DOCSLIB.ORG

2010 Connecticut Mandated Health Insurance Benefits Reviews

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
2010 Connecticut Mandated Health Insurance Benefits Reviews Connecticut Mandated Health Insurance Benefits Reviews 2010 Volume II The Center for Public Health and Health Policy, a research and programmatic center founded in 2004, integrates public health knowledge across the University of Connecticut campuses and leads initiatives in public health research, health policy research, health data analysis, health information technology, community engagement, service learning, and selected referral services. http://publichealth.University of Connecticut.edu/aboutus.php © January 2011, University of Connecticut Connecticut Mandated Health Insurance Benefit Reviews Volume II. Introduction Volume II contains eleven of the forty-five comprehensive reviews of existing health insurance required benefits (mandates) completed by the University of Connecticut Center for Public Health and Health Policy pursuant to Public Act 09-179. (P.A. 09-179 is attached to this report as Appendix I.) The mandates in Volume II are found in Title 38a of the Connecticut General Statutes Annotated and apply to certain individual and group health insurance policies delivered, issued for delivery, renewed or continued in this state after the effective date of the respective statute. The types of policies to which health insurance mandates may apply as described in CGSA § 38a-469 include: • Basic hospital expense coverage (Subsection 1) • Basic medical-surgical expense coverage (Subsection 2) • Hospital confinement indemnity coverage (Subsection 3) • Major medical expense coverage (Subsection 4) • Disability income protection coverage (Subsection 5) • Accident only coverage (Subsection 6) • Long term care coverage (Subsection 7) • Specified accident coverage (Subsection 8) • Medicare supplement coverage (Subsection 9) • Limited benefit health coverage(Subsection 10) • Hospital or medical service plan contract (Subsection 11) • Hospital and medical coverage provided to subscribers of a health care center (Subsection 12) • Specified disease coverage (Subsection 13). Volume II is intended to be read in conjunction with the General Overview and the actuarial report for these mandates prepared by Ingenix Consulting. The Ingenix Consulting report for this set of mandates is attached to this Volume as Appendix II. The following table lists the mandates covered in this volume and the chapter in which each is reviewed; their statutory references (from CGSA Title 38a); and the applicable policy types. The order in which they are listed coincides with the order in which they are reviewed in the Ingenix Consulting report. 1 Index of Mandates: Volume II Individual Group Policy Types policy plan Applicable Chapter Description statute statute (Subsection) 1 Mammography and Breast Ultrasound § 503 § 530 1,2,4,11,12 2 Maternity Minimum Stay § 503c § 530c 1,2,4,11,12 3 Mastectomy or Lymph Node Dissection Minimum Stay § 503d § 530d 1,2,4,6,10,11,12 4 Prescription Contraceptives § 503e § 530e 1,2,4,11,12 5 Infertility Diagnosis and Treatment § 509 § 536 1,2,4,11,12 6 Autism Spectrum Disorder Therapies § 488b § 514b 1,2,4,11,12 7 Coverage for Newborn Infants § 490 § 516 1,2,4,6,11,12 8 Blood Lead Screening and Risk Assessment § 490d N/A 1,2,4,11,12 9 Preventive Pediatric Care and Blood Lead Screening N/A § 535 1,2,4,6,11,12 10 Low Protein Modified Food Products, Amino Acid § 492c § 518c 1,2,4,6,11,12 Modified Preparations and Specialized Formulas 11 Neuropsychological Testing for Children Diagnosed § 492l § 516d 1,2,4,11,12 with Cancer Each chapter reviews a single mandate and includes five sections: Overview, Background, Methods, Social Impact, and Financial Impact. The Overview includes the statutory references and the language of the mandate, the effective date, the premium impact, and the extent to which the mandated benefit is included in self-funded plans. The Background describes the disease, condition, treatment or provider to which the mandate applies, provides information on the current research and other pertinent information for each mandate. The Methods section documents the research methods followed by the mandate review team. The Social Impact section addresses the sixteen criteria contained in section 1(d)(1) of P.A. 09-179. The Financial Impact section addresses the nine criteria contained in section 1(d)(2) of P.A. 09-179. The following table summarizes the expected medical costs of each mandate in this volume for group plans. Medical cost is the primary component of health insurance premiums. See the Ingenix Consulting report (Appendix II) for further details. 2 Summary of Estimated Medical Costs of Mandates In 2010: Volume II Group Plans Per Member Per Month Percent of Mandate (PMPM) Premium Mammography and Breast Ultrasound $2.54 0.80% Maternity Minimum Stay $1.85 0.60% Mastectomy or Lymph Node Dissection Minimum Stay $0.10 0.03% Prescription Contraceptives $1.20 0.40% Infertility Diagnosis and Treatment $2.80 0.90% Autism Spectrum Disorder Therapies $0.03 0.01% Coverage for Newborn Infants $4.96 1.70% Blood Lead Screening and Risk Assessment $0.01 Less than 0.01% Preventive Pediatric Care and Blood Lead Screening $1.91 0.60% Low Protein Modified Food Products, Amino Acid Modified $0.24 0.10% Preparations and Specialized Formulas Neuropsychological Testing for Children Diagnosed with $0.00 Less than 0.01% Cancer TOTAL $15.64 5.16% 3 Volume II. Table of Contents Chapter I. Mammography and Breast Ultrasound ...................................................................................7 Overview ...........................................................................................................................9 Background .....................................................................................................................10 Methods ..........................................................................................................................11 Social Impact...................................................................................................................12 Financial Impact..............................................................................................................19 Chapter 2. Maternity Care Minimum Stay .............................................................................................23 Overview .........................................................................................................................25 Background .....................................................................................................................26 Methods ..........................................................................................................................28 Social Impact...................................................................................................................29 Financial Impact..............................................................................................................40 Chapter 3. Mastectomy Care Minimum Stay ........................................................................................45 Overview .........................................................................................................................47 Background .....................................................................................................................48 Methods ..........................................................................................................................49 Social Impact...................................................................................................................50 Financial Impact..............................................................................................................57 Chapter 4. Prescription Contraceptives .................................................................................................61 Overview .........................................................................................................................63 Background .....................................................................................................................65 Methods ..........................................................................................................................69 Social Impact...................................................................................................................70 Financial Impact..............................................................................................................79 Chapter 5. Infertility Diagnosis and Treatment ......................................................................................83 Overview .........................................................................................................................85 Background .....................................................................................................................87 Methods ..........................................................................................................................89 Social Impact...................................................................................................................90 Financial Impact..............................................................................................................98 Chapter 6. Autism Spectrum Disorder Therapies ................................................................................101 Overview .......................................................................................................................103 Background ...................................................................................................................104
Load more

Recommended publications
  • Polypharmacy in Cancer Patients: Health-Related Quality of Life, Expenditures, and Adverse Events
    University of Rhode Island DigitalCommons@URI Open Access Dissertations 2019 POLYPHARMACY IN CANCER PATIENTS: HEALTH-RELATED QUALITY OF LIFE, EXPENDITURES, AND ADVERSE EVENTS Zachary R. Babcock University of Rhode Island, [email protected] Follow this and additional works at: https://digitalcommons.uri.edu/oa_diss Recommended Citation Babcock, Zachary R., "POLYPHARMACY IN CANCER PATIENTS: HEALTH-RELATED QUALITY OF LIFE, EXPENDITURES, AND ADVERSE EVENTS" (2019). Open Access Dissertations. Paper 869. https://digitalcommons.uri.edu/oa_diss/869 This Dissertation is brought to you for free and open access by DigitalCommons@URI. It has been accepted for inclusion in Open Access Dissertations by an authorized administrator of DigitalCommons@URI. For more information, please contact [email protected]. POLYPHARMACY IN CANCER PATIENTS: HEALTH-RELATED QUALITY OF LIFE, EXPENDITURES, AND ADVERSE EVENTS BY ZACHARY R BABCOCK A DISSERTATION SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN PHARMACEUTICAL SCIENCES UNIVERSITY OF RHODE ISLAND 2019 DOCTOR OF PHILOSOPHY DISSERTATION OF ZACHARY R BABCOCK APPROVED: Dissertation Committee: Major Professor Stephen J. Kogut Ami Vyas Aisling Caffrey Mary Greaney Nasser H. Zawia DEAN OF THE GRADUATE SCHOOL UNIVERSITY OF RHODE ISLAND 2019 Abstract Polypharmacy (PP), often defined as the use of five or more medications, is highly prevalent in patients with cancer. As the quantity of medications for treating cancer and comorbid conditions in patients with cancer become more numerous and diverse, it is important to understand the various ways in which patient health and economic outcomes may be adversely affected by prescribed medications. The purpose of this dissertation was to investigate three distinct associations between PP and the lives of patients living with cancer by estimating how PP (1) affects health- related quality of life (HRQoL), (2) is associated with healthcare expenditures, and (3) affects health complications (HCs).
