Health insurance helps cover the cost of the diagnosis and treatment of cancer. In the past, most people in the United States had private, fee-for-service (indemnity) insurance. This meant that a person could go to any doctor or hospital. The insurance company and the patient would each pay part of the bill. Today, more than half of Americans who have health insurance are enrolled in some type of managed care plan, another way of providing and paying for health care services.

For those who are 65 or older, health coverage is offered through Medicare, a federal insurance program. People with Medicare now are offered either managed care or indemnity plans. Medicaid, a joint federal and state health insurance program that is run by the states, covers some low-income people (especially women and children) and disabled people. Each state chooses the type of health plan to offer these people. Veterans may receive benefits through a Veterans Administration (VA) program.

Whatever the type of insurance you have, you will want to get the most that you can from your plan. You will get the best care if you stay informed and know about the benefits, coverage, and limits of your plan. Take charge of your care by asking questions. Be involved in making decisions about your care, and keep track of the care you receive.

What the patient can do

• Get a copy of your health insurance policy and find out what it covers, especially related to your cancer and cancer treatment.
• If you are able to work and have a job with health insurance benefits, consider keeping it until you have a new job with the coverage you need.
• Keep your insurance needs in mind when you look at getting a new job.
• Do not let your health insurance expire.
• If you are unable to work for a time, talk with your employer about ways to keep your health insurance. For instance, the Family and Medical Leave Act (FMLA), paid or unpaid time off, or short-term disability benefits may be helpful.
• Keep careful records of all your health care expenses and claims. If your health insurance requires claims, send them in for all covered costs.
• Get help in filing a claim if you need it.
• Work with your doctor's office staff or billing department to get the most coverage you can.
• Follow up with your insurance company and ask questions about filed claims.
• If a claim is denied, submit it again.
• Keep complete records of all claims submitted, pending, and paid.
• Find out if a case manager has been assigned to you by your insurance company. Get to know this person and keep him informed of what's happening with your treatment. This person can help you through many of the health insurance issues that may come up.
• Consider filing an insurance complaint if you feel you have been treated unfairly.
• Look at all the options for getting health insurance if you do not have it. Options may include joining your state's "high risk" health insurance pool for people who cannot get regular health coverage; using Medicare or Medicaid; getting dependent coverage under your spouse's insurance plan; joining your current company plan; getting coverage through an independent broker; or getting group insurance through an organization you've joined.
• If your cancer care team has a social worker, talk with them about your insurance and job situation.

What caregivers can do

• Help the patient track insurance claims for treatments, drugs, and hospitals. You may need to handle the paperwork during times that the patient is very weak or sick.
• Keep the phone numbers of employer's benefits departments, insurance companies, and claim agents in a handy place. You may want to keep all the insurance information in a notebook or binder.

For more in-depth information on health insurance, see Medical Insurance and Financial Assistance for the Cancer Patient. 

Go back to Caring for the Patient with Cancer at Home: A Guide for Patients and Families.

Last Medical Review: 04/27/2009
Last Revised: 04/27/2009