Investigating Health Insurance and Payment Options for Cancer Treatment

By: Roswell Park Comprehensive Cancer Center

When you first learn you have cancer, your attention likely turns to understanding the available treatment options and what to expect from the side effects and recovery. Something you might not think of immediately, but will need to consider, is the cost of your treatments.

Planning ahead, choosing the right health insurance plan and negotiating the right network coverage will help you reduce stress and make the process towards recovery easier. No one plans for a diagnosis of cancer in his or her life, so it’s advisable to investigate health care coverage options while you are healthy to make sure you have adequate access to the nationally ranked care of Roswell Park Comprehensive Cancer Center, our area’s only designated comprehensive cancer center. 

Keep in mind that advocating for your best case scenario will involve asking a lot of questions and making sure you understand the answers. It may be helpful to write down questions ahead of time, keep a journal for reference and bring along a friend or family member to help you in this process.

Here are some questions to consider when you are evaluating your current health insurance:

•What type of health insurance do I have and will it cover my cancer treatment?

•Will I be able to change my health insurance after I have been diagnosed with cancer if I have a pre-existing condition?

•What is Open Enrollment?

•What are the deadlines for Open Enrollment? (Different plans will have different deadlines)

•How do I know if my insurance covers the doctor/s I want to see?

•What is the difference between in-network and out-of-network insurance?

•Will I be able to receive services if my insurance plan is out-of-network?

•What questions should I ask my insurance plan about my coverage?

•What are some of the non-medical costs, such as transportation (gas, parking) and is there coverage for these costs?

“We realize that it’s often difficult to predict the costs of the treatment as payment methodologies and benefit structures are increasingly complex,” says Stephanie Evans, manager for financial counseling at Roswell Park  and part of the team that works with patients and insurance companies to negotiate in-network coverage of services. “Patients can certainly have a conversation with their doctor about less expensive alternatives for treatment, such as one drug versus another drug.  But ultimately, we have to ask the question: Would a patient want to forgo the best treatment option to save money?”

Roswell Park offers a financial assistance program to help patients sort out payment plans if necessary. Roswell Park’s financial counselors are ready to assist patients with any of their open enrollment, health insurance and billing questions at 1-800-ROSWELL (1-800-767-9355).