    [Show full text]
  • 2012 Connecticut Mandated Health Insurance Benefits Reviews
    Review and Evaluation of Certain Health Benefit Mandates in Connecticut 2012 The Center for Public Health and Health Policy, a research and programmatic center founded in 2004, integrates public health knowledge across the University of Connecticut campuses and leads initiatives in public health research, health policy research, health data analysis, health information technology, community engagement, service learning, and selected referral services. http://publichealth.uconn.edu/aboutus.php © January 2012, University of Connecticut Executive Summary Pursuant to Public Act 09-179, the Chairs of the Insurance and Real Estate Committee of the Connecticut General Assembly (the Committee) directed the Connecticut Insurance Department to review six proposed health benefits in a letter dated August 26, 2011. The proposed health benefits listed in the letter to be reviewed include: an act concerning health insurance coverage for autism spectrum disorders, P.A. 09-115; group health insurance coverage for an alternative therapy in the treatment of autism spectrum disorders, based on S.B. 974 from the 2011 Regular Session; an expansion of group health insurance coverage for the treatment of autism spectrum disorders to certificate holders in this state based on S.B. 978 from the 2011 Regular Session; an act concerning coverage for the treatment of prostate cancer, P.A. 11-225; elimination of cost-sharing on breast cancer screening by ultrasound procedures, based on S.B. 848 from the 2011 Regular Session; and health insurance coverage for breast cancer screening by means of thermography, based on H.B. 5448 from the 2011 Regular Session. This review has been performed in accordance with that request and with follow-up communication with the Committee.
    [Show full text]
  • Cancer Insurance Brochure
    SUPPLEMENTAL BENEFITS SPECIALIST FOR YOUR INDUSTRY Cancer Insurance Limited Benefit Specified Disease Cancer Indemnity Insurance Cancer Insurance Cancer can be a costly disease. A cancer diagnosis may be both a physical and emotional drain. Thanks to advances in medicine and procedures to treat cancer, more and more people are beating the disease. However, with the arrival of these advances also comes the continuing rise in the cost of cancer treatment. The financial impact of a cancer diagnosis can affect anyone’s financial situation. American Fidelity Assurance Company’s Limited Benefit Cancer Insurance may offer a solution to help you and your family focus on fighting the disease. This plan may assist with the expenses that may not be covered by other medical insurance. Did You Know? DIRECT Non-medical expenses, such as INDIRECT MEDICAL travel, lodging, and meals, are MEDICAL usually not covered by many medical policies. Only 40% of the overall medical cost of cancer is for direct expenses, while 60% of cancer treatment costs are indirect medical costs.** It is essential to have a plan Over 1.6 million new cases of cancer set in place that could help if you were diagnosed. will be diagnosed this year.* SCREENING BENEFIT+ How It Works Receive a benefit for your annual internal cancer This plan is designed to help cover expenses screening test, including but not limited to should you be diagnosed with cancer. With Mammogram, PAP, PSA, and Colonoscopy. more than 25 built-in plan benefits, this plan provides benefits for the treatment of cancer, DIAGNOSTIC AND PREVENTION BENEFIT transportation, hospitalization, and more.
