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LBBC Helps Develop Tool to Navigate Health Insurance Marketplaces

New resource makes comparing health plans easier for those with cancer

September 26, 2013

Written By Nicole Katze, MA, Editor and Manager, Publications

In preparation for the October 1, 2013 opening of states’ Health Insurance Marketplaces established as part of the Affordable Care Act (ACA), Living Beyond Breast Cancer is pleased to announce the launch of the Cancer Insurance Checklist—a tool created in collaboration with 18 partnering cancer and patient advocacy organizations.The Checklist is designed to help people currently diagnosed with, with a history of, or at risk of developing any type of cancer when shopping for insurance through their states’ Health Insurance Marketplaces or Exchanges. The website and tool production costs of the project were supported by Novartis Oncology.

Background

The Health Insurance Marketplaces/Exchanges were created under the Affordable Care Act with the goal of making health insurance more affordable and accessible to the majority of Americans, and to lessen the number of people who are uninsured or underinsured. Depending on where you live, the Marketplace or Exchange is run by the state or federal government, or, in some instances, by a partnership between the two.

The ACA’s Health Insurance Marketplaces/Exchanges give everyone the opportunity to enroll in plans that meet the requirement of offering Essential Health Benefits. By providing a space for individuals to compare plans, choose one that best suits their healthcare needs and enroll online, they help break down past obstacles faced by Americans who had limited or no access to healthcare, for reasons like exclusion for pre-existing conditions,  losing employer-based coverage, or being unemployed.

Healthcare plans will be offered at the bronze, silver, gold and platinum levels, with premium and out-of-pocket expenses varying at each level to offer more financially viable options for families and individuals of every income. Those who are uninsured or underinsured will benefit most from the Marketplaces; in many cases, employer-based insurance may still provide the most coverage at the lowest cost to you.  

About the Cancer Insurance Checklist

The many policy changes brought about through the ACA can be hard to navigate, especially if you’re dealing with the stress of a new cancer diagnosis. The creation of the Cancer Insurance Checklist was initiated after Matthew Farber, MA, director of provider economics and public policy at the Association of Community Cancer Centers (ACCC), gave a presentation at the American Society of Clinical Oncology 2013 Annual Meeting in June on the impact of the ACA’s policy changes on those in treatment for cancer. Patient advocates and advocacy groups present at the meeting hoped to build a singular, trusted resource for information on Marketplace plans that made often complicated insurance information easier to understand and access.

Michelle Bielko, editor and manager of publications, represented LBBC on the working group that came together on the project, which was chaired by Michelle Johnston-Fleece, MPH, director of state initiatives for the Policy Institute of the Cancer Support Community. Users can access the tool by visiting CancerInsuranceChecklist.org and downloading a four-page checklist, which, once completed, serves as a convenient visual comparison of each plan under consideration by the individual.

Categories included on the checklist track whether specific cancer-related specialists, medicines, therapies, counseling sessions, medical equipment, testing and procedures are covered or not covered by individual Marketplace/Exchange plans, because while they must all offer Essential Health Benefits, there is no guarantee that every treatment or therapy will be covered by all available plans.

The Checklist can also be used to compare the cost of co-pays, co-insurance, premiums and deductibles in order to find the most affordable plan with the best coverage options. Healthcare navigators should be able to use the Checklist along with you if you need assistance.

 “The Marketplace, along with other policy changes, allows even those with pre-existing conditions like breast cancer access to healthcare coverage,” Jean A. Sachs, MSS, MLSP, LBBC’s chief executive officer, says. “Our Cancer Insurance Checklist is another way to broaden that access.”

To learn more, visit:

CancerInsuranceChecklist.org

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