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Insurance coverage and cancer: What women need to know

Tuesday, December 12th, 2017

Everyone has the right to get back to feeling like themselves after a cancer diagnosis or resulting disability, but women, in particular, may face insurance obstacles, including obstacles with disability insurance. Here are a few things you might not know about insurance coverage and cancer.

You may have the right to reconstructive surgery

An amendment to ERISA, the Women’s Health and Cancer Rights Act (WHCRA), requires some insurance plans to provide reconstructive surgeries and other benefits after a mastectomy.

These health insurance providers may not deny coverage in order to avoid paying for the breast reconstruction. If they do, they are breaking the law.

When you can’t work: Short- and long-term disability claims

Short- and long-term disability coverage may be options for individuals who face the debilitating side effects of cancer treatments and can no longer work. Unfortunately, many disability insurance companies will refuse coverage or find ways to restrict benefits. It is a good idea to speak with your lawyer about coverage.

Health insurance needs — and coverage — are different for everyone

There are specific laws in place to protect women’s needs during and after cancer, but determining what procedures your health insurance covers can be difficult. For example, individuals under 40 may face more aggressive cancers and need additional treatments. Women of child-bearing age may need medical therapies for infertility while those who are post menopause may qualify for ovarian suppression and other hormone therapies. Explore your options to determine what treatments you may need and ask how your insurance company will cover those treatments.

Even when it’s obvious you have cancer, insurance companies will put themselves first

The last thing anyone going through cancer needs is to fight for the benefits they are owed. Shouldn’t it be obvious that you can’t work? That you need treatment? Unfortunately, disability insurance claims adjusters will look for ways to change your disability condition, restrict your benefits and even outright deny claims for cancer.

Think about the future you want. Think about the time you need to heal, including time away from work. Do not let insurance coverage be what stands in the way of what you need.

Justin C Frankel

Written By:

Justin C. Frankel - Disability Insurance Attorney

Justin Frankel is a founding partner of the disability insurance law firm Frankel & Newfield and is a highly skilled litigator and advocate. He has published numerous articles on the challenges facing clients with private or individual disability insurance policies and those who own group or ERISA disability insurance policies.

Learn more about Justin | See Justin’s Publications



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