Best Health Insurance for Cancer Patients
Best Health Insurance for Cancer Patients
UnitedHealthcare, Blue Cross Blue Shield, CareSource and Cigna sell the best health insurance for cancer patients.
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UnitedHealthcare sells the best health insurance for cancer patients because of its good coverage and cancer support program.
You can also get good coverage with Blue Cross Blue Shield, CareSource and Cigna. Cancer treatment is expensive, but health insurance can help you access and pay for the treatments you need.
Best health insurance for cancer patients
UnitedHealthcare's cancer support program and large network, which includes cancer doctors, make it the best health insurance company for cancer patients.
Blue Cross Blue Shield is the best if you need access to specialist doctors. CareSource has the best coverage for common cancer medications, and Cigna offers the best supplemental cancer insurance.
Health insurance company | Best for | Monthly cost* | |
|---|---|---|---|
| UnitedHealthcare | Best overall | $546 |
| CareSource | Drug coverage | $571 |
| Blue Cross Blue Shield | Specialist doctors | $607 |
| Cigna | Supplemental policies | N/A |
*Average monthly cost for a 40-year-old with a Silver plan
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To choose the best health insurance for cancer patients, we first looked at each health insurance company's provider network. Since cancer patients often need to see several doctors and specialists, a large provider network makes it easier to get care. Each company's drug coverage and patient costs were also reviewed. Finally, each company's cancer-specific programs and benefits were factored in.
UnitedHealthcare: Best overall
UnitedHealthcare's cancer support program can help you understand your treatment options and coordinate your care.
Cancer treatment can be complex, and cancer patients might see multiple doctors during their treatment. UnitedHealthcare offers a cancer support program that can help you manage the complexity. UnitedHealthcare is one of the best health insurance companies for anyone, but its large network, coverage options and cancer support program make it the best overall health insurance company for cancer patients.
UnitedHealthcare
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Editor's rating:
- Average cost: $546/month
- Marketplace plans available in 22 states
UnitedHealthcare's cancer support program can help you understand your medications, manage your symptoms and find community support. Once enrolled, you'll have access to a trained cancer nurse to help you manage and navigate your treatment plan. The program isn't available with all plans. If you have cancer and want access to the plan, make sure the plan you buy lists the cancer support program as an option.
HMOs and EPOs are types of health insurance networks, which lay out what doctors and medical offices are covered. HMOs and EPOs restrict you to certain medical offices. You will have to pay the full cost if you get care from an office or doctor outside the network.
UnitedHealthcare only sells HMO and EPO plans on the health insurance marketplace. EPOs are the better option for cancer patients because they allow you to see specialists without a referral. You might still need pre-authorization for your care, though, which could slow the process down.
UnitedHealthcare sells Affordable Care Act (ACA) marketplace plans in 22 states.
- Alabama
- Arizona
- Colorado
- Florida
- Georgia
- Illinois
- Kansas
- Louisiana
- Maryland
- Massachusetts
- Michigan
- Mississippi
- Missouri
- Nevada
- New York
- North Carolina
- Ohio
- Oklahoma
- Tennessee
- Texas
- Virginia
- Washington
Blue Cross Blue Shield: Best for specialist doctors
A Blue Cross Blue Shield policy makes it easier for cancer patients to see specialists.
Cancer patients often need to see specialists. Having health insurance that is widely accepted makes seeing them easier. It can also help reduce worry over getting high bills for accidentally going outside of your plan's network. More than 90% of the doctors and medical offices in the country take Blue Cross Blue Shield health insurance, so it's likely that there are covered doctors in your area.
Blue Cross Blue Shield
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Editor's rating:
- Average cost: $607/month
- Marketplace plans available in 47 states
A PPO from Blue Cross Blue Shield gives you easy access to specialists. A PPO doesn't limit you to certain doctors. You'll pay more if you go to an out-of-network doctor, but you'll usually still have some coverage. You also don't need a referral to see a specialist with a PPO. This could mean you will have less wait time and can start cancer treatment faster.
While the overall average cost of a Blue Cross Blue Shield plan is $607 per month, you'll pay more for a PPO since it allows you to get care at any doctor's office. A PPO plan from Blue Cross Blue Shield costs an average of $658 per month. Nationally, PPOs cost $576 per month, so Blue Cross Blue Shield's PPO plans are more expensive on average. But since Blue Cross Blue Shield is accepted by most doctors and specialists, the extra cost may be worth it, especially since cancer patients may need to see several different doctors.
The Blue Distinction Centers for Cancer Care
The Blue Distinction Centers for Cancer Care offer safe, effective and cost-efficient specialty medical care. Using the Blue Distinction designation to find a cancer treatment center can help you feel confident that you're getting high-quality care. You can find Blue Distinction Centers for Cancer Care using the search tool on the Blue Cross Blue Shield website.
CareSource: Best cancer drug coverage
CareSource covers at least eight of the most commonly prescribed brand-name cancer medications.
