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How the Health Plan You Have May Determine Your Cancer Treatment

One of the most frightening phrases in the world is “You have cancer.”  The prospect of facing an illness that claims the lives of almost 600,000 Americans each year is terrifying, and even if you survive the initial round as more than 1.1 million do each year, you will live in fear of it returning for the rest of your life. Cancer is more than just your illness; your family will suffer alongside you as you undergo painful treatments.

As if this disease isn’t frightening enough, you must also worry about the financial consequences of battling cancer. In 2014, cancer patients spent $3.9 billion in out-of-pocket expenses on cancer therapies, while the rest of the $88 billion in national cancer treatment expenditure came from private and government insurers.

The expenses incurred during cancer treatment broke down nationally as follows:

  • 58 percent Outpatient or physician office services
  • 27 percent Hospital stays
  • 12 percent Prescribed medications
  • 2 percent Home health services
  • 1 percent ER visits

There are hundreds of types of cancer, each requiring a unique approach for diagnosis and treatment.  There are three primary types of cancer treatment: surgical, radiation, and medication.  Surgery is often used to examine the spread of the cancer or remove cancerous growths and is usually a very expensive form of treatment.  Radiation therapy uses multiple high energy applications over many weeks to retard cancer growth; this therapy is moderately expensive but may be more burdensome for patients with higher deductibles.  Finally, pharmacological therapies like chemotherapy may be extremely expensive as newer medicines may cost thousands of dollars monthly.

In addition to the medical fees, there are almost always a host of secondary fees that make cancer treatment a financial nightmare.  In addition to basic living expenses like special dietary supplies, lodging near a treatment facility and child care, you are likely to experience a drop in income due to reduced work hours or even employment termination. You may also encounter other expenses like legal fees, mental health treatment and home nursing care.

Why Coverage Matters

It is obvious that fighting cancer in America is not a cheap proposition, but what is not as obvious is that the type of health insurance you have often affects the quality of care that you receive and the length of time you are likely to live following your cancer diagnosis. You probably think that as long as you have any kind of health coverage, you are medically and financially protected from the direst cancer scenarios, but you should know that the level of coverage you have influences what kind of treatment you will likely get.

Cancer Treatment

Money shouldn’t be that important when it comes to life and death situations, but hospitals and medical providers must pay attention to the bottom line if they want to continue operating.  Although they aren’t likely to explain that your insurance is insufficient to pay for the new lifesaving drug, your physician may merely recommend a cheaper but less effective therapy instead.

A new article published in JAMA Oncology reveals the relationship between coverage types and survival rates among cancer patients. The study examined more than 1.1 million cancer cases in the California Cancer Registry from 1997 to 2014.  The researchers correlated patients with the type of health insurance—none, public, or private. During this period, survival rates among patients with no or some types of government issued insurance remained unchanged or declined.  However, patients with Medicare experienced an increase in survival rates, almost as high as those with private insurance.

The researchers concluded that although the same type of cancer struck patients with varying levels of health coverage, those with the most robust insurance like Medicare and private insurance were more likely to obtain a higher level of care that would extend their lives.  They then recommended changes in the health care system that would deliver “all the necessary elements of health care” to all cancer patients regardless of coverage status.

This is only one study, but it is indicative of the nature of our health care system. Doctors want to provide the best possible care to their patients, but they are often constrained by the financial situation of patients and provider organizations.  Although providers are not permitted to deny care to those in need, the level of care is within their discretion to control.

How to Protect Your Family

If you want to give yourself and your loved ones the best chance of survival if they should encounter cancer, then you need to take some immediate steps. If your family is going without insurance, but you can afford it, then you should contact a trusted insurance broker like Boost Health Insurance to obtain coverage. Not only can you find private insurance policies, but you may also be able to obtain enormous discounts for policies found on the Obamacare exchanges.

Why Obamacare is Becoming More Popular

If you don’t have insurance due to a lack of income, you may be able to qualify for your state’s Medicaid program. You must meet some income criteria or other eligibility requirements, e.g. disability or pregnancy, depending on your state.  Although Medicaid coverage may not provide all of the benefits of other kinds of insurance, it is considerably better than no coverage at all.

For policyholders with some kind of health insurance already, you should strongly consider a supplemental policy specifically for cancer. If there is a history of certain types of cancer like breast, ovarian, prostate or colorectal in your family, obtaining this kind of supplemental insurance is often a wise precaution. You should also keep in mind that almost 50 percent of all men and 33 percent of all women develop cancer at some point in their lives.

Many cancer supplemental policies not only offer additional financial resources for medical treatment and gaps in your existing policy, but because they award a lump sum of cash, they are extremely valuable for paying for secondary expenses including lodging, travel and basic living expenses.

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