Cancer Insurance

Cancer Insurance

It is a shocking, yet accurate statistic that 1 in 2 men, and 1 in 3 of all women will get cancer at some point in their lives. You can be proactive about preventing cancer through healthy eating, exercise, and other lifestyle changes. However, sometimes cancer simply comes down to genetics and other unpredictable factors. Do you have the right cancer insurance?

Unfortunately, if you are diagnosed with cancer, the likelihood that your health care insurance will cover all of your needs is quite low. According to the American Cancer Society, 65 percent of all cancer-related costs will not be covered by your insurance. Fortunately, there is a way to combat the high costs of cancer treatments.

Cancer insurance is supplemental health care coverage which can be added to a comprehensive plan that you already have. In many ways, it’s a form of “income protection”.

Who should by cancer insurance?

You may want to consider purchasing supplemental insurance if you have the following risk factors:

  • You have a family history of cancer

  • You don’t have enough money in the bank to cover the medical bills that a regular medical plan won’t pay for

  • You are the sole wage earner in your household

  • You want to protect your family’s future financial assets

Steps to Coverage

  1. Chose a plan. There are three different types of cancer insurance:

a. Expense-incurred policy: this plan pays a certain percentage of your cancer treatment expenses, up to a certain pre-determined amount.

b. Indemnity policy: this plan assigns certain dollar amounts to each cancer treatment that you may undergo. This amount is not related to the actual expense of the treatment.

c. First occurrence policy: if you get diagnosed with cancer, this plan pays you a pre-determined sum of money. You won’t be denied this coverage if you have any pre-existing conditions, but you may have to wait longer to get your payment.

  1. If you’d like to add a cancer supplemental insurance to your existing health plan, keep in mind that once you purchase the policy, it takes 30 to 60 days before it becomes valid. If you get diagnosed with cancer before this period is complete, you will not be covered. Additionally, if you do not have cancer, but have certain risk factors, you may be rejected.

 

Advantages

Depending upon the cancer insurance coverage you chose, there may be many different benefits at your disposal. The following is an example list of these advantages from Cancer Insurance Info:

 

First Occurrence Benefit:

This benefit is paid when a covered person is diagnosed for the first time as having cancer, other than skin cancer. Payable only once for each covered person.

Coverage Limits Vary:
$1,000 to $5,000

Hospital Confinement Benefit

When confined to a hospital for treatment of cancer as an inpatient

Daily Benefits Paid:
$250 to $450

Attending Doctor or Surgeon

Pays charges up to the amount shown each visit for the services of an attending doctor or surgeon while a covered person is an inpatient receiving cancer treatment, up to 90 days.

Daily Benefits Paid:
$15 per day to $40

Drugs and Medicine Benefit

Pays charges made by the hospital for drugs and medicine while hospital confined, up to the amount shown for each continuous confinement.

Coverage Varies From:
$15 a day to $250 per confinement

Private Nursing

While a covered person is an inpatient receiving cancer treatment and they require the full time services of a Private nurse – Must be authorized by doctor

Daily Benefits Can Run:
$100 to $150

Transportation

Most cancer companies will pay the charges for the lowest unrestricted published coach class plan, train or bus fare or the amount shown each mile for travel by car (up to 1,000 miles each way) if a covered person must travel more than 100 miles one way from home to receive covered cancer treatments or to receive consultation (once a year) about his or her cancer at a Comprehensive or Clinical/Cancer Care Center (as defined by the National Cancer Institute)

Amounts Vary From:
Coach fare or $.20 to $.50 per mile

Ambulance

Payment for charges for each continuous hospital confinement for transportation of the covered person by a licensed air or surface ambulance service to or from a hospital in which the covered person is confined for treatment of cancer.

