Prestizia Insurance Blog
The battle with cancer now goes well beyond the fight against the disease. Patients may have problems because of the expensive treatments. The costs of treating cancer may not go down anytime soon. In 2014, the average annual treatment for cancer was more than $120,000. It will continue to rise by 7.5 – 10.5% every year until 2020.
Health insurance might help with some of these costs. Understand your insurance policies and other financial help avenues. It could help you cut some of the stress of rising medical bills.
Know the Costs that Insurance Covers
Insurance policies have various coverages. People may get insurance through government programs. These are Medicaid and Medicare and private insurance agencies. There are two basic care models in private insurance. They are PPO or preferred provider organization and HMO or health maintenance organizations.
Most plans provide coverage for essential benefits. These are prescriptions, preventive care, hospitalizations and annual checkups regardless of type. There is a variety of out-of-pocket payments. It has a basis on the individual plans' coinsurance amounts, co-pay, or deductible. There are limits in the network of private insurance. Whenever a patient seeks help from a doctor or specialist outside their network, it may cost more.
Sometimes plans need pre-approval for visits that are out of their network. Patients with the rare cancer mesothelioma might need to travel. It is important for these people to seek help from a specialist. Mesothelioma specialists are all over the country. Finding one within your network can be hard. Patients may need to get extra costs for lodging and travel to get help. They might also pay more for the cancer treatment that is already expensive.
Expenses may increase before the start of the treatment. Seeking a second opinion may lead to higher costs for some patients, but can be worth it if you feel a second opinion is needed. However, many insurance policies will not pay for tests a second time. A diagnostic imaging scan may cost more than $800, so plan ahead.
Keep records of reimbursements, medical bills, and records. Also, include things that the insurance won't cover. It is what the American Cancer Society recommends. It will be great if you keep track of the expenses that have relation to treatment. They are procedures or testing, clinic visits, and travel. Doing this can assist appealing decisions by the insurance company.
Clinical Trials and Insurance
Patients may not be able to see the results they want from standard treatment. They may join a clinical trial. It involves the study of a new treatment.
Clinical trials include two types of costs: research expenses and patient care costs. Patient care costs are hospital stays, doctor visits, and treatment for side effects. It also includes imaging tests or lab work and standard cancer treatment. Insurance covers the clinical trial's routine care expenses if:
1) It is an approved clinical trial. The federal government funds it. The researchers should submit an application for the FDA approval of the drug.
2) The trial does not involve hospitals and doctors that are out of their network.
3) The patient has eligibility for the clinical trial.
Expenses that have relations to the study are research costs. It usually includes the studied drug and imaging tests or lab work for the test. Clinical trials often include extra hospitalizations and doctor's visits. These may not have coverage because it goes beyond the standard treatment. Most of the time, the study's sponsor covers part or the whole research cost.
At Prestizia Insurance we take pride in making sure our clients are well protected at prices they can afford. To learn more about how we can help you, please contact our agency at (855) 436-6353 or Click Here to request a free quote.