insurance can be tough, especially during times of stress. However, a
step-by-step plan may help you understand your options and decide what is best
The first step is to understand the
three types of insurance that are most important for people with breast cancer:
health insurance, disability insurance and long-term care insurance.
A health insurance
policy is a legal agreement where an insurer gives coverage for costs related to
medical care for a certain price. Health insurance pays either some or all of
the costs related to medical treatment. It can be bought by a person or an
employer. It can also be provided by the federal or state government, such as
Medicare (for people over age 65) or Medicaid (for people with a low income).
There are three basic types of health insurance:
Each type has pros and cons. If you have a
choice through your employer or you are buying an individual policy, weigh the
pros and cons when making insurance decisions. For example, a fee-for-service
plan gives the most flexibility, but you pay more in terms of time (such as time
spent doing paperwork) and money. With a managed care plan, you pay less, but
you have fewer choices. With the preferred provider organization, you can leave
your options open and balance flexibility and cost each time you make a health
Disability insurance pays part of your income if
you become too sick to work (any job, not just your current one). Most policies
pay about 60 percent of your salary for a certain amount of time.
employers provide disability insurance. You can also buy disability insurance on
your own or add to the disability insurance that your employer provides.
If you are employed, check the details of the coverage provided by your
company. Some people are covered by Social Security disability payments. You can
get an estimate of these payments, which depend on your salary and years of
work, from a local Social Security office. (To find an office near you, visit
the Social Security Administration website.)
If you are buying or choosing disability insurance,
check the following:
insurance covers any help needed if you have a chronic illness or disability and
are unable to care for yourself. You may get this care in a nursing home or in
your own home. Long-term care insurance covers a wide range of services beyond
medical and nursing care, including:
Long-term care is costly. Most long-term care policies are indemnity policies
that pay a fixed amount for each day you get care (ranging from $50 to hundreds
of dollars per day). Daily benefits for at-home care are at the lower end of the
range, while nursing home care is the most expensive.
If you are buying a long-term care
policy, consider the following:
No insurance plan covers all the costs related to
breast cancer treatment. However, some cover more than others. It is important
to find out how much of the cost of your treatment you will need to pay yourself
so that you can plan ahead.
Most hospitals and treatment centers have
financial counselors. They can help you with the details of your insurance
paperwork and give you an estimate of the cost of your treatment.
Financial counselors can also help you work out a payment plan for the costs
you will have to cover. If you are unable to pay, some places may be willing to
reduce or wave the costs if you ask. And, no matter your income, you may qualify
for financial aid from federal, state or local programs. A financial counselor
can help you learn about these programs.
The next step is to
review your current policies to see what coverage you have for each type of
If you work, start by reviewing the coverage given by your
employer. It is a good idea to meet with someone from the human resources
department to go over your questions. If you do not work, you may want to talk
about your insurance options with a hospital social worker or another person
recommended by your health care provider or treatment center. The hospital may
have a financial information office that can offer guidance. You can also talk
to a staff member of your state or local health department.
reviewing your policies, be sure to read the policies themselves and not just
the marketing brochures that describe them. An insurance policy is a legal
contract that describes your rights and responsibilities, as well as those of
the insurer. It deserves the same level of attention as any other legal
The final step in making insurance decisions is
to find out whether there are any gaps in your coverage. If there are gaps, you
may want to consider buying supplemental (extra) insurance or getting help to
obtain the coverage you need.
Facts for Life: Making Treatment Decisions
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