Amounts Vary From:
$150 to $250

Family Member Transportation

If a covered person is an inpatient in a hospital more than 100 miles from home for covered cancer treatment prescribed by a doctor not available within 100 miles from home, we pay charges of the lowest unrestricted published coach class plane, train or bus fare or the amount shown each mile for travel by car (up to 1000 miles each way) for a family member to accompany the covered person. This benefit is limited to two one-way trips for each period of continuous hospital confinement. This benefit will not be paid if a mileage benefit is paid for the covered person and the family member lives in the same city as the covered person.

Coverage Varies:
Coach Fare or $.20 to $.30 per mile

Family Member Lodging

If a covered person is hospitalized as an inpatient more than 100 miles from home for covered cancer treatment not available within 100 miles of home, we will pay charges for lodging of a family member who accompanies the covered person up to the amount shown each day for up to 60 days for each continuous hospital confinement.

Lodging Benefits Range:
$40 per day to $60

Radiation and Chemotherapy

The charges per day, up to the amount shown, for radiation therapy or chemotherapy treatments received by covered person as part of cancer treatment. This benefit is only payable for days that radiation therapy or chemotherapy treatment is actually received for cancer treatment.

Daily Benefits:
$200 to $300

Comfort and Anti-nausea Medicine

Charges up to the amount shown each year for prescribed anti-nausea medication in conjunction with cancer treatment. This benefit is only payable for days that radiation therapy or chemotherapy treatment is actually received for cancer treatment.

Not Available on All Plans:
$200 per year

Waiver of Premium

If the covered person becomes disabled due to cancer first diagnosed after the waiting period and remains disabled for 90 consecutive days, the company pays the premium that becomes due for the policy and any attached optional benefits after 90 days, for as long as the covered person remains disabled.

Not Available on All Plans

Mammography

Annual mammogram benefit paid once per calendar year.

Amounts Vary:
$70 to $200

Cervical Cancer Test/Pap

Annual pap test benefit paid once per calendar year.

Amounts Vary:
$30 to $200

Cancer Screenings and Wellness Benefits

One of these tests paid per year – see list of wellness exams

$50 to $100

Extended Care Benefits

Daily benefits paid for nursing facility, hospice and home care recovery

Amounts Vary:
From
$15 to $150 for each covered event.

Inpatient Surgical Benefits

Benefits paid for surgery due to the diagnoses or as treatment of cancer.

Varies per Procedure:
$6000 to $10,000

Outpatient Hospital Surgical Benefit

Surgeries performed on an outpatient occurence

Benefits Vary on Plans:
$0 to $300

Anesthesia

Based on procedure provided

From $100 to $5000
or
a percentage of surgery cost

Second Surgical Opinion

Charges paid for an independent second opinion in conjunction with a surgery for cancer treatment (other than skin cancer) up to the amount shown. This second opinion must be rendered prior to surgery being performed and obtained from a doctor not in practice with or otherwise affiliated with the doctor giving the original recommendation

Varies From:
$200 to $300

Prosthesis and Reconstructive Breast Surgery

Will pay for one of the following benefits whose procedure provides you the greatest benefit: 1. charges up to the amount shown for a surgically implanted prosthesis, prescribed by a doctor as direct result of cancer surgery or cancer treatment: 2. charges up to the amount shown for non-surgically implanted prosthesis, prescribed by a doctor as a direct result of cancer surgery or cancer treatment; 3. reconstructive breast surgery, the cost of such surgery up to amount shown. We will pay the reconstructive breast surgery benefit only once for each covered person diagnosis of cancer.

Depending on the Procedure: $250 to $5000

Optional Intensive Care Unit Rider

Daily benefit paid to you for any accident and/or illness. Plus the cost of the ambulance ride

Not Available with All Companies:
$200 per day to $800

Bone Marrow Transplants

Different Treatments covered: 1. transplant for cancer treatment other than a non-autologous (donor to patient) transplant. 2. non-autologous (donor to patient) transplant for cancer treatment, other than leukemia. 3. non autologous bone marrow transplant for cancer treatment for leukemia. Each benefit is payable only once for each covered person.