Cancer patients often take chemotherapy or immunotherapy drugs during their treatment. Prescription drugs can be expensive, and specialty drugs are among those with the highest costs. CareSource insurance is only available in six states, but the plans cover at least eight common brand-name cancer drugs. That's more than most of the company's competitors.
CareSource
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Editor's rating:
- Average cost: $571/month
- Marketplace plans available in 6 states
While CareSource covers a variety of name-brand cancer drugs, it also sells plans that have good generic drug coverage. Several plans fully cover generic drugs, but only after you meet your health insurance deductible. Other plans charge a low amount, like $15 or $20, for generic drugs even before you've reached your deductible.
CareSource sells marketplace health insurance plans in six states.
- Georgia
- Indiana
- Kentucky
- North Carolina
- Ohio
- West Virginia
CareSource only sells HMO plans, which means you have to go to certain doctors to have coverage. Since you may see several doctors during your cancer treatment, check that your current doctors and specialists are in the network before buying a CareSource plan.
Cigna: Best supplemental cancer insurance
Cigna's Lump Sum Cancer Insurance and Cancer Treatment Insurance plans can help pay for things your health insurance doesn't cover.
Health insurance doesn't always cover the costs associated with cancer treatment. Cigna's supplemental insurance can fill the gaps. You could use the money from Cigna's policies to pay for transportation and lodging if you have to travel for treatment, help around the house while you're recovering, your health insurance deductible or drugs that your main policy doesn't cover. Supplemental cancer insurance can help you pay unexpected bills, but it shouldn't be used as your primary health coverage. And to have coverage, you have to buy a policy before you are diagnosed with cancer.
Cigna
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Editor's rating:
- Average cost: $18-$19/month
- Availability varies by product
Lump-sum plans, also called fixed indemnity plans, pay you a lump sum of cash if you meet certain requirements. You can use the cash for anything, including your health insurance deductible, copayments and coinsurance, and costs that aren't covered by health insurance, like hiring someone to help with household tasks or child care while you're ill.
Cigna's Lump Sum Cancer Insurance plan pays you a cash amount when you're diagnosed with a covered cancer. You can buy a policy that has a payout from $5,000 to $100,000 in most states. You can add extra coverage for cancer recurrence, chemotherapy and radiation, and heart attack and stroke. Plans cost an average of $19 per month, according to Cigna. Plans aren't available in Idaho, New York, Virginia or Wyoming.
Cancer Treatment Insurance pays you a set amount for covered cancer treatment services. It also covers related costs, like transportation and housing if you have to travel for treatment. You can add extra coverage for intensive care unit stays, hospitalization, and heart attacks and strokes. You can also add coverage for a lump-sum cancer payment, instead of purchasing a stand-alone Lump Sum Cancer Insurance plan. Plans cost $18 per month, on average, according to Cigna. Plans aren't offered in Idaho, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Utah or Wyoming.
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Alternative health insurance for cancer patients
There are ways to get coverage for cancer treatment even if you don't have traditional health insurance. You might qualify for Medicare or Medicaid, or your health care system might offer financial assistance or a payment plan.
You may be able to get help paying for cancer treatment by contacting charities and organizations in your community. Hospitals may also have charity programs for customers who need financial help. The Patient Advocate Foundation could also help. The organization can provide cancer patients with financial counseling, legal advice and debt management tools.
Medicare
If you are eligible for Medicare, you could get coverage for your cancer treatment. Original Medicare will cover your hospital and doctor costs through Parts A and B, as well as the costs for chemotherapy. If your chemotherapy is in a hospital setting, Medicare Part A covers it. If you get chemotherapy in a doctor's office or clinic, Medicare Part B covers the costs. In both cases, you may have to pay some of the costs.
The best Medicare plan for cancer patients is to combine Original Medicare with a Medicare Supplement Plan G policy and a Medicare Part D drug coverage plan. This combination of coverage is typically going to result in the lowest health care costs for you.
If you buy a Medicare Supplement plan when you first become eligible, your health status won't matter and you'll get the best rates. There are also other times, depending on your situation and the state you live in, that you can buy a plan without your health being factored in. If you've missed those enrollment periods, you could be denied coverage for a Medicare Supplement plan or you might pay higher rates. In that case, you could consider a Medicare Advantage plan.
One of the perks of Medicare Advantage is that it combines Medicare Parts A and B into one plan, and it also usually includes drug coverage. However, unlike Original Medicare, Medicare Advantage plans restrict you to a network of doctors. You should make sure your cancer doctors and specialists are in-network before you buy a plan.
Medicaid
Medicaid is primarily for low-income households. If you qualify for Medicaid, many of your health care costs could be eliminated or significantly reduced. Medicaid coverage can vary by state, so some treatments and services might not be covered.
