Mesothelioma Insurance Claims – Getting mesothelioma treatment can be expensive. Learn more about insurance options that can help pay for treatment.
Health Insurance Types
There are three types of health insurance plans that can help mesothelioma patients pay for treatment. Although the actual amount each plan covers will vary between plans and from patient to patient, knowing the pros and cons of each can help patients understand what to expect financially.
Individual Private Insurance
Individual private insurance plans come in many shapes and sizes and can help pay for mesothelioma treatment costs.There are two main kinds of individual private insurance:
Managed Healthcare Plans
These plans include HMOs (health management organizations) and PPOs (preferred provider organizations). Typically, a patient is only covered if he or she uses a doctor who is under contract with the HMO or PPO network. This may restrict a patient’s choice of doctor for a disease like mesothelioma, which requires specialized treatment.
HMOs and PPOs usually require less paperwork and lower co-pays/premiums than most other individual private insurance plans. This makes the claims process easier and allows patients to focus more on getting treatment.
Traditional Health Insurance (Fee-for-Service Plans)
Traditional health insurance plans require patients to pay a monthly premium and yearly deductible. Patients must also file their own claims and may, under some circumstances, have to pay up front for treatment. These additional costs should be recorded so that the insurance company can reimburse patients for the exact amount they paid out-of-pocket.
Traditional plans are more flexible than HMOs or PPOs because the patient is not restricted to a network of doctors and has the option of choosing a specialist with mesothelioma experience.
Employee Health Insurance
Employee Health insurance plans are chosen, and sometimes purchased, by employers for their workers. They differ from individual private insurance in that the plan itself is negotiated by the employer for a group of people, namely the employees, and not for individuals.
This type of health insurance benefits mesothelioma patients in a number of ways. Because policies are typically negotiated by the company for employees as a group, the insurance company does not screen each individual employee for pre-existing conditions. Patients won’t be turned away for a pre-existing condition like mesothelioma or have to pay high premiums to obtain coverage.
Additionally, there is less paperwork when a claim is filed for a group plan, a feature which saves time and a considerable amount of stress. Another benefit is that federal regulations require employers to purchase full coverage for their employees. Full coverage helps patients get the quality of treatment mesothelioma, an aggressive disease, demands.
Medicare and Medicaid
Mesothelioma patients may also qualify for government health insurance programs like Medicare and Medicaid. Medicare is a program instituted by the government to help Americans over the age of 65 pay for health care. Since 60 percent of mesothelioma patients are over the age of 65, Medicare can serve as a resource to help older patients pay for treatment.
Medicaid is available for patients who cannot afford to pay for health insurance. If you are a low income earner or are unemployed, Medicaid can help you pay for treatment. Patients with questions about these government programs should contact the Centers for Medicare and Medicaid.