Insurance Issues

We must not, in trying to think about how we can make a big difference, ignore the small daily differences we can make which, over time, add up to big differences that we often cannot foresee.

— Marian Wright Edelman

There are three types of insurance that are important for breast cancer patients: health, disability and life insurance.

Health Insurance

Thinking about the fine print of an insurance policy is probably the last thing you want to worry about when you are going through diagnosis and treatment for breast cancer. However, it is very important to know both how much coverage you have and what is required of you in order to receive full coverage.

First, read your policy before you begin any treatment. Then, read it again. Make sure you understand every word of the policy. Call your insurance company and ask them to explain, in language you can understand, any portions of the policy you don’t understand. Your policy is your contract with the insurance company and will govern what care you get. An insurance company is a business committed to its own interests. You must be just as prepared to represent and protect your own interests.

Example: Does your policy cover the cost of a second opinion, if you want one? Or, does your policy require that you get a second opinion before they will cover the costs of particular treatments?

Health insurance is like car insurance or home insurance. There are different packages and types of coverage. Your plan may not pay for all the health care you need. You must learn the details of your health plan package so that you can plan your budget and know how much you might have to pay.

Health insurance policies can be difficult to understand. Do not hesitate to call your insurance company and have them explain if you don’t understand something. Your doctor or nurse also may be able to help. You might also call your state Department of Insurance. In North Carolina, call 800.JIM.LONG.

I’m not sure what kind of health insurance I have. What kinds are there?
There are three basic types of health insurance coverage: fee for service plans, managed care plans/HMOs and preferred provider plans.

Fee for Service Plans. These plans generally allow the most flexibility in choosing doctors and treatment facilities. However, the insurer reimburses for only a portion of the medical costs. Typically, the insurer pays 80% and the patient pays the other 20% (called “coinsurance”). Also, these types of policies have a deductible—where the patient has to pay a certain amount of the medical costs before the insurance payments begin. In addition, there may be “co-pays”—small amounts to be paid by the patient each time you visit the doctor.

With fee-for-service plans, patients generally coordinate their own medical care and may or may not have to submit their own claim forms for reimbursement.

Managed Care Plans or HMOs. Compared to fee-for-service plans, patients in managed care plans or health maintenance organizations (HMOs) have less flexibility in choosing doctors and treatment facilities. However, they also pay less money for their medical care. All services must be obtained from healthcare providers and facilities that belong to the plan. Most of the plan’s services are covered by the monthly or quarterly premiums that patients pay. Usually the only out-of-pocket expense is a small co-pay for office visits or hospital stays.

In managed care plans or HMOs, medical care is usually coordinated through a primary care doctor, who controls all referrals to specialists. Patients rarely have to submit their own claim forms.

Keep in mind that managed care plans or HMOs are concerned with controlling costs, and a person’s medical care may be affected by this. If you have questions about your care, it may be a good idea to get a second opinion about diagnosis and treatment with a doctor outside of the HMO network, even if this requires paying out-of-pocket for the expense.

Preferred Provider Organization (PPO). This type of plan is a combination of the fee-for-service and managed care plans. In a PPO, patients choose on a per-service basis 1) whether they want to see a healthcare provider from within a limited network and have most of their medical expenses covered (like a managed care plan), or 2) whether they want to see a healthcare provider out of the network and have fewer expenses covered (like a fee-for-service plan).

What type of health insurance is available that is paid for by the government?
There are also two health insurance plans paid for by the government: Medicare and Medicaid.

Medicare is health insurance paid for by the federal government and funded through the Social Security program. It is not just for people over 65 years of age. People are eligible for Medicare if they meet ANY of the following criteria:

• 65 years or older and entitled to Social Security
• Totally disabled and collecting Social Security, regardless of age
• Legally blind
• On renal dialysis, regardless of age

Medicaid is a health insurance program funded jointly by the federal and state governments. To be eligible for Medicaid, people must meet certain low income requirements. The local county Department of Social Services can help determine eligibility and has applications for Medicaid. These requirements differ from state to state.
For more information about health plans, Medicare or Medicaid, see the Resources at the end of this section.

What are some of the differences between group plans and individual plans?
A separate issue from the different types of health insurance listed above is how the plan is purchased—through a group or individually.

Group insurance. Employers are the main source of group insurance coverage, but some other organizations (professional associations, unions, churches, etc.) may also offer group plans. Often, monthly premiums under group plans tend to be lower than for individual plans.

