People without insurance or who are denied coverage for certain treatments or procedures need to explore their options.
The program has provided more than 16.5 million breast and cervical cancer screening examinations.
Information from this biopsy will be key in deciding how to treat you.
Mark Kostich / Getty Images
This may require additional imaging studies, procedures, office visits, and hospitalizations.
This could include breast implants or a prosthesis.
Unlike cosmetic surgery, reconstructive breast surgery is performed for medical reasons.
Those benefits included the services needed to treat serious conditions like cancer.
Unfortunately, not all health plans have to follow the ACA rules.
Individual private plans and small group plans do.
Depending on the jot down of insurance you have, your cancer coverage may vary.
Plans are divided into metal categories (bronze, silver, gold, and platinum).
Premium subsidiesare available to help people keep costs down.
Large employers offering insurance canself-insure or fully insuretheir plans.
“Self-insured” means the employer puts their health plan together and pays for your care directly.
“Fully insured” means the employer purchases care through an insurance company.
The difference is important because self-insured plans are not regulated by state law.
Having a self-insured plan means you could miss out on certain benefits other people in your state get.
Dense Breasts
Dense breastsare not something you feel; theyre something seen in medical imaging.
People who display this radiological finding on a mammogram may be at an increased risk of breast cancer.
It is offered to families with low incomes, pregnant people, children, and those who aremedically needy.
States thatexpanded Medicaidunder the Affordable Care Act may also extend eligibility to single people who qualify based on income.
Medicaid, in general, pays toward cancer care.
What is covered and what you pay will depend on the state in which you reside.
Medicare
Medicareis a federally funded healthcare program for people 65 and older or those withqualifying disabilities.
The federal government runs Original Medicare (Part A and B).
Mammograms are covered for free if the healthcare provideraccepts assignment.
If necessary,breast ultrasoundandbreast MRIare also covered for a fee.
Regarding treatment, Part B covers surgeries, radiation, and a wide range of chemotherapy options.
Other medications, including some specialized chemotherapy treatments and immunotherapies, require Part D coverage.
Costs in Original Medicare are relatively standard.
There are fixed rates for inpatient hospital care depending on the number of days you are hospitalized.
Costs for Medicare Advantage and Part D plans vary based on the insurer.
The trick is to enroll in one of these plans before you are diagnosed with cancer.
Not everyone can afford to do so.
In reality, not all plans are created equal.
Treatments your healthcare provider recommends may or may not be covered.
It may be in your best interest to change to a plan that gives you more treatment options.
However, you cannot switch plans whenever you want.
), you’re able to usually only change your plan once a year.
This occurs during a designated period known as the open enrollment period.
Its important that you make an informed decision.
Resources for Patients Without Insurance
No one should be denied cancer treatment because they cant afford it.
Be proactive and reach out for help.
Others cut back significantly on expenses such as food, clothing, or utilities.
Know that there are resources to help you through these difficult times.
Thanks to the Affordable Care Act, cancer care is offered through most plans.
Beyond insurance, there are charitable organizations and financial planning services that can help you manage costs.
Do not let cancer get the upper hand.
A Word From Verywell
The costs of cancer care add to the burden of the condition.
Know that you are not alone.
There are a number of resources available, from health insurance to charitable programs.
Do not hesitate to ask for help.
Cancer insurance is not meant to be used on its own.
These plans can be difficult to get after youve been diagnosed with cancer.
You often need to enroll in these plans when you are healthy.
Chemotherapy costs, in particular, can range from $10,000$100,000 without insurance.
With insurance, you could expect to pay only a percentage of these costs.
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