If you don’t get the answers about chemo treatment coverage you’re looking for, asking your insurance company some of the following questions before your treatment starts may benefit you.
Questions about insurance plan benefits
- Does my policy cover chemotherapy treatment for breast cancer/metastatic breast cancer?
- If I go out of my health plan to get care, will my benefits change?
Questions regarding insurance plan rules
- Does my oncologist need to give me a referral?
- Do I need a written referral?
- Do I need approval from my insurance company for any of the following services related to chemotherapy treatment?
- Specialist visits
- Obtaining treatment
- Getting tests done
- Receiving medical equipment
- Physical therapy
- Trips to the hospital or emergency room
- If my lab work, including blood work and/or pap smears, will be sent to a special lab, will those costs be covered under my plan?
Other questions for your insurance company
- Do I have a co-pay at each chemo session? What is it?
- Does my insurance plan have an annual deductible, meaning that I must pay some of the medical expenses before my insurance will pay for the remainder? If so, what is it?
- Are there any limits on how much of my medical expenses my insurance will cover annually or over the course of my life?
- Is the pharmacy where I normally get my prescriptions covered in my plan?
- Will treatment be covered both as an inpatient and as an outpatient?