A plus of group plans is that pre-existing conditions may not be taken into account when you enroll. If they are, the group insurer is only allowed to look back at an individual’s health for the six months prior to enrollment in the health plan. If you do have a pre-existing condition, insurance coverage for health care can be “excluded” (meaning that insurance will not cover treatment) for up to 12 months after enrollment. However, it is important to know that any previous, creditable insurance coverage can be used as credit toward the 12-month period.

Individual Insurance. Purchasing insurance as an individual—rather than as a member of a group—often results in higher premiums, but not always. If you can tailor benefits to suit your individual needs, it may be more helpful for you to buy an individual plan.

As with group insurance, there may be limits on coverage based on pre-existing conditions. Insurers are allowed to look back at an individual’s health for the 12 months prior to enrollment in the health plan, and exclude paying for care related to that condition for 12 months after enrollment. However, you can get credit for prior continuous coverage that was not interrupted by a break of 63 or more days in a row.

In general, North Carolina residents are not guaranteed the right to buy an individual health plan. Most insurance companies can decline you if they determine that you are not an “acceptable risk.” Blue Cross and Blue Shield of North Carolina does offer an “open access” plan for people who are not able to purchase insurance anywhere else. However, you may be charged considerably higher premiums because of your health status.

A “high-risk pool” is another type of group plan, available in several states, that sells insurance to people who have serious medical conditions and cannot find an insurance provider to insure them at an affordable rate. Unfortunately, North Carolina is one of the few states that does not have one. However, it is currently under consideraton. You may want to consider asking your state congressperson why North Carolina does not offer a high-risk pool. Share your story and your troubles in obtaining affordable health insurance. It’s one of the only ways to change the situation. Make your voice be heard.

For help with sorting out different health plans and their coverage policies, see the Resources at the end of this section.

If I get sick, can my health insurance be canceled?
In North Carolina, your health insurance cannot be canceled because you get sick. This applies to both group plans and individual plans. Most health insurance is guaranteed renewable. You have this protection provided you pay the premiums, do not defraud the company, and, in the case of managed care plans, continue to live in the plan service area.

However, if you have individual health insurance, when it is time for you to renew your coverage your premiums can increase quite a bit as you age or if your health declines.

Some insurance companies sell temporary health insurance policies, sometimes called Short Term Major Medical. They will only cover you for a limited time, such as six months. These policies are not guaranteed renewable.

Note that health insurance contracts can be canceled within the first two years if the applicant provides incorrect answers to the application questions and the company’s decision to issue the policy was based on the incorrect answers. Always verify that answers and information submitted on any application for insurance are complete and accurate.

If I get breast cancer, do I need to stay in my job to keep my health insurance? Or can I take my health insurance with me?
If you leave your job or lose your job, you may be able to remain in your old group plan for a certain length of time. This is called COBRA continuation coverage (if your employer has 20 or more employees) or state continuation coverage (if your employer has 2-19 employees). You will need to pay the entire cost of the premiums (employer and employee share). COBRA continuation coverage generally lasts 18 months. In addition, if you join a new health plan and the new plan has a waiting period or a pre-existing condition exclusion period (the time during which a health plan will not pay for covered care relating to a pre-existing condition), you can keep whatever COBRA coverage you have left during that period. To qualify for COBRA continuation coverage, you must meet three criteria:

• First, you must work for an employer with 20 or more employees. If you work for an employer with 2-19 employees and your employer offered health benefits, you may qualify for state continuation coverage.
• Second, you must be covered under the employer’s group health plan as an employee or as the spouse or dependent child of an employee.
• Third, you must have a qualifying event that would cause you to lose your group health coverage (such as termination of employment, or reduction in number of hours worked).

Keep in mind that, as a breast cancer survivor, it may be very difficult to obtain affordable coverage after the COBRA period ends, unless you can join another group plan or obtain coverage through a spouse’s group plan.

What can I do if my insurance claim is denied?
Call the insurance company to find out why the claim was denied. In some cases, it may just have been a paperwork error. Sometimes there are differences between what your policy is supposed to cover and what the insurance company offers to cover (sometimes referred to as “policy interpretation”). If you challenge the company’s decision, you will probably be referred to the claims department. If you are not satisfied with the information you are given by a customer service representative, ask to speak with a supervisor or manager.