Range of Payments:
$2,500 to $10,000

Blood, Plasma and Platelets

Daily benefit paid for blood, plasma and platelets received by a covered person in conjuction with cancer treatment.

$100 to $150 per day

Experimental Treatment Benefit

There are some experimental treatments covered – refer to plan

Not Available With All Companies:
$100 to $300 per day

Skin Cancer Surgery

Surgical operation is performed for diagnosed skin cancer

Coverage Varies:
$100 to $600

 

Disadvantages

All forms of cancer insurance have limitations. If you need to pay for all treatments, prescriptions, hospital stays, surgeries, in-home care, or lost wages incurred, it won’t be completely covered, no matter the policy. The following is a list of issues to be aware of:

  • Some cancer insurance plans only cover treatments done in the hospital, although some out-patient treatments may be covered as well.

  • Your plan may have a maximum number of days you can remain in the hospital and be still covered.

  • Other plans have fixed maximum dollar amounts for hospital stays, such as $200 per day of coverage, up to $4,000.

  • Your cancer treatments may cause your immune system to weaken, making you more vulnerable to other illnesses. These illnesses will not be covered under your cancer insurance.

  • Not all types of cancer are covered and vary based on the policy you select.

  • Cancer insurance premiums are tied to your age, health history, etc.

  • Your monthly premium price may fluctuate over time.

  • Unlike your major medical insurance which pays the hospital or clinic directly for services you needed, your cancer insurance will pay you (and then you’ll need to pay the hospital).

  • Your cancer insurance is supplemental, so the benefits will remain inactive until your major medical plan has reached its maximum limit.

FAQs

The website, eSupplemental, provides the following list of commonly asked questions.

Q: I currently have cancer, or have had cancer in the past. Can I be covered?

A: Unless you had mild skin cancer, or have been diagnosed more than 5 years ago, then you probably won’t be able to purchase cancer insurance.

 

Q: What if I’m a smoker?

A: You can most likely get coverage, but your monthly premiums will be higher.

 

Q: Does age matter?

A: No, most cancer insurance policies will allow those between the ages of 18 to 85 to purchase a plan.

 

Q: Are there lump sum policies that will pay large benefits upfront?

A: Yes, but you’ll need to speak to your individual insurance agent to find the type of policy that best fits your needs.

 

Q: If I already have another health insurance plan, will this hinder my ability to purchase cancer insurance?

A: No. Cancer insurance is a supplemental plan that works in collaboration with your previously existing plan.

 

When considering a plan, read through the Cancer Insurance Checklist, designed in collaboration with many cancer societies and health insurance companies. You can use the checklist either before or after you have been diagnosed with cancer, if you are re-evaluating your insurance needs, or before speaking with your health care provider.

 

Resources

Speak with your doctor and your employer’s health benefits coordinator before purchasing a cancer insurance plan. They will be able to provide you with more details regarding your own health and a better understanding of your current health benefits.

When dealing with insurance providers (and this is true for all health insurance plans), always keep the following documents as records for your own benefit:

  1. Medical bills

  2. Claims filed

  3. Reimbursement and Explanation of Benefits forms

  4. Names, dates, and record of all contact with insurance providers and medical personnel

  5. Outstanding medical costs

  6. Travel expenses

  7. Phone expenses related to medical care

  8. All clinic visits, tests, treatments, and procedures done

  9. Drugs given and prescriptions filled

Visit healthcare.gov or call 1-800-318-2596 if you have any other questions.

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What Do I Need to Know about Insurance When I Retire

Enhanced Insurance is not written by attorneys. If you’re looking for legal advice, you need to contact a lawyer. Further, insurance practices and forms change constantly and are varied from state to state. For definitive answers in your area, contact a local agent.

While the majority of people want an agent involved in their purchase of insurance, many people want to see if they can save money by buying direct from the insurance company. Others want to try a direct quote to make sure the premium they’re now paying through their local agent is fair. If you want a quote for your coverage, click on the competitive quote button on the right side of this page.