Can My Insurance Drop Me If I’ve Been Diagnosed with Cancer?

When somebody is diagnosed with cancer or another serious illness, the medical reality of what they’re facing is already overwhelming. But all too often that diagnosis comes with a fear that nobody should have to face—is my insurance going to drop me when I need medical coverage the most?

For those who have existing health insurance plans, it is not legal for an insurance
company to cancel the policy simply because the insured gets sick.

This does not mean that it is impossible for somebody to lose coverage in the middle of a serious illness. A policy can still be canceled if the premiums aren’t paid or if the coverage was obtained fraudulently (that is, the applicant intentionally put false or incomplete information on their application, as opposed to making an honest mistake or omitting information that isn’t relevant to their health).

Dealing with ongoing medical issues can make it impossible to remain working and retain employer-provided coverage, though. The stress of dealing with a diagnosis of cancer or something similar can also result in divorce, potentially leaving the patient without coverage if their spouse was the one whose employer provided the insurance. Maintaining continuous coverage is vitally important for conditions like cancer, where a lapse or delay in treatment can dramatically worsen outcomes. Fortunately, there are options to keep coverage to ensure that patients can get the treatment they need.

Options for Maintaining Health Insurance Coverage For Cancer Patients

Using COBRA (the Consolidated Omnibus Budget Reconciliation Act of 1986) is one way to keep existing group health insurance benefits even after losing a job or getting divorced from a spouse who was the covered employee. This law the person receiving benefits can be entitled to up to 18 months (or sometimes 36 months) of continuing coverage under the group plan if they have experienced a “qualifying event.” Qualifying events include job loss for reasons other than gross misconduct, reduction in work hours that results in the employee losing health insurance benefits, divorce or legal separation of a spouse from a covered employee, loss of dependent child status under the insurance plan rules, and more.

Unfortunately, the cost of COBRA is often a significant disadvantage—the law allows the beneficiary to be charged up to 102% of the cost to the plan for similarly situated individuals. This can include both what the employer would normally pay as well as the costs paid by employees, so it can be substantially more than what they previously paid if the premiums were subsidized in whole or in part by the employer. COBRA also does not qualify for financial help, which can make it even less affordable when illness has
also resulted in a loss of income.

Individuals facing the loss of group health insurance coverage are often able to find more affordable coverage through the Health Insurance Marketplace (Covered California). All Marketplace plans must offer coverage for preexisting medical conditions, and they may be eligible for income-based subsidies that can lower the cost of monthly premiums for those who need financial help. Losing healthcare coverage can qualify individuals for a Special Enrollment Period to choose a Marketplace plan, meaning they won’t have to wait for the annual open enrollment period to get new coverage.

FREE Consults: Finding the Right Plan For Cancer Patients

For those struggling with a difficult diagnosis, having to find new medical insurance in the midst of treatment can be unbearably stressful. At Medical Insurance Today, we’re here to provide the support and information you need to choose a plan that will provide the care you need so you can focus on recovery. We’re dedicated to ensuring that you understand all your options, finding affordable solutions, and getting you qualified for any financial assistance you’re entitled to. Our compassionate, knowledgeable team speaks English and Spanish, offering plain-language explanations that demystify the details and help you find the coverage that is right for you. To find out more, contact us
here today.