For many people, health insurance is a safety net. It provides financial assistance and adequate medical coverage in times of a medical emergency. Yet, for others, a standard health insurance policy just isn’t enough. According to a new report by the Kaiser Family Foundation and the American Cancer Society, even people with health insurance can be overwhelmed with large medical debts for cancer care.

“It’s not necessarily not having insurance — it’s not having adequate insurance.” So says John Seffrin, CEO of the American Cancer Society in a new story published by NPR’s Morning Edition.

via Cancer’s Hidden Costs – ACS CAN.

Based on various studies, the American Cancer Society feels that most health insurance plans are inadequate in the event of a cancer diagnosis. These days, many forms of cancer are being treated like chronic conditions. Cancer treatments – such as MRIs, bone density scans, ultrasounds, and chemotherapy – are administered through a physician’s office, not through the hospital. So, if you have a “catastrophic” health insurance policy – one that just covers hospitalization and surgery, you will not be covered for these necessary treatments.

Cancer Insurance Policies do exist – their sole purpose is to provide benefits only if the policyholder gets cancer. Cancer policies vary greatly in cost and coverage benefits, and there are several common limitations:

• Some cancer policies only cover hospital care.

• Many cancer policies have fixed dollar limits.

• Many policies agree to increase benefits after a patient has been in the hospital for 90 consecutive days. It sounds good in theory, but the average cancer patient only stays in the hospital for 13 days.

• Cancer insurance policies will not cover cancer-related illnesses. Many times the disease or the cancer treatments will lead to other health conditions, such as infection, diabetes, or pneumonia.

• Several cancer policies have time restrictions. For example, some policies require a 30-day (or longer) waiting period before coverage begins, while other cancer policies will discontinue coverage after a fixed amount of time.

• No cancer policy will cover cancer that was diagnosed before you applied for the policy.

Although Cancer Insurance Policies may sound like an added safety net, they often go unused. And event if you are diagnosed with Cancer and your cancer insurance policy is utilized, its limitations can still be quite devastating. Instead of opting for a Cancer Insurance Policy, it is often suggested that you purchase a comprehensive or major medial policy. While these policies will probably cost more than a cancer policy, they will also provide more coverage – which ends up benefiting you more in the long run.

So, in an effort to ensure that everyone has adequate health insurance coverage, NPR enlisted the help of Dr. John Rowe, a health policy professor at Columbia University, and the former head of Aetna Health Insurance. Dr. Rowe provided a few tips on how you can get the most from your health insurance:

• Contact your insurer and ask whether they have any special programs for people with cancer. Some insurers have special arrangements with doctors or hospital groups for low-cost cancer care.

• Obtain a list from your insurer of all the doctors and hospitals that are included in your coverage network. Carry this list with you to every doctor visit. If your doctor refers you to another doctor or specialist, ask him or her to choose one off your list.

• If your health insurance company refuses to pay for your care, try negotiating with the doctor’s office or hospital. The charges may be lowered, and you should be able to set up a monthly payment plan.

• Choose the right health insurance policy in the first place. Although insurance plans with high co-payments or high deductibles may have lower monthly premiums, these plans can be financially devastating for someone diagnosed with cancer. It may be a better idea to pay a higher monthly premium for better coverage. As always, do your research before you buy, and choose the health insurance plan that best fits your needs.

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