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.
The
government usually agrees that you
are “disabled” if you have
metastatic breast cancer (breast cancer
that has spread to other parts of the
body). |
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.
Things
To Think About With Viaticals
- Is a viatical
really the best course of action
for you?
- A viatical will
require you to verify your life
expectancy with your doctor.
- Will your Medicaid
or other benefits be affected?
- Shop around: get
several bids to find the best settlement.
- Is the company
a broker? A broker gets commission
from the company and may not act
in your best interest.
- Negotiate: you
might get a better deal.
|
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.
Questions
To Ask About Viaticals
- What will the exact
amount of the settlement be?
- How long will it
take to complete the transaction?
- Will I have to
pay taxes on the settlement? If
so, how much?
- How long do I have
to own the policy prior to considering
a viatical settlement?
- Is the viatical
company licensed? There are few
laws to protect the rights of consumers
against problems with viatical
settlements.
- Will the company
put the full amount of the transaction
in an escrow account until the
transaction is completed?
|
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
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