Learn. Speak. Act
International recording artist and poet, Michael "MIKE-E" Ellison


Access to Care 101
Learn more about the access to health care issue, why it matters, and what the Society is doing about the problem.


Access to Care 201
This video illustrates the importance of providing access to health care for the uninsured and undersinsured and what the American Cancer Society is doing to help. It addresses some of the questions that have arisen since the organization's campaign began in September 2007.

Choosing Health Insurance: Making an Informed Decision

Things to consider when buying health insurance for yourself and your family

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Each year, most people with employer-sponsored insurance have the opportunity to choose a health plan during what's commonly called the "open-enrollment period" for benefits. Some people will research monthly premiums (payments) when making decisions about their health insurance, and some will check to see whether or not a plan will let them continue to see their current doctors. But few people carefully consider other important aspects of their health insurance, such as what kind of coverage they can expect if they develop a disease like cancer.

The purpose of this guide is to offer general information to help you recognize what a comprehensive health plan should offer in the areas of cancer prevention, early detection, and treatment. This guide should be used as one of many sources of information that you consult when deciding on the health insurance plan that is best for you. We do not suggest that you rely solely on this tool. The questions posed here do not address every issue that someone diagnosed with cancer could face, and they do not address issues related to diseases other than cancer. But they do touch on the major factors that everyone should consider when choosing a health plan, and they should help you evaluate how prepared you really are for the possibility of a serious illness.

Don't base your choice only on cost.

A plan may seem to be a bargain, but its coverage may fall short. Also, don't think just about your current health care needs—keep the future, and your family's potential demands, in mind.

Even if your employer offers only one plan, or if there is only one plan you can afford, you still need to understand your coverage. Don’t wait until you have a serious health problem to discover that your selected health plan falls short of your health care needs. Get essential information now, such as by asking your employer or health provider for a plan summary that details what your plan includes and does not include. Then evaluate your plan by considering the questions and factors below. If you are unsure about some aspect of your plan, contact your human resources representative or the health insurer itself.

Here are some essential questions to ask about any health plan you are considering

  • Coverage – Know what is covered and what is not covered by your plan. What kinds of cancer prevention, screening, and treatment services are covered by the plan?
  • Access – What steps do you have to take to get the care you and your family members need? Can you go straight to a specialist or do you need a referral from your physician? Does the plan provide access to after-hours and emergency care? Which services require pre-approval from the insurance company? How long does pre-approval take?
  • Cost – What are your out-of-pocket costs (such as co-pays, deductibles, and premiums) under a given plan? Does the plan limit or include caps on coverage for treatment? How will your medical bills be paid? Will the insurance company cover them directly, or do you have to pay out of pocket and submit a claim?
  • Choice – Can you choose any doctor, clinic, or hospital you prefer, or can you select only those included in your plan?

Before making a decision as important as choosing a health plan, everyone should thoroughly understand what their plan does and does not cover. The following list describes some of the specific benefits and services that are important to cancer prevention, early detection, and treatment.

10 Key Cancer-Related Components to a Quality Health Plan

  • The health plan reminds you to get routine cancer screening tests, and covers those tests that are recommended by the American Cancer Society.
  • The health plan offers information about healthy lifestyles (such as good nutrition, physical fitness, and tobacco avoidance).
  • The health plan provides for a "health risk assessment" when you join.
  • The health plan ensures that doctors respond to abnormal screening test results by ordering follow-up tests and treatment by qualified specialists.
  • The health plan covers second opinions.
  • The health plan provides access to high-quality palliative care (to relieve pain and other symptoms) and end-of-life care (such as hospice services).
  • The health plan ensures that its providers follow best practices for cancer prevention, diagnosis, and treatment.
  • The health plan provides access to and coverage for diagnostic tests/exams and treatment options in accordance with established practices, such as National Comprehensive Cancer Network (NCCN) treatment guidelines.
  • The plan provides access to information regarding clinical trials for cancer and provides ongoing monitoring and treatment as necessary after clinical trials. Even if you choose to receive care under a clinical trial, the health plan still provides coverage for normal and customary care (such as hospital costs).
  • The health plan provides access to specialists qualified in cancer treatment, and health care professionals and resources that provide care consistent with members' cultural and language needs.

When considering which health plan coverage is right for you, it is important to ensure that coverage includes benefits that are relevant to specific forms of cancer. The following information provides general information to help you recognize what a comprehensive health plan should offer in the areas of cancer prevention, early detection, and treatment.

Here are some essential cancer-specific health plan benefits that should be part of any health plan you are considering

Skin cancer

  • The health plan provides education about sun safety, warnings about indoor tanning, and information about skin self-examination. The plan covers skin cancer screening by health professionals.

Colon and rectal cancer

  • The health plan provides coverage for and convenient access to all of the screening options recommended in American Cancer Society guidelines.

Prostate cancer

  • The health plan provides coverage for and convenient access to all of the screening options recommended in American Cancer Society guidelines.

Breast cancer

  • The health plan provides coverage for and convenient access to all of the screening options recommended in American Cancer Society guidelines.
  • The health plan provides access to genetic counseling and testing for high-risk patients with a family history of breast and/or ovarian cancer.
  • The health plan provides access to and coverage of breast reconstruction after mastectomy without time limitations.
  • The health plan provides access to and coverage of drugs that reduce cancer risk and screening MRI for women at high risk of developing breast cancer.

Ovarian cancer

  • The health plan provides access to genetic counseling and testing for high-risk patients with a family history of breast and/or ovarian cancer.
  • The health plan provides access to a gynecologic oncologist for surgical staging (an operation to accurately determine how far the cancer has spread).
  • The health plan provides education for doctors regarding referral to appropriate specialists for care of ovarian cancer.

Cervical cancer

  • The health plan provides access to all screening tests recommended by the American Cancer Society.
  • The health plan provides access to human papillomavirus (HPV) testing for evaluation of abnormal Pap test results, in accordance with established practices and recommendations of relevant professional organizations.
  • The health plan provides coverage for HPV vaccination as recommended by the American Cancer Society.

Tobacco cessation

  • The health plan provides coverage for care to help members quit smoking or using other tobacco products. Specifically, it treats tobacco use as a substance abuse issue, providing coverage of counseling that meets standards. In addition, the plan provides coverage for all seven first-line medications or lozenges for tobacco dependency:
    • Bupropion SR (Zyban, Wellbutrin)
    • Nicotine gum
    • Nicotine inhaler
    • Nicotine nasal spray
    • Nicotine patch
    • Nicotine lozenge
    • Varenicline (Chantix)
  • Out-of-pocket costs for smoking cessation treatment are limited.
  • The health plan has reminder systems in place to ensure doctors ask whether patients use tobacco, advise smokers to quit, assist with counseling, and arrange follow-up.

For an overview of early detection of cancer guidelines, see American Cancer Society Guidelines for the Early Detection of Cancer