Insurance can be a lifesaver when it comes to uncontrollable life challenges. It covers almost every sector of society regardless of the cost and effect. Mesothelioma cancer is rare cancer that makes it a lot difficult to treat. Also, the cost of treatment can be considered to be quite expensive.
so, we will be talking about Insurance for Mesothelioma Cancer, what it covers, its types, and other frequently asked questions about this topic.
What is Insurance?
Insurance is a contract whereby one party undertakes to indemnify or guarantee another against loss by a specified contingency or peril. These contracts are carefully put in place mostly to help the needy and those whose losses are insurmountable.
Categorically, there are different types, furthermore, it can be a bit tricky. You will have to look out for the right Insurance policy that suits you best. The different types of insurance include;
- Life insurance
- Travel Insurance
The above-listed types are the major type of insurance. In addition, there are other subtypes but in this blog post, we will be looking at health insurance relating to Mesothelioma cancer.
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What Does Health Insurance for Mesothelioma Patients Cover?
In general, it covers the vast majority of cancer treatment costs. Furthermore, the amount you have to pay out of pocket depends on what type of treatments you receive, where you receive them, and what type of health insurance you have.
In a nutshell, the level of coverage you get is directly proportional to the amount you can afford to pay.
A 2017 American Cancer Society report estimated how much patients with different types of coverage have to pay for one year of advanced lung cancer treatment, which is comparable to pleural mesothelioma treatment.
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Insurance services provided by top companies
Here, we will be discussing the services provided by top companies like Medicare, Medicaid, and VA Health Care.
Most mesothelioma patients are covered by Medicare or Medicaid Insurance companies, which are the largest federally funded public health care programs in America. Similarly, many mesothelioma patients are also eligible for VA health care benefits.
Medicare typically covers those over the age of 65 who have paid into the system throughout their working lives. There are four main parts of Medicare that determine what is included in each person’s coverage.
- 1: Covers inpatient care in hospitals and nursing, hospice, or home facilities.
- 2: Costs an additional premium each month and includes doctor visits, laboratory costs, medical equipment, and ambulance care.
- 3: (Medicare Advantage): Purchased from a private provider as an alternative to original Medicare. Includes benefits of parts A, B, and usually D.
- 4: Costs an additional premium each month and helps pay for prescription drugs.
A Medigap policy is a private health insurance plan that supplements Medicare. Medigap policies often have expensive premiums, but they can close the gap between what Medicare covers and what a patient needs.
Medicaid is designed to cover the cost of medical care for those with low income. Not all health care providers accept it, and benefits can vary from state to state, but it often covers mesothelioma treatment.
Veterans with mesothelioma are often eligible for low-cost or free cancer treatment from the U.S. Veterans Health Administration. This national network includes prominent mesothelioma specialists in Los Angeles, Boston, Miami, and Houston.
Factors Affecting Insurance Coverage for Mesothelioma Treatment
The best time for financial planning is at the beginning of your mesothelioma treatment. Ask an insurance company representative, hospital social worker, or patient advocate for help understanding the following terms and what they mean for your situation.
How much do you have to pay out-of-pocket every year before your insurance coverage kicks in.
Copay and Coinsurance
How much do you have to pay even when your insurance is covering you? A copay is a flat fee per service, and coinsurance means you have to pay a percentage of each medical bill.
Your monthly payment needed to stay covered. Generally, a higher premium means a lower deductible and lower copays/coinsurance.
In-Network vs. Out-of-Network
Health insurance plans usually specify certain doctors, hospitals, and pharmacies where copays and coinsurance are cheaper. This is called their health insurance network. Because asbestos-related cancer is rare, seeing a mesothelioma doctor may require you to go outside your plan’s network.
Once you have paid the maximum out of pocket, the law requires most insurance plans to cover your medical bills at 100 percent for the rest of the year. For 2019, the maximums were set at $7,900 for individual plans and $15,800 for family plans.
Affordable Care Act (ACA)
This 2010 law enacted many reforms that directly benefit mesothelioma patients today.
The ACA sets minimum health insurance standards that include cancer screenings, cancer treatment, and follow-up care. It forbids insurance plans from having lifetime or annual limits for how much they provide for cancer treatment.
Most importantly, the ACA prohibits companies from dropping patients with serious diseases or excluding patients with pre-existing conditions such as cancer.
The American health care system still presents many serious challenges, however. A 2021 report in the Journal of Thoracic Disease concluded that younger age, female sex, non-white race, private insurance, Medicare, and a higher income were associated with better survival.
When a health care provider sends a bill to your insurance, but they decide not to pay all of it, you could be billed for the remaining balance. This often happens when patients receive care from an out-of-network provider without realizing it.
Further, when patients receive a treatment their provider refuses to cover, the company could deny your claim completely.
Some frequently asked questions
What If My Health Insurance Claim Is Denied?
If your health insurance company denies a claim for mesothelioma treatment, don’t get discouraged. Push for the resources you need, and look for assistance wherever you can find it.
Mesothelioma presents a unique set of problems because it is so rare. Few medical professionals know how to treat it effectively. To get the best care, patients should seek a mesothelioma specialist, even when it means going outside their network to do it.
Medical Outreach Director and Patient Advocate Missy Miller explains, “A lot of times people just give up when they are told ‘no.’ But you can’t give up. You resubmit the request. You go back to your doctor, and you talk to him about it. We work with patients to help get them approved.”
How do I apply for Health Insurance?
It’s quite easy to apply for. You can find their application form online by visiting any of your preferred choices using the internet. In addition, you can try visiting any of their outlets.