Payment plans and financial aid
If you don't have any insurance coverage, talk to your doctor, hospital or health care system about a payment plan or financial aid. Many health care systems offer financial assistance based on income, payment plans and financing options. You could also consider taking out a medical credit card or a medical loan. Just make sure you understand the terms of any payment plan, credit card or loan you sign up for, so you know how it will affect your finances.
How to choose health insurance for cancer patients
The high cost of cancer care often means a more expensive health insurance plan is worth it.
Lower plan tiers, like Catastrophic and Bronze, are usually better for young, healthy individuals who don't need much medical care. Gold and Platinum plans cost more, but they'll also reduce how much you pay for your medical care. If you have high medical costs, they can be a better deal.
Average cost of health insurance by plan tier
Plan tier | Monthly rate* |
|---|---|
| Catastrophic | $332 |
| Bronze | $440 |
| Silver | $560 |
| Gold | $604 |
| Platinum | $737 |
*Average monthly rate for a 40-year-old.
With higher-tier plans, you'll usually have a lower deductible and a lower out-of-pocket maximum. This means that, although you'll pay more for the plan each month, you'll pay for less of your health care costs.
Silver plans balance affordability with coverage. The coverage isn't as comprehensive as a Gold or Platinum plan, but Silver plans come with an extra perk: cost-sharing reductions. You qualify based on your income. Cost-sharing reductions reduce the amount you have to pay for your deductible, copay and coinsurance, and out-of-pocket maximum. This means you'll pay less for your overall health care expenses. If you qualify for cost-sharing reductions, it's a good idea to check your overall costs with a Gold plan versus a Silver plan. You might find that a Silver plan with cost-sharing reductions will pay more of your medical bills than a higher-tier plan.
Tips to lower your health insurance costs
Health insurance for cancer patients can be expensive since you may be more likely to buy a higher-tier plan. But there are ways to lower your costs and get cheaper health insurance.
Shop around: Shopping on a marketplace site or a comparison website lets you compare multiple health insurance companies and plans at once. This can help you find the coverage you need at the best price.
Take advantage of subsidies: Subsidies, also called premium tax credits, lower your monthly rate for health insurance. They're available on Bronze, Silver, Gold and Platinum plans, but eligibility is based on income.
Balance affordability with coverage: As a cancer patient, you probably have higher medical bills than most. Finding affordable cancer insurance might be important, but the coverage you get is probably even more important. Paying more for a plan with better coverage is probably going to be better for your finances.
Frequently asked questions
What is the best health insurance for cancer patients?
UnitedHealthcare sells the best health insurance for cancer patients. Blue Cross Blue Shield, CareSource and Cigna are also good options. Cancer patients might want to look for a health insurance company that is accepted by many doctors. PPO networks are also a good idea since they let you see specialists without a referral. If you take medications, it's also smart to check to make sure a plan covers them before buying the plan.
Can you buy insurance when you have cancer?
Yes, you can buy health insurance after you've been diagnosed with cancer. The Affordable Care Act prevents most health insurance plans from considering preexisting conditions when you buy coverage. Not all plans have to follow those rules, though. Short-term health insurance plans and lump-sum supplemental insurance can refuse to sell you a policy if you have a preexisting condition. These plans can also refuse to pay for medical bills resulting from a preexisting condition.
Can insurance deny cancer treatment?
Health insurance companies can refuse to pay if your treatment isn't considered medically necessary or if it's experimental. They may also deny coverage for a drug that isn't included in their list of covered medications. You can file an appeal if your treatment has been denied. Secondary health insurance, like a cancer insurance policy, can be used to pay for things that your health insurance won't cover. Health insurance companies can't stop you from getting treatment, but they can deny coverage, which means you would have to pay out of pocket.
Methodology and sources
Average health insurance rates are from data published by the Centers for Medicare & Medicaid Services (CMS). Data is for private health insurance plans sold on HealthCare.gov. States that have state-run marketplaces instead of using HealthCare.gov were excluded. Rates are for a 40-year-old individual with a Silver plan, unless otherwise noted.
PPO rates for Blue Cross Blue Shield are based on the average cost of each state's plans. To determine the best drug coverage, we checked each company's drug formulary for the following common brand-name cancer drugs: Revlimid (lenalidomide), Opdivo (nivolumab), Imbruvica (ibrutinib), Keytruda (pembrolizumab), Ibrance (palbociclib), Tecentriq (atezolizumab), Darzalex (daratumumab), Perjeta (pertuzumab) and Xtandi (enzalutamide).
Average rates for Cigna's supplemental policies come from Cigna. The rate for a Lump Sum Cancer Insurance policy is based on a 40-year-old in Alabama with a $20,000 fixed benefit. The rate for a Cancer Treatment Insurance policy is based on a person age 40-44 in Alabama with a $500 per day hospitalization benefit.
Additional sources for this article include Blue Cross Blue Shield, CareSource, Cigna, HealthCare.gov and UnitedHealthcare.
Editorial Note: The content of this article is based on the author’s opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.