Write down everything. Do not rely on verbal commitments. If you don’t understand what the insurance company representative said, talk to him or her until you do understand. If possible, get them to write it down. Keep records of what was said, when, and who you talked with. Also, note the claim number and policy and/or procedure code on all correspondence. If necessary, send a confirmation letter describing the verbal communication you had with company representatives, and name them. This paper trail can be important evidence in negotiating with insurance companies.

Identify a “point person” in your insurance company’s customer service department. Try to speak with the same person each time you call. This should help with communication if the person is familiar with your situation.

Check the facts. Review the policy to make sure that pre-certification, authorizations and other procedures required by the insurer are followed.

Ask for a doctor’s help if fees, charges or procedures are questioned. Most healthcare providers and their staff are experienced in working with insurance companies. Ask your doctor to write a letter to the insurance company documenting and/or justifying the charges, and keep a copy for yourself.

Try to negotiate fees with your doctors and healthcare providers. Most insurance policies will cover costs within certain limits (charges they consider “usual and customary”). If your physician charges are higher, you may want to discuss this with your doctor. Some doctors will discount their fees or “forgive” the additional amount that you would otherwise have to pay. If your physician agrees to do this, you may need to make a follow-up call with billing services if you are still charged for the entire bill.

Ask for a formal review of the denied claim. Often, claims that were denied at first are paid in later reviews. If this fails, ask for an appeal of the review with outside oncology experts.

If you need assistance with processing a claim, contact the North Carolina (or your state’s) Department of Insurance. The Department of Insurance can tell you if there are state laws that apply to your case and provide some counseling. See the Resources at the end of this section for contact information.

Find out if your hospital or cancer center has patient representatives. They usually act as patient advocates in case of a dispute with the insurance company. The patient representative can contact your insurance company to challenge or negotiate a denied claim.

If the above steps fail to help with getting reimbursement for a claim that you and your physician think is justified, a final possibility is to contact a lawyer. Choose a lawyer with experience in health care and health insurance.

There are organizations that can help with negotiating claims or with finding a lawyer. See the Resources at the end of this section.

Will I be able to get health insurance after a breast cancer diagnosis?
While dealing with insurance companies during treatment for breast cancer is stressful enough, you may need to be prepared for the challenge of obtaining health insurance coverage after treatment has been completed. It can be very difficult to find affordable health insurance after you have been diagnosed with a serious medical condition such as breast cancer.

If you currently have a health insurance plan that is meeting your needs, if at all possible try to stay with this plan. Your policy cannot be canceled if you become sick. However, if you have an individually-purchased health plan, your premiums can be increased when you renew coverage. This is not true for group plans—your premiums can not be increased due to your health status.

If you change jobs and work for a company that does not offer health insurance benefits, or if you become unemployed, your challenge is magnified. You are faced with the need to obtain health insurance coverage as well as the financial burden of paying for it yourself. You should be able to obtain COBRA or state continuation coverage for 18 months after you end your job, if your previous job offered group health benefits. Do not wait until the COBRA or state continuation coverage expires to begin your search for alternative coverage.
Your best bet for finding new health insurance coverage is to try to get in a group health plan through an employer, obtain coverage through a spouse’s group plan, or look into group insurance options through professional, fraternal or political organizations.

If you are self-employed, or plan to be, consider getting health insurance coverage through a “small employer group plan.” Insurers must offer group plans to small employers who have 2 to 50 employees. Some insurance companies offer these plans to self-employed people who have no employees. Self-employed individuals do not have access to all plans, but they must be offered two standardized plans established by North Carolina law (Standard and Basic health plans) regardless of their health status.

When applying as a small employer or self-employed person, be prepared to show tax forms and business documents indicating this status. Unfortunately, health insurance companies can still base the cost of the plan on the health status of the self-employed person or small employer group. However, state law (North Carolina’s Small Employer Group Health Coverage Reform Act) establishes limits on how much insurers can vary premiums from one small employer to another.

What if I don’t have health insurance and can’t afford to pay for it?
If you can’t afford health insurance, and aren’t able to join a group health plan where the premiums will be paid by the employer, look for free or low-cost health care services. There are several programs to help with diagnosis, treatment, medications, and other breast cancer-related services in North Carolina. See Financial and Other Assistance.

If you meet certain low-income guidelines, you may be eligible for Medicaid. See your local county Department of Social Services for guidelines or check the Resources at the end of this section.

