonprofit organization that raises awareness about cancer research and treatments. This group recommends that patients should learn about their total costs before starting treatment. Every person’s healthcare regimen will be different. Once you know about your healthcare costs, you can financially plan for them. Patients with cancer generally have to prepare for the following medical expenses:
- Office visits with healthcare providers
- Clinic visits for treatments
- Lab tests (Healthcare facilities submit separate bills for blood and urine screenings.)
- Diagnostic and treatment procedures (These can include charges for rooms, equipment, physicians and more.)
- Imaging tests (These screenings may include X-rays, CT scans, MRIs, radiologist fees, equipment and medicines.)
- Radiation treatments (implants, external radiation, etc.)
- Drug costs (These involve chemo and other medicines that you’ll need to treat your cancer. Some regimens may be inpatient, outpatient, prescription, non-prescription and procedure-related.)
- Hospital stays (These may include costs such as drugs, tests, procedures, nursing care, doctor visits and consultations with specialists)
- Rehabilitation expenses
- Surgery (It includes surgeons, anesthesiologists, pathologists, operating room fees equipment and medicines.)
- Home care (These include equipment, drugs, visits from specially trained nurses, etc.)
- Specialist referrals (other specialist doctors, physical therapy, etc.)
- Transportation costs (train, plane, cab and other forms of travel to the hospital)
- Lodging during treatment (The American Cancer Society may be able to help if you need lodging closer to your treatment.)
Before You Undergo Therapy, Ask About Your Expected Cancer Treatment Costs
Are you scheduled to undergo treatment soon? Speak with your healthcare team to find out how much your treatment will cost. The American Cancer Society recommends asking the following questions:
- How long will I need to be treated, and what is the estimated total cost of my proposed treatment plan?
- For my treatment options, how much will insurance pay, and how much out-of-pocket expenses will I have?
- Does my health insurance need to pre-approve or pre-certify my treatments before I start?
- Is there any way I can obtain financial assistance or get help setting up a payment plan?
- Where will I receive my healthcare treatment? Will it be at home, the doctor’s office, clinic or home?
- If undergoing chemotherapy, how much will my prescription medications cost, and are there patient assistance plans?
- What other prescription drugs will I need for my cancer treatments, including those to prevent pain, nausea, anxiety and diarrhea?
- Does my insurer have to pre-approve or pre-certify any services during my hospital stay?
- How much will rehabilitation or home health care cost after I leave the hospital?
What Are Supplemental Cancer Insurance Policies?
Many cancer patients incur significant financial hardships during their recoveries since healthcare expenses continue to rise at an exponential rate. Their employer insurance plan may require them to pay some out-of-pocket medical costs, including:
- Out-of-network care
- Shared fees
- Private nursing costs
- Traveling to and from medical centers
- Experimental treatments
Health insurance companies have recently created supplemental cancer policies that can help patients pay for some treatment-related expenses. This coverage is supplemental, which means it doesn’t replace the need to buy comprehensive health coverage. If you don’t have traditional health insurance that protects you from catastrophic medical expenses, you should enroll in a plan that will pay for these costs.
Insurers designed supplemental cancer policies pay for expenses that major insurance policies don’t cover, such as travel, lost wages, or other treatment-related costs.
These include the following expenses:
- Co-pays and Deductibles
- Hospital stays/li>
- X-rays and radiation therapy/li>
- Chemotherapy and other therapeutic treatments/li>
- Trips to out-of-network specialists/li>
- Diagnostic exams, treatments, and procedures/li>
- Child care/li>
- Ambulance services, travel, and lodging for treatments/li>
- Prescription drugs/li>
- Mortgage payments/li>
Supplemental policies can also provide employees with additional coverage when employees have high deductible medical plans. It also provides individuals using medical and disability leave with additional income. Please remember that supplemental cancer policies provide support and cannot replace traditional healthcare coverage. Although these policies cover some expenses, they don't cover everything. Some of these policies won't provide ongoing support, especially if you receive a one-time, lump-sum payment. If you don't have enough traditional coverage, you could end up footing the bill for other healthcare expenses.
