Health Insurance

I will start this section with a personal note. In 1995 my husband passed away, abruptly and unexpectedly. That following day his employer told me that as of midnight the night before, I and my son no longer had health insurance coverage through them.. I couldn't afford private insurance at that point. I learned what a very important commodity health insurance is the hard way, during an already rough period in my life. Sadly, the hard lessons are the ones that I never forget.

Not Insured or Underinsured?

To my knowledge, the cost of medical care in the US has never gone down from one year to the next. Health insurance is an important asset. Of course, some people are not able to afford health insurance. So, what do you do if you have just been diagnosed with cancer and you have no health insurance? The first step is to contact the social services department of the hospital or treatment facility that diagnosed your cancer. Be honest about your lack of insurance. Ask them if they can help you with advice on how to proceed.

In the US, there are a few alternatives that you may want to investigate. The first is Medicaid, if you financially qualify. If your income level is over the Medicaid limit, you may still qualify for Medicaid by using a spend down equation (usually the amount of income you receive over and above their income guidelines). To become eligible for Medicaid your allowable medical expenses must be more than your spend down amount. Expenses for medical care that may be considered in this equation include care from hospitals, doctors, clinics, dentists, drugs, medical supplies and equipment, health insurance premiums, transportation to get medical care, personal assistance services, and adult home help services that are related to your medical care. Read more on this here:
--> Medicaid Eligibility

Your second alternative may be Medicare if you are considered to be terminally ill or unable to be gainfully employed for a long period of time. Please apply for Social Security disability benefits as soon as possible. You may qualify for Medicare benefits only after being permanently disabled and receiving Social Security disability for more than 29 months or reaching the age of 65. A little personal advice, when you do qualify for Medicare benefits, it is wise to pay for the additional Part B cost. Part B helps to pay for diagnostic studies, doctor's services, and ambulance transportation. Some states have programs that will assist you with the cost of Part B, if you have a financial need.

A possible third alternative is if you have ever been in active military duty, you may qualify for medical care at a Veteran's facility. Contact the Department of Veteran's Affairs or visit this website:
--> VA Eligibility Requirements

Lastly, some institutions in the United States participate in the Hill-Burton aid program. The income eligibility requirements are usually not as low as Medicaid's. Participating institutions are listed here:
--> Hill-Burton Facilities Obligated to Provide Free or Reduced-Cost Health Care

Insured?

Keep in mind that health insurance companies are in the business to make a profit. You, as a cancer patient, are not helping them reach that goal. If you have insurance or have been able to acquire insurance, you will first want to review your entire health insurance policy, if you are physically able. Being familiar with the limitations and conditions will help you to utilize your insurance coverage effectively and to be prepared with documentation should a submitted bill be denied.

You will also need to keep diligent records of all of your medical bills. You may even want to keep records of all of your doctor's reports. This may help you if you have an insurance dispute. If you believe you are not up to this task, you may want to ask a family member to do this for you. I kept a notebook with all of my surgical, doctor's, and treatment reports. It not only helped me to dispute financial matters with the insurance company, it also helped me when visiting other specialists. You would be surprised how many times my pertinent records did not get forwarded prior to a visit with a specialist. My notebook was always with me and always getting updated.

If your treatment is being done consistently at a particular hospital or facility, you may be able to elicit the help of the social service department of the hospital for help with bill submission or payment. If you are of retirement age, your state or county may have an Office for the Aging or other senior organization that can help. If you need to file a complaint against your health insurance provider, you can get your state commissioner's address here:
--> National Assocation of Insurance Commissioners

For more information and help with insurance information, visit these websites:

Insure Kids Now Program

Health Insurance Consumer's Guide from Georgetown University

Medicare Rights Center

Child Welfare League of America State Medicaid List

List of State Medicaid Directors

Here are a few resources that help with medical expenses for specific situations:

Drug Assistance - List of websites that help with medicine cost.

Bone Marrow Foundation - fills the financial gap transplant patients may experience during treatment.

Leukemia and Lymphoma Society - financial aid to patients in significant financial need.

Operation Smile - provides reconstructive surgery to indigent children/young adults.