If you are disabled due to your breast cancer and are unable to maintain employment, you may be eligible for Social Security Disability (SSD) or Supplemental Security Income (SSI).

Disability Insurance

You become eligible for disability when you cannot continue to work at your job because of illness or injury. If you have disability insurance, you may be able to receive cash benefits during your period of disability. If you do not have disability insurance, you may be eligible for a government disability program.

How does disability insurance work?
Disability insurance replaces a portion of your income if you are too sick or injured to continue working in your job. Disability insurance can be offered through a group plan or individual policy. To qualify for benefits, the insured person must meet the policy’s definition of disability. Some policies only cover disabilities from accidental injury, not from sickness. Read your policy carefully.

The disability insurance policy may have an “elimination” or “waiting” period following the beginning of disability, where benefits are not payable. In addition, the policy may deny coverage for claims due to pre-existing conditions.

A policy may state that an Own Occupation disability provides benefits when an insured is unable to perform the usual and customary duties of their own occupation. However, some policies have an Any Occupation definition, where an insured person is eligible for benefits when they cannot perform the duties of any occupation for which they have education and training. Long-term policies (benefits for more than a year or two) often use this definition. It can be considerably more difficult to qualify for benefits under an “any occupation” definition instead of an “own occupation” definition.

For more information about disability insurance, see the Resources at the end of this section.
What can I do if I’m disabled and don’t have disability insurance?

If you are disabled, and your disability will last six months or more, you may be eligible to get disability benefits through the federal government. There are two programs available: Social Security Disability Insurance (SSD; also called SSDI) and Supplemental Security Income (SSI).

When you apply for either program, you will need to provide medical and other information and meet Social Security’s definition of disability. Generally, it takes between 90 to 120 days to process claims for disability benefits. You can shorten the process by having the required information ready when you apply. Regardless, get the application in as soon as possible after you become disabled. If you are rejected, appeal the decision.

Important to Know: It is not uncommon to be rejected for SSD or SSI the first time around, and for 2-3 subsequent appeals. Your appeal may then go to a hearing before a judge, where it is more likely to be approved. It can take a year or more from the time you submit an application to be approved, if you are approved at all. The following may help your case:

• Write a letter to your congressman or congresswoman or Senator in your state.
• Get letters from your doctors stating your condition and prognosis. Keep track of your doctors’ appointments and any visits to the emergency room.
• Get copies of all your tests and lab work.

Social Security Disability (SSD) pays benefits to you and certain members of your family if you have earned a certain amount of money in the past 10 years and had Social Security taken out of your paycheck (for people younger than 31, less is required). You must also meet a strict definition of disability. After two years on SSD, you are eligible for Medicare.

Supplemental Security Income (SSI) pays benefits based on financial need. No work history is required but you must have a low income and low resources. The program is designed to help aged, blind and disabled people who have little or no income. If you get SSI, you usually get food stamps and Medicaid too.

See the Resources at the end of this section for where to find more information about SSD and SSI.

Material for the above sections was adapted in part from educational publications and fact sheets about health insurance from the Susan G. Komen Breast Cancer Foundation, Y-ME National Breast Cancer Organization, the Georgetown University Institute for Healthcare Research and Policy, the U.S. Department of Labor, the North Carolina Department of Insurance, Social Security Online, Breast Cancer Action, the National Breast Cancer Coalition, and CancerCare, Inc.

LIFE INSURANCE

After a cancer diagnosis, there are two issues you may want to consider regarding life insurance: whether you should “cash in your policy” and whether you will be able to obtain a policy should you desire one in the future.
What is meant by “cashing in a life insurance policy”?

If you have a terminal illness, you may be able to gain living benefits (see below) from your life insurance policy by selling the policy (called a viatical) or by taking out a loan against the face value of the policy. Viatical settlements are regulated by state Insurance Departments, and requirements will differ from state to state. Not all types of insurance policies can be sold or borrowed against. Most types of life insurance policies can qualify. The most common are Universal Life, Whole Life, and convertible Term Life. Other Term Life Insurance policies may not qualify. Call your state Department of Insurance (in North Carolina, 800.JIM.LONG) if you’re not sure what your policy is or if your policy qualifies.

What are “Living Benefits”?
Living Benefits enable a person diagnosed with a terminal illness to obtain money from life insurance while they are still living. Three options available include: viaticals, advances on insurance policies and loans from a third party.

