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Health Insurance for Cancer Survivors

 

Many insurance companies refuse coverage for cancer survivors because their preexisting condition is considered a financial risk. HIPAA has brought some relief to working cancer survivors by guaranteeing that insurance companies do not discriminate based on medical conditions, but the available coverage is still not enough for a former cancer patient’s medical needs. Often cancer survivors who are unable to work can apply only for individual types of health insurance plans, which require a physical exam and usually result in higher premiums. Individual insurance plans often include a medical underwriting, which means that an insurance company has the right to review the medical history of the applicant and determine coverage based on that medical history. The insurance company can also charge a higher premium because of preexisting medical conditions.

 

Health Insurance for Cancer Survivors: Group Plans

Group plans are ideal because the premium is often lower, and the coverage is more extensive. A group plan usually consists of an employer and his employees. The employer sometimes pays part of the premium for his employees as well. Insurance obtained through a job is beneficial for a cancer survivor because federal law prohibits insurance companies from refusing coverage based on a preexisting medical condition with a group insurance plan. This limitation applies only to group plans, not individual plans. In the United States, many employers are choosing not to offer group plans, forcing cancer survivors to pursue an individual or high-risk pool insurance plan.

 

Health Insurance for Cancer Survivors: Protection

Cancer survivors who are part of SSDI may also apply for Medicare. This eligibility starts 2 years after remission begins. Cancer survivors in a low-income family can apply for Medicaid as well. COBRA protects policies holders from losing their insurance coverage when their jobs are terminated. The employer must continue offering insurance coverage for an extended period of time.

 

Health Insurance for Cancer Survivors: Harvard Survey

Massachusetts General Hospital and Harvard Medical School conducted a study on the insurance plans of childhood cancer survivors versus those who never had cancer. They discovered that the cancer survivors had considerably smaller plans, higher premiums, and much less coverage. This is the result of the reluctance of insurance companies to cover a policy holder with such a serious preexisting condition.

 

Health Insurance for Cancer Survivors: Preexisting Condition Waiting Period

Although insurance companies are unable to deny coverage for a preexisting condition in a group plan, they can place the policy holder in a waiting period. Often the policy holder is required to wait for up to a year before the insurance company will cover the expenses relating to the preexisting condition, Insurance companies usually require a waiting period because they do not want policy holders to wait until they are sick to seek insurance. During that waiting period the insurance does cover other medical expenses not related to the cancer. If a policy holder had coverage through another insurance plan for 18 months and the lapse between coverage was no more than 63 days, often the insurance company will not require a waiting period before they will offer coverage. After 5 years of remission, the former cancer patient is considered insurable again. After those 5 years, the cancer survivor no longer has to claim a preexisting condition. A policy holder who develops cancer while covered under insurance cannot be cancelled from the plan. Federal law prohibits an insurance company from canceling a policy holder because of a new medical condition.

 

Health Insurance for Cancer Survivors: Options

Some cancer survivors seek out high-risk pool insurance plans. These plans are easier to join, but they also have a much higher premium. Once a cancer survivor has been accepted by an insurance company, he is protected from discrimination by federal law. Some plans such as HMOs, or Health Maintenance Organizations, limit which doctors’ offices and hospitals are covered under the insurance plan, so it is important to review an insurance plan carefully to ensure that the desired doctor and hospital will be covered under the plan. PPOs, or Preferred Provider Organizations, are often more flexible, but they can be more expensive as well. Although insurance plans for cancer survivors are difficult to find, there are several options for a cancer survivor to consider.

 

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