Who Should Consider Getting a Supplemental Cancer Insurance Policy?
As mentioned earlier, supplemental policies only reduce the out-of-pocket costs of cancer treatment: they do not replace a traditional health insurance policy. If you don’t have a family history of cancer, purchasing these supplemental policies may not make sense for you. People should consider buying cancer insurance if they fall into the following categories:
Persons who have a family history of cancer. For instance, if several family members have had cancer diagnoses, you may consider getting one of these policies.
Individuals who have an elevated risk of developing the disease.
People who don’t have enough savings to pay for medical bills.
Individuals who are their family’s sole wage earner.
Experts recommend shopping for a supplemental cancer policy when you are in good health, rather than when you receive a diagnosis.
Four Types of Supplemental Cancer Insurance
Although these policies can offer some financial relief, not all plans provide the same amount of coverage. There are major differences regarding how they pay for expenses.
Expenses-incurred policies – These plans pay off a percentage of treatment costs up to a maximum dollar amount.
Indemnity policies – These pay for a certain fixed amount for each benefit listed.
First-diagnosis or first-occurrence cancer policy – This insurance provides a single, lump-sum cash benefit to policyholders after their first diagnosis of cancer. These benefits can’t be denied because of a pre-existing condition if the physician diagnoses the illness after the policy takes effect.
Critical illness insurance – These policies cover more than one illness, but also provides a lump sum after a diagnosis. They generally cover conditions that include heart attacks, cancer, and strokes.
How Much Does Cancer Insurance Cost?
Cancer insurance policies can differ in how much they cost. Insurers base them on benefits offered, coverage areas and amounts, and how comprehensive the policy costs. Some cancer policies can cost as low as $19 a month for an individual. When purchasing an insurance plan, remember that it is in addition to the cost of your traditional health insurance plan.
How Cancer Insurance Differs from Health Insurance
As mentioned earlier, supplemental cancer insurance are not comprehensive medical plans. Instead, these policies focus on providing coverage for people that have cancer diagnoses. A cancer insurance plan doesn’t cover non-cancer medical care, such as vaccines or doctor’s appointments.
Not all health insurance plans cover cancer diagnoses, and may not pay for extended hospital stays, prescription drugs and lodging. But if your plan covers your necessities, you may not need to purchase a supplemental cancer insurance plan. Know the terms and conditions of your traditional insurance policy before you sign up for a supplemental cancer policy.
Will I Qualify for Supplemental Cancer Coverage?
Most companies will only insure healthy people for supplemental cancer policies. If you’ve received a recent cancer diagnosis, an insurance company will most likely deny you coverage. They will also turn down applicants that have had cancer within the last ten years.
People who have cancers that are considered minor by insurers may be able to receive coverage. It is completely at the discretion of the insurance company. For more information, contact your local insurance agent to find out if you meet their qualifications for supplemental cancer coverage.
Some providers may also turn down people with other diagnoses that can lead to cancer. These include people recently diagnosed with Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency Syndrome (AIDS), and AIDS-Related Complex.
Some companies won’t insure people who don’t fall into their age requirements for coverage.
Individuals should read the qualifications of each policy before applying for coverage.
Tips When Shopping for a Supplemental Cancer Insurance Policy
When searching for supplemental cancer insurance, read the fine print of your policy to find out what it covers. Some policies have limitations and exclusions for specific diagnoses. For instance, your insurance may not cover certain conditions such as skin or lung cancer.
You can use SmartFinancial's online tool to find out what each supplemental cancer policy covers. Our tool allows you to compare coverage and insurance rates between local insurers. Fill out the form on this page to get started. Here are a few additional tips to keep in mind when shopping for one of these policies.