Viaticals. A viatical is the sale of a life insurance policy for cash, providing money for a person living with a terminal illness. The payment is often 60-80 percent of the face value of the policy. The payment belongs to the insured person to use in any way as he or she sees fit. The viatical is accomplished by applying to a viatical settlement company.

Reasons to choose a viatical: To pay for pressing needs, medical or otherwise.

Reasons not to choose a viatical: Your heirs will receive no insurance money; once a policy is sold, it is usually not reversible.

Advances on Insurance Policies. Instead of selling the policy to an unrelated company, you might be able to get more money from your life insurance company. An advance on an insurance policy (accelerated death benefit) is an agreement between an insured person with limited life expectancy and his or her life insurance company. The company advances up to one-half the face amount of the policy for use during the remainder of the insured’s life. The balance of the policy is payable to the people receiving policy benefits after the insured’s death. There are restrictions on the dollar amount. Proof of a terminal prognosis (six months to a year) and other information are required.

Loan from a third party. Some lending companies will loan money to terminally-ill people, and the life insurance policy is used as collateral. The company will loan a portion of the policy’s face value, which is paid back at the time of the patient’s death from the proceed from the policy. Any surplus funds go to the original beneficiary. The interest rates on the loan vary from between 13 to 18 percent. There are no restrictions on how the money may be used.

Before making any of the decisions listed above, you may want to talk to a lawyer, a financial planner and/or your state Department of Insurance. Make sure the lawyer is experienced in life insurance work. See the Resources for help finding one.

Will I be able to get a life insurance policy after a cancer diagnosis?
Many insurance companies charge very high rates for breast cancer survivors. Check around for policies with favorable rates. One option is for you or your spouse to work for a large organization that offers group life insurance, where there may be less restrictions on who is accepted.

Another idea is to purchase an annuity. The monies earned can be used in the same way you would use a life insurance policy. Talk to a financial planner. Consider hiring one who charges by the hour, rather than by commission; they may give the most unbiased advice as to which companies have the best annuities.

RESOURCES

Organizations

Alliance of Claims Assistance Professionals
877.275.8765 (toll-free)
www.claims.org
Offers assistance in getting insurers to pay for experimental treatments, as well as other reimbursement and billing problems.

American Association of Retired Persons (AARP)
800.424.3410
www.aarp.org
North Carolina Chapter:
919.755.9757 or 800.523.5800
www.aarp.org/statepages/nc.html
A resource for people having problems with health insurance companies and for help navigating the health care system. Provides free publications for those over age 50 and caregivers.

Centers for Medicare and Medicaid
877.267.2323 (toll-free) or 866.226.1819 (TTY)
http://cms.hhs.gov
The U.S. government agency that administers the Medicare and Medicaid programs. Has information about who is eligible and what plans cover. For more Medicare information, call 800.444.4606 or see www.medicare.gov. For more Medicaid information in North Carolina, call 800.662.7030 or see www.dhhs.state.nc.us/dma.

Health Insurance Association of America (HIAA)
202.824.1600
www.hiaa.org
A trade association that serves as the voice of health insurance. Publishes consumer guides to disability, health, long-term care and Medicare Supplement insurance.

National Breast Cancer Coalition/Fund
202.296.7477 or 800.622.2838
www.stopbreastcancer.org
The nation’s largest breast cancer advocacy group. Offers the excellent “Guide to Quality Breast Cancer Care” free through 866.624.5307 or www.stopbreastcancer.org/nbccf. The Guide has helpful information on health insurance and finding affordable care.

National Coalition for Cancer Survivorship
877.NCCS.YES (877.622.7937)
www.canceradvocacy.org
Publishes “What Cancer Survivors Need to Know about Health Insurance” booklet that provides a clear understanding of health insurance and how to receive maximum reimbursement on claims.

National Insurance Consumer Helpline
800.942.4242
A general information source for all types of insurance-related issues, including life and health insurance.

National Partnership for Women and Families
202.986.2600
www.nationalpartnership.org
Formerly Women’s Legal Defense Fund, this organization has guides to health insurance, health care, and laws and bills affecting health insurance and health care.

North Carolina Bar Association (Raleigh, NC)
919.677.0561 or 800.662.7660
www.ncbar.org
Offers the North Carolina Lawyer Referral Service for help finding a lawyer. The NC Bar can also help with finding a pro bono (free or reduced cost) attorney and has Spanish language services.

