The new Health Insurance Marketplace opens today and I'm sure many of your cancer patients have lots of questions.
This will be our first glimpse into the “new reality” of insurance coverage and cost. For many of our patients, the Affordable Care Act will make insurance coverage available and accessible as never before. The idea behind the marketplaces -- transparency in plan comparison -- is a powerful one. It puts some control in the hands of healthcare consumers at least as far as being able to analyze, compare, and make informed choices about which plans of coverage will serve them best.
In anticipation of the complex needs of people living with cancer or at risk for cancer, a resource has been developed to assist in the process of marketplace navigation and choosing a plan. Nineteen cancer and patient advocacy organizations, with support from many more, have partnered to develop and launch the Cancer Insurance Checklist.
This three-page document is designed to be completed by healthcare consumers for each plan that they are considering within their marketplace. The checklist prompts consumers to think about everything from primary care physicians to the multiple specialists that may become a part of their care team, along with other areas:
- Primary hospital, secondary care centers, clinics, and home care
- Prescription medications to chemotherapy
- Preventative screenings to follow-up imaging
- Prompts on palliative and other supportive care services
- Mental health care
- Fertility preservation
- Clinical trials
- Genetic and biomarker testing
- Respite care
Co-pays, co-insurance, maximums and limits, as well as the need for pre-authorizations or referrals can be indicated on the list. There is space to include any information on tax credits or other savings as well as out-of-pocket costs that may not have been accounted for in the body of the checklist.
With all of this data at hand, consumers can readily compare one plan to another based on the kinds of services that they are most likely going to need, along with the availability of providers and the associated costs.
The checklist may be equally useful when speaking with marketplace navigators or even one’s own healthcare team.
Are you or your patients aware of this cancer checklist? If so, have you found it to be helpful?