Health Forums Online.

Health insurance
Cancer survivors in the US identify health insurance as a problematic issue more than any other issue except cancer itself. The delays and denials of managed care are the most common complaint, but other insurance issues also arise. Larry Coffman, five-year survivor of SCLC, is disappointed by healthcare coverage in the US:

I haven't met an insurance company that I liked, or one that would pay out on the things that I thought that they should. Medicare did cover my annual exam and my one pair of bifocals, which helped greatly. An old saying, "When in doubt, check it out," holds true, especially for cancer patients/survivors. You cannot put a price tag on peace of mind.

If your medical insurance plan is in some way lacking, find out if your employer offers more than one medical insurance plan or holds an open enrollment each year. Open enrollment is the time period during which you may change plans without a medical examination or questionnaire; that is, without having your pre-existing health conditions held against you. Use the open enrollment period to upgrade to a better policy Examine all plans closely for what they cover, especially for coverage of care given under the auspices of a clinical trial. Weigh an indemnity or preferred provider plan, which may offer more access to more doctors for a higher price, against a high-coverage HMO requiring referrals and gatekeepers. The indemnity plan may cost more per doctor visit, but may provide you with the freedom to get care wherever you think best, without the delay of pre approval, including out-of-state care within a clinical trial or at a distant, but excellent, cancer center.

If you have been approved for Social Security Disability Income (SSm, discussed later under "Disability income,") you'll be automatically enrolled in Medicare after getting disability benefits for two years. Moreover, Medicare coverage is free for 39 months after returning to work, if you're still disabled. If your income is low, your state may pay your Medicare premiums as part of Medicaid benefits. Contact your local Social Security Administration office for more information.
Take care when answering insurance company questions about "other insurance." The wife of a cancer survivor describes a frustrating problem with answering such questions:

When my husband changed jobs, we changed medical insurance plans, too, but his plan didn't provide dental insurance that was as good as I'd had, so I kept my previous dental plan through COBRA. His new medical insurance company sent us paperwork to fill out that contained a question about whether we had other insurance. I wrote in "yes," but noted that it was just dental insurance.

Big mistake. For months afterward, until I dropped my dental coverage with the previous company, all of my claims for allergy shots, blood tests, and gynecology visits were denied on the premise that I had "other insurance" that ought to pay for these services. When I called the insurance company and held their feet to the fire, the customer service rep said, "To be honest with you, this is happening because your claims are processed by many different people, and some of them just don't bother to check for what your other insurance really is." Suppose they had denied my husband's claims for cancer surgery or chemotherapy?
Losing medical insurance coverage if you change or lose jobs is still a problem, but less of a problem than before. In addition to various state laws, several federal laws exist to help you retain coverage. HIPM, COBRA, and ERISA are enforced by the US Department of Labor Pension and Welfare Benefits Administration, (202) 219-8776.
• HIPM. The Health Insurance Portability and Accountability Act of 1996 is a federal law intended to prohibit the permanent denial of medical coverage based on pre-existing conditions. HIPM covers only employers with twenty or more employees. In general, it states that if you have had continuous medical insurance coverage for more than twelve months, your new medical insurance company cannot refuse to pay for medical care for your previous health problems. If your previous health coverage was for less than twelve months, each month you were covered reduces by one month the amount of time your new medical insurance company can refuse to pay for your previous health problems. No medical insurance company, however, can refuse to pay for your previous health problems for more than twelve months. There are loopholes in this law, though, that medical insurance companies might exploit. Some companies define a change of coverage from husband-and-wife to family coverage, for example, as a switch to a new plan, which could, in theory, restart the twelve-month clock. In July 1998, President Clinton issued a warning to insurance companies covering federal employees that such denials of payment will not be tolerated. Some states have older, stricter laws that resemble HIPAA, but provide better coverage. Call your state insurance commissioner for details.
• COBRA. The Consolidated Omnibus Budget Reconciliation Act of 1985 provides for a continuation of your old employer's medical insurance coverage for a temporary amount of time: from 18 to 39 months, depending on your circumstances. Always elect COBRA continuation coverage if you lose or change jobs until you're certain that your new employer's policy will cover expenses associated with your care. HIPAA, discussed above, does not always provide the continuous coverage the law intended because of its design and various loopholes.
• ERISA. The federal Employee Retirement Income Security Act of 1974 was a piece of legislation intended to safeguard employee pension rights, but it also has impacted employee health insurance. Self-insured employers are governed by ERISA in ways that can override state laws. Large, self-insured employers may hire a medical insurance company, such as Blue Cross, to administer their plan, so the insurance forms you receive might contain the insurance company's letterhead, but your employer is bearing the exact and full cost of your care at the time it is incurred instead of paying large indemnity premiums in advance. Owing to the overlap of state and ERISA regulations, self-insured employers cannot be sued in state courts for failing to pay claims. For this and other reasons, disputes about health insurance claims with self-insured employers can become very complex and may require the assistance of an attorney

Most states have insurance pools known as CHIPS, comprehensive health insurance plans, for those who cannot get coverage through typical channels. Contact your state insurance commissioner for more information.
Ask about group health insurance policies that might be available through civil and community groups, fraternal organizations, professional groups, churches, or your union.