What You Need to Know About Your Insurance

It is important to know the details of your health insurance policy before you have a cancer diagnosis, but most people are thinking about cancer benefits until they need them. Here are some questions to consider ...

1) Get a copy of the healthcare policy, not the one or two page summary.

2) Is there a cap on the total annual benefits available. Some policies may limit oncology expenses in a calendar year which may limit your treatment options because of inadequate coverage.

3)Does the plan cap the number of treatments types. For example, if you are capped at 12 radiation visits a year, and since many radiation treatment protocols recommend 30 treatments, you may have to pay out of pocket for the remaining 18 visits.

4) What are the co-payments (flat fee or percentages) for different types of services such as office visits, out patient procedures, radiation, chemotherapy, pharmaceuticals, etc.

5) What is the lifetime cap for benefits? It may be as high as $1 or 2 million or much lower. Once you exceed the cap you are uninsured. If you have a low lifetime cap you may want to explore enrollment in another plan with your employer or spouse.

Adapted from What you Need to Know About Your Insurance Plan

by Nancy Davenport-Ennis, President and CEO, Patient Advocate Foundation and National Patient Advocate Foundation