Insurance Rights for Cancer Survivors. Bobbi Meins, M.S. Director UBC Cancer Rehab Centers

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1 Insurance Rights for Cancer Survivors Bobbi Meins, M.S. Director UBC Cancer Rehab Centers

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3 Over the last 12 months

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5 Regardless of what you think about Obamacare, there are some good things that have come out of the Affordable Care Act Kids are able to stay on their parents insurance until age 26. Insurance Companies can t exclude kids with preexisting conditions Insurers are not able to rescind policies to avoid paying medical bills when a person gets cancer Some preventive services are now free of copays and deductibles 50% discount for Medicare enrollees for name brand medications

6 In (Depending on what the Supreme Court rules) Insurers will no longer be able to refuse to sell or renew policies based on the fact that someone has a pre existing condition Insurers will no long be able to charge higher rates because a person has cancer or based on gender. Annual limits on essential health benefits will be prohibited. Medicaid eligibility will increase to 133% of poverty level (couple=$1,677/mo, family of 4 = $2,555/mo) Tax credits for individuals below 400% of poverty ($5043/mo) who don t have access to affordable health insurance. All insurance must offer a minimum set of health benefits including preventative and wellness services and chronic disease mgt.

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8 Different Types of Health Coverage Employer Plans (both self funded and non self funded) Insurance for self employed, associations or small groups Commercial Individual Plans WA Health Plan Pre existing condition through the State of WA (ends 1/1/2014 when health care reform takes over) or WSHIP WA Breast and Cervical Health Program Veteran s Administration Medicare

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16 What Does Math have to do with COBRA? Regardless of HOW expensive your COBRA is you really need to do the Math Where you are in treatment phase Look at the EOBs (Explanation of Benefits) you have been receiving from your insurance company how much are you currently paying out of pocket? What is your premium? Call your health insurance provider and ask if you transfer to an individual plan, what will the monthly cost be, what are the differences in policies and can you transfer straight across w/o a waiting period? Then compare and see which is cheaper. Often COBRA is a good option while in treatment.

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20 Small Business Health Insurance This may be another option for those who might otherwise be rejected for individual insurance. If you are a small business owner with 2 to 50 employees you can purchase group health insurance.

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32 As a Cancer Survivor, you have the same rights as anyone who is disabled. That means you can ask your employer for accommodations maybe you need to work less hours, take a short nap in the middle of the day, go home early. Don t be afriad to ask YOU ARE PROTECTED under the American Disabilities Act. If you are Stage IV you can be fast tracted onto Social Security Disability under the Compassionate Allowances Program. Talk to your doctor, make sure he/she is in agreement and that your files indicate this decision Call Social Security and tell them you are Stage IV and don t think you can work any longer, give them your SS # and they will tell you how much you will receive each month. Get your medical records together and complete the application online

33 Charity Care Covers procedures, treatment, labs, X Rays that done in the hospital. Does not cover physicians who are on contract. Patients with incomes less than or equal to 100% of the Federal Poverty Level (FPL) (see table below) receive free hospital care. Patients with incomes between 100% and 200% FPL (see table below) receive discounted hospital care. The hospital may consider how much savings you have and how much your assets are worth in deciding what charity care you should receive, if your income is above 100% FPL. Don t be afraid to ask DO NOT put medical bills on your credit card if you think you will not be able to pay the credit card bill.

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