Insurance can be complicated

Health insurance or some kind of health coverage is a key work benefit. Having it eases some of the worry that comes with a major medical problem. Everyone knows that hospitalization, surgery, radiation therapy, chemotherapy, medicines, state-of-the-art equipment and procedures, and a medical professional’s time are all costly. But no health plan covers all the costs of treatment. Very few families know exactly what their insurance or managed care plans provide. Many are surprised to find that, even for a major illness, not everything that’s ordered or prescribed will be approved or paid for by the health insurance plan.

In the effort to control medical costs, insurance companies have rules and guidelines that require hospital admissions, tests, treatment, and specialized care be approved ahead of time. And since health insurance is expensive for employers, they often limit benefits and pass along some of the costs to their employees. Families must be ready to deal with many phone calls, lots of paperwork, ongoing follow-up, and careful record keeping. This is a lot to add to your schedule. And it’s even harder when you are worried about your sick child and all the other problems illness can cause.

There are also new expenses that come with illness. Transportation, a place to stay during treatment, food, and child care for other children in your family are not part of your health plan. A parent may have to take unpaid time off work or give up a job because of treatment schedules. (See our information Family and Medical Leave Act for more about taking time off but keeping your job. You can find it on our Web site or call us to get a copy.) Missed time at work for one or both parents may cause a serious loss of income.

Parents who don’t have health insurance may be even more concerned about how this might affect their child’s treatment. Whether families have insurance or other sources of payment, most families worry about the out-of-pocket costs they will face and how family income may be affected by their child’s illness.