3b. Health Insurance: Understanding Your Policy Benefits & Exclusions
Common Insurance Terms
After a cancer diagnosis, it’s important to contact a health insurance provider for more information on treatment costs. Knowing common insurance terms can be helpful when trying to interpret a policy. Tap or hover over the images to learn more.
The percentage of costs paid by the insurance company after the deductible amount is paid.
For example, a patient may have a plan that covers 80% of their costs after the deductible is paid. If a medical service costs $1,000, the patient pays $200 and the health insurance company pays $800.
The amount a patient pays for healthcare services, such as an appointment with a physician or prescription. For example, each time a patient visits a physician, their plan may require a copayment of $75 for the visit.
The amount paid by the patient for healthcare services before the health insurance plan begins to pay. For example, a patient may have a deductible of $4,000, meaning they must pay $4,000 of their expenses before the health insurance plan begins to cover a portion of the cost
A provider or facility that isn’t on the list of in-network providers/facilities. For example, a patient may visit a specialist that doesn’t work for an in-network facility to receive treatment for a rare type of cancer.
Any expense paid by the patient. For example, after coinsurance, a patient pays $200 towards a medical bill.
Health Insurance Plans
There are four main types of health insurance plans. Tap or hover over the images to learn more.
For coverage information, call Medicare or visit the Medicare website.
For coverage information, contact the county eligibility worker.
For coverage information, contact the local VA facility.
For coverage information, contact the insurer and ask for a policy review for coverage. It’s a good idea to wait for pathology results on the specific cancer diagnosis before calling the insurer.