Health Insurance for Patients With Cancer History

The Affordable Care Act of 2010 will clear many of the barriers between cancer survivors and health insurance by the end of 2014. But before then, patients with a cancer history must thoroughly research the insurance options available to find a health plan that fits their needs. Adults without employer-provided health insurance are the most at risk of being uninsured if their cancer returns.

Group Insurance

• Cancer survivors with access to group health insurance, which is typically provided by an employer, are the most likely to find affordable and comprehensive coverage. Unlike private insurance plans, group plans can temporarily exclude coverage only for a pre-existing condition like cancer. In addition, a patient's cancer must have been treated within the six months prior to his joining the plan to be considered a pre-existing condition.

Private Insurance

• Purchasing a private, individual health insurance plan is challenging for patients with cancer history. In 2014, health insurers will not be allowed to deny consumers coverage because of a pre-existing condition such as cancer. But, until then, most states will allow insurers to do so. Some patients may find an "elimination rider" added to their health insurance contract, which allows the insurer to provide coverage only for treatments unrelated to a specific condition, like cancer.

  Cancer survivors seeking a private insurance plan must thoroughly read their plan contract to ensure that proper coverage is being offered.

Medicare

• If you are older than 65, are disabled and have been receiving Social Security benefits for more than two years, or suffer from permanent kidney failure or amyotrophic lateral sclerosis (ALS), you are eligible for Medicare, which is a public health insurance option funded by the federal government. Medicare's premiums and deductibles are smaller than those of private insurance companies. Also, its more comprehensive coverage options will pay for cancer screenings, intravenous chemotherapy treatments, and other services beneficial to a cancer survivor.

Medicaid

• Another public option is Medicaid, which covers the health costs of low-income patients. Although Medicaid's eligibility requirements and coverage options vary from state to state, it typically covers low-income people who are dependent or disabled. It is possible to be eligible for, and enroll in, both Medicare and Medicaid, with Medicaid covering some or all of a patient's Medicare costs.

  Uninsured women with breast or cervical cancer are eligible for special Medicaid coverage after receiving a free screening from the Center for Disease Control's (CDC's) National Breast and Cervical Cancer Early Protection Program.

Other Options

• When cancer survivors are rejected by health plans and are ineligible for the most popular forms of public assistance, some states offer alternatives. One option is high-risk pools, which cover those deemed too risky by other insurers. Some states may offer help with paying high insurance premiums relating to a patient's cancer history.