North Carolina Department of Insurance (Raleigh, NC)
919.733.2032 or 800.JIM.LONG (800.546.5664)
www.ncdoi.com
Has consumer guides and other information about insurance (health, life, disability, cancer, and more) and insurance claims. You can request an external review for insurance claims purposes or file a complaint online.

Patient Advocacy Coalition
303.744.7667
http://medicalreporter.health.org/tmr0497/PAC.HTM
Focuses on assisting people in the appeals process when an insurance company has denied coverage for medical treatments. Provides free advice and support on how to present a comprehensive and compelling case.

Patient Advocate Foundation (PAF)
800.532.5274
www.patientadvocate.org
This organization serves as an active liaison between the patient and their insurer, employer and/or creditors to help with insurance issues, job discrimination or debt crisis matters relative to their diagnosis. Also has a Managed Care Answer Guide and a guide to the appeals process.

Questions Women With Breast Cancer Frequently Ask About Health Insurance Benefits
www.hopkinsmedicine.org/breastcenter/treatment/choice/questions.htm
Helpful information about health insurance coverage questions for women with breast cancer, including about reconstruction.

Seniors’ Health Insurance Information Program (SHIIP)
800.443.9354
www.ncshiip.com/Consumer/Shiip/ShiipWhat.asp
A program of the NC Department of Insurance. Answers questions and counsels senior citizens about Medicare, Medicare supplements, long-term care insurance and other health insurance concerns. Has a comparison of Medicare supplement plans.

U.S. Department of Labor
866.4.USA.DOL (toll-free)
www.dol.gov/dol/topic/health-plans/index.htm
The U.S. Department of Labor has fact sheets about COBRA, women’s health and cancer rights protections, health plans and health benefits.

U.S. Social Security Administration, Disability Programs
800.772.1213
www.ssa.gov/disability
Administers the SSD and SSI government disability programs. Call to learn more about the programs or to apply. You can also apply online.

Viatical and Life Settlement Association of America
202.367.1136 or 800.842.9811
www.viatical.org
Information and news about viaticals.

Books and More

A Cancer Survivor’s Almanac: Charting Your Journey, Barbara Hoffman, JD, Ed. (1998). Has information about health insurance, disability, employment rights, and legal, financial and survivorship issues. Contact National Coalition for Cancer Survivorship, 877.NCCS.YES or see www.canceradvocacy.org.

Be Prepared: The Complete Financial, Legal, and Practical Guide for Living with a Life-Challenging Condition, by David S. Landay (2000). This book, written by an attorney with experience in cancer matters, offers information about health and life insurance, disability, job issues, financial and end-of-life planning.

Health Care Meltdown: Confronting the Myths and Fixing Our Failing System, by Bob LeBow, MD, MPH (2002). Written by a physician who cares for patients excluded from the health care system, this book proposes a solution so every American can get the health care he or she needs.

Web Sites

CancerCare
www.cancercareinc.org/campaigns/advocacy1.htm
Has an online guide to health insurance and financial issues.

A Consumer Guide to Getting and Keeping Health Insurance
www.healthinsuranceinfo.net
Consumer information guides available for each state.

Insurance, from the Y-ME National Breast Cancer Organization
www.y-me.org/diagnosed/insurance.php
This page offers useful advice about dealing with health insurance after a diagnosis.

Insurance Issues, from the Susan G. Komen Breast Cancer Foundation
www.komen.org
Click on “About Breast Cancer,” then “Treatment” on left, then “Insurance and Other Financial Issues.” Provides information about health, disability and long-term care insurance.

Medicare Rights Center
www.medicarerights.org
Provides free counseling services to people with Medicare questions or problems and provides telephone hotline services to individuals who need answers to Medicare questions or help securing coverage and getting the health care they need.

North Carolina Consumer’s Guide to Health Plan Selection
www.nciom.org/hmoconguide
From the North Carolina Institute of Medicine. Helps consumers select a health insurance plan. Focuses on HMOs.

Viatical Settlements: A Guide for People with Terminal Illnesses (FTC)
www.viaticals.us
This Guide was published online by the Federal Trade Commission but is no longer available from the FTC Website. It is presented as a public service to those seeking unbiased information in making a decision whether to enter into a viatical settlement. Has information, resources and a consumer’s guide to viatical settlements