Posttreatment Financial and Insurance Issues
When first diagnosed with cancer, your financial concerns centered on maintaining your income during treatment and understanding your health insurance coverage (or finding help if you’re uninsured). Even with insurance coverage, your cancer experience can create large expenses for you and your family.
After treatment, your financial and health insurance concerns change somewhat. Now the focus is more on long-term issues such as:
Your Job and Income
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- Cancer therapies can cause exhausting fatigue or create physical limitations that may be temporary or permanent. Because of those effects, you may have taken time off from work or even quit your job. If you worked during treatment, you may have had to change your job duties or schedule to adapt to your care needs and energy level.1 You may now be worried about continuing at your present job or finding a new one.
- If you have an employment contract or union contract, it may cover your right to keep your job or appeal a firing. The Americans With Disabilities Act (ADA) prohibits employers with 15 or more employees from treating you unfairly if you have a disability due to cancer treatment. The law also:
- protects you, when you’re applying for a job, from being asked questions about your medical history
§ requires your employer to try to make adaptations for your specific needs
§ guarantees that if your employer offers benefits, they match those given to employees who have not had cancer
§ prohibits employers from denying you employment or firing you due to your genetic history
o If you are unable to work after treatment, you may be eligible for disability or supplemental security income under the Social Security Administration. Contact your local Social Security office for information relevant to your situation.
o You willl find more advice on getting help with medical costs and other money issues at Financial Support.
· Your Health Insurance
o By law, if you work for a company with an employer-sponsored health insurance plan (for groups of two or more), that plan must cover you, regardless of your health status or cancer history.
o If you leave your job, get laid off, retire, or your insurance-covered spouse dies or you divorce, you have the legal right—regardless of your cancer history—to continue in a group plan sponsored by employers of 20 or more workers. Called COBRA coverage, this law lets you keep your health insurance for 18 months to 3 years, depending upon the circumstances, with you (not the employer) paying the full premium.
o When applying for a job with a new employer that has a group health plan, you may be temporarily excluded (up to 12 months) on coverage for your pre-existing condition. However, if you have been covered under another plan until starting your new job, there’s no temporary exclusion waiting period.
o You have fewer protections when buying individual health insurance. Individual policies may require you to disclose your medical history, and they can turn you down for coverage because of having had cancer. Even if you are approved for coverage, your premiums may be higher because of your cancer history. Rates are also based on age; the older you are, the more the individual health insurance costs.
§ Check to see if your state has a high-risk pool for health insurance. More than 25 states do. These programs cannot turn you down due to health conditions.
o Medicare, the federal program providing health insurance to people aged 65 and older, also provides coverage to individuals who have been on disability for 24 months.
o To learn more about all types of health insurance and what to do if you’ve been denied coverage, visit the “Understanding Insurance” section in Financial Support
· Your Debt
o Cancer treatment may have left you with bills from unreimbursed medical expenses, nonmedical care items, and lowered or lost income. That debt may continue to grow after your treatment has ended. You may have had to use savings, credit cards, or take out a loan to pay your bills.
o For help with burdensome debt, contact a nonprofit credit-counseling service in your area.
o Be sure to deduct all of your post-treatment medical expenses, including insurance premiums you paid, home nursing costs, and anything else related to your care. Treat these as itemized deductions on your federal income tax return. The Internal Revenue Service offers free publications and advice on what medical expenses are allowable.
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