Never buy a supplemental cancer policy based on emotion - Know what terms and conditions that you must meet before your insurance starts paying off your expenses.
Supplemental cancer insurance may not cover all expenses – Some plans don't cover certain healthcare expenses, such as transportation, home care and rehabilitation. Traditional health insurance generally pays off other costs. Hospitalizations account for 78 percent, and doctor visits and consultations are 13 percent. Professional services, medications, skilled nursing care account for the remainder.
Avoid purchasing duplicate coverage - Before you buy supplemental cancer insurance, make sure that it pays off expenses that basic insurance won’t cover. These providers may claim they'll pay for your expenses no matter what your traditional insurance covers. Some have a coordination of benefits clauses that prohibit duplicate coverage. Speak with an insurance agent to find out what each policy pays off.
The National Association of Insurance Commissioners also advises people to ask themselves three questions when buying policies:
Does my current health insurance adequately cover my medical costs?
How much will treatment cost if I develop cancers?
How likely am I to develop cancer?
Additional Advice to Help Cancer Patient Track Their Medical ExpensesHere are a few tips from the American Cancer Society to handle insurance issues.
Don’t let your traditional health insurance lapse – The American Cancer Society recommends paying your health insurance premiums and other costs in full, because new insurance can be difficult to get. Even after a cancer diagnosis, most patients don’t get a special enrollment period to buy marketplace coverage if you lost it because you didn’t pay your premiums.
If you’re switching health insurance plans, don’t let your former policy lapse before the new one starts. These include when you decide to switch to a federal healthcare plan, such as Medicare.
Speak with your insurance company to ensure that any upcoming medical procedures (surgeries, procedures, or treatments) don’t require prior authorization.Contact a caseworker, hospital financial counselor, or social worker to assist you if you have limited financial
assistance. Businesses or hospitals may help you make special payment arrangements if they know about your situation.
Have a system to document all files and important paperwork – Assign a family member or friend to keep track of your paperwork. It is helpful for people who are single or live alone. Keep copies of all paperwork related to your claims, including letters of medical necessity and explanation of benefits (EOB). Also keep track of expenses related to meals, lodging, prescriptions, and letters to insurance companies. You can also scan these forms and keep them in e-files or use online tracking and other tools. Also identify tax-deductible expenses and keep originals of them.
When you receive bills, send them to your insurer for reimbursement as you receive them. Ask your family or friends to help if you become overwhelmed with handling paperwork. You can also ask your local American Cancer Society branch or government agencies within your state for extra assistance.
Are you searching for a supplemental cancer insurance policy or primary health insurance policy to pay for future treatments? SmartFinancial is a digital insurance comparison engine that provides real-time rates and insurance services in all 50 states. You’ll only need to complete a quick form and we’ll provide you with quotes from local insurance agents in your area. You can compare coverage and rates from multiple vendors in your area. Find supplemental cancer insurance the intelligent and easy way through SmartFinancial.
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If you are healthy and looking for a couple of preventative care checkups a year, you may want to consider a high-deductible health plan or a bronze tier plan. You’ll like the cost.
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It’s always a good idea to get acquainted with the way plans are set up and what you’re responsible to pay before open enrollment which takes place in late fall. If you have a qualifying event, like a new job or if you’ve moved, had a baby, gotten divorced or had any life change that affect your coverage, you may be able to buy a new health insurance plan today.
Like auto and homeowners insurance healthcare insurance also has a deductible which needs to be paid before insurance begins to cover expenses. However, healthcare deductibles work a little differently. For instance, your healthcare insurance will pay for some services even before you meet your deductible.
You may be shopping for health insurance because you got a new job, which doesn’t offer health insurance. Some people even prefer to have a health plan separate from their jobs. It’s usually a more expensive option to buy an individual health insurance policy when an employer offers to pay a portion of your premiums each month. However, some people prefer to choose their own insurance company and a plan that fits their needs.