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Living Now: Understanding health insurance

When you’re renewing or buying health insurance, there are new things to consider now that you’re on the road to recovery. And, sometimes it can be hard to know where to start.

A good first step is to look at the health insurance policy and check the: 

  • Summary of benefits, which gives an overview of your coverage 
  • Certificate of coverage, which has more details about your plan 
  • Prescription drug formulary, which tells you which medicines are covered, how much your insurance company will pay and how much you will pay 

Find out if your insurance plan will cover your: 

  • Appointments with your transplant doctor, hematologist/oncologist, primary care doctor and other specialists you see 
  • Hospital stays at your local hospital or your transplant center 
  • Blood tests, imaging tests (like PET or CT scans), and emergency room visits 
  • Prescription medicines at your local, specialty or mail-order pharmacy 

Remember, your insurance coverage can change from year to year. So be sure you review this information every year before you enroll again. To help you plan financially, be sure to learn about and understand your:

  • Monthly premium: This is the amount you pay each month to your insurance company for your health insurance policy.
  • Deductible: This is the amount you pay for health care services (such as treatments or office visits) before your health insurance begins to pay.  
  • Co-insurance: This is the percent of health care costs that you pay after your deductible is met, such as 20% of the charge for an office visit.  
  • Co-payments (co-pay): This is a fixed amount you pay after your deductible is met, such as $20 for an office visit 

Resources for you  

If you’re buying your own health insurance, the best place to start is healthcare.gov. You can see all of your options and compare plans side-by-side to decide which plan is the best option for you.

CancerInsuranceChecklist.org has useful tools that can help you organize treatments, costs and other pieces of your care that you need to think about when buying or renewing insurance.

CMS.gov offers a glossary of commonly used health insurance terms. Enter the search term “uniform glossary.”