Can we get cancer insurance after diagnosis?

Hi there,
My potential reoccurrence of pan cancer occurred about Nov 1, 2023. I had a Medicare HMO with Blue Shield at the time. I tried so fervently to get 2nd opinions from UCLA and Cedar-Sinai at the time and was u successful. At the time, my oncologist was with Hoag Hospital. I was trying to get more opinions because my beautiful ca19-9 of “6” was basically quadrupling, but my oncologist group wanted to basically ignore it since my CT and PET scans showed no new growth based on the radiologists’ readings (they were wrong). I used the time to research new oncologists and with the holidays I was only able to get an appt the first week of January in 2024. I switched to a PPO. By this time my CA19-9 was 3840. In December of 2023 I asked for a MRI (only due to the comments of another ATM “member” in this group) and it was found that I had 2 small lesions on my liver, masses in the abdominal peritoneum, and around the hepatic/celiac artery that Hoag radiologists had previously incorrectly identified as scar tissue. You can can change insurances when you move or change in jobs. Would be interested to know about cancer insurance.

My understanding is that it is difficult to switch back from an Advantage plan. That was the reason I have a part G plan and part D. I have read that you can switch back but there are some type of penalties. Sorry but I do not know the specifics. With my part G plan and part A&B I can go anywhere in the US that accepts Medicare.

Before I was able to get Medicare I had a self pay BCBS policy that was an EPO plan. It really had a small network that I could go to. I did have a bit of luck with using a condition in that plan that permitted me to go out of network for a service that was not available in the network of doctors I was restricted to. I do not know if that will help you, but you might check. Look for something that your local network doctors don't do but the better doctors you want to go to do. Then check and see if you have a clause in your advantage plan that lets you go out of network. Took me 3 years to get mine done and my network doctor may have suffered the full wrath of BCBS for submitting the form.

Anyway, it is a tough go and I really feel bad for you and others that have an advantage plan and do not live close to the best doctors in the world. Check about what those penalties are and see what your watered-down plan would be if you switched back to a part G and D plan in the fall at open enrollment. Might be really expensive as well.

Good luck to you.

My sister had stage for cancer and she did not have insurance in the state of Colorado and then she got on the insurance of the State insurance cuz she thought insurance through the state of Colorado it depends on your state but she had stage four cancer and she cannot work anymore in this state needed to cover her and she got it through the state yes you can get insurance with cancer and it will be through your state it'll be like Medicaid are lb through Medicaid her Medicare and they cannot deny you she lived one year after her diagnosis one year and 2 months she was a 48 but when she passed away. 🥲

Thanks for the advice. Very sorry to hear about your sister.

Thanks for sharing. Sorry to hear about your difficulties with health providers and insurance. Open enrollment won't take effect until 1/1/25, so we're still looking into cancer insurance now.

@steveron
I do know people who were allowed to see providers outside of their Medicare Advantage network, but it is usually when an in-network provider referring them because the care required was not provided by in-network providers. The Medicare Advantage company had to approve.

My understanding of Cancer Insurance or Critical Illness insurance it is designed to be used in addition to major medical health coverage, but not replace it. I cannot specifically answer if you would be able to get Cancer Insurance, but I asked an insurance broker about once at Health Expo. Because I had previously had cancer I was not eligible for the policies he sold. He was selling a critical illness policy that included cancer.

If looking at cancer insurance, check policy carefully to determine what is and isn’t covered. Things to look for are:
• Preexisting conditions
• Waiting period
• Type of cancer / illness it covers

If looking at changing your Medicare Advantage plan outside of normal enrollment plan, check the Medicare site for exceptions for changing:
https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan/special-enrollment-periods

Thanks for the info. We'll check it out.

Medicare Open Enrollment for 2025 is underway. I echo others' comments recommending changing to Original Medicare + Supplemental Part G, which allows you to go to any doctor who takes Medicare. Be sure to check for pre-existing conditions limitations.

I am not an insurance agent or financial planner, just a pancan patient. It's my understanding that if you're moving from Medicare Advantage (part C) to traditional Medicare (parts A/B), you will undergo underwriting in order to obtain a supplemental Medigap policy. Companies are NOT required to issue a Medigap policy to you. If you can't get the supplemental, that means that all copays would be on your nickel. Obviously, with an active cancer diagnosis, making it through underwriting would be impossible. But you're right, open enrollment is under way, so now is the time to ask questions.

If anyone out there is getting ready to move onto Medicare, I am an advocate for starting with traditional and a supplement rather than Advantage. Please examine your options carefully. I can tell you that in late 2020, I landed in the hospital for three months with cardiac issues likely related to covid. My bill was $1.7 million; I paid less than $100 out of pocket. So far this year, I've had multiple surgeries and lots of chemo, scans, MD visits and such. I've paid only my original deductible. For us, the higher monthly premiums are definitely worth it.

My ins. agent I've used for many years told me that since I had a previous cancer diagnosis, no medicare supplemental insurance company would take me. In my opinion, tradtional medicare is better than Medicare Advantage. I'm fortunate in that the VA is picking up what my supplemental plan would have. Please check on this and I hope I'm proven wrong about coverage for cancer patients by medicare supplemental ins. companies.