    [Show full text]
  • Cancer Insurance Program
    Here are some answers to your questions about exceptions & limitations. Cancer Insurance Program Underwritten by: National Teachers Associates Life Insurance Company (NTA Life) 4949 Keller Springs Rd • Addison, Texas 75001 • P.O. Box 802207 - Dallas, Texas 75380 • (888) 671-6771 • ntalife.com 75-420 (2/13) Educators Select Most benefits availablewhether or not you are Series ® Hospital confined & without regard to actual costs: GREEN LEVEL TREATMENT BENEFITS GOLD LEVEL CANCER DIAGNOSIS, SCREENING, AND TESTING Express Payment Benefit: Paid one time for a Covered $2,000 adult Person upon first diagnosis of internal Cancer or melanoma. $3,000 adult $3,000 child Not payable for Skin Cancer. Benefit is 50% larger for $4,500 child diagnosis in a covered Child. Cancer Screening Wellness Benefit: Paid once per Calendar $50/Year Year for each Covered Person who receives a mammography exam, pap-smear lab, chest x-ray, colonoscopy, certain blood $75/Year tests, or other wellness tests specified in the Policy. National Cancer Institute (NCI) Benefits: Paid once per Covered Person, for seeking NCI’s opinion on the Covered Person’s Cancer treatment. $500 One-Time Consultation Benefit: Not payable on same $750 day as 2nd/3rd Surgical Opinion Benefit. $200 One-Time Transportation Benefit: Payable only if NCI’s $300 Cancer center is more than 100 miles from the Covered Person’s home. Not payable on same day as Covered Person and Family Transportation Benefit. HOSPITAL CONFINEMENT 1 /day Hospital Confinement Benefit: Paid daily for the first 60 Cancer Insurance Program $200 $300/day Days of One Period of Confinement. Extended Hospital Confinement: Paid daily for the 61st $600/day and later Days of One Period of Confinement.
    [Show full text]
  • American Fidelity Assurance Company's
    AMERICAN FIDELITY ASSURANCE COMPany’s Cancer Insurance Enhanced Plus C-12D Plan A Limited Benefit Cancer Indemnity Insurance Policy Cancer Can Be A Costly Disease. Anyone can develop Cancer. Most Cancers are not inherited, but rather are the result of damage to genes that occurs during one’s lifetime.* If you think it can’t happen to you, think again. CONSIDER THESE FACTS & g Men have a 1 in 2 lifetime risk of developing Cancer. Women have a 1 in 3 chance of developing * 1 in 2 1 in 3 some form of Cancer. Men Women With statistics like this, it would help to prepare for Cancer early. Ask yourself, “If I were to be diagnosed, how would I pay for this Will Develop Some Form Of costly disease?” Cancer In Their Lifetime.* Non-medical expenses, such as travel, lodging, and meals, are usually not covered by most medical policies. Only 41% of the overall medical cost of Cancer is for direct expenses, while 59% of Cancer treatment costs are not direct medical costs.* It is essential to have a plan set in place that would help if you were diagnosed. Cancer screenings can help detect Cancer earlier which could increase your survival rate if you were to be diagnosed with Cancer. The 5-year relative survival rate for all Cancers diagnosed is 66%.* Yet, sadly, many Americans cannot afford the expense of these all-important screenings. The good news is that American Fidelity provides a product that can help with these expenses. Our Limited Benefit Cancer Insurance plan can help cover the cost of these screenings, giving you the early detection that can be so important when fighting the illness.
    [Show full text]
  • Guardian Cancer Benefits Summary
    Citizens Memorial Healthcare Group Number: 00543041 Cancer Benefit Summary About Your Benefits: Cancer is a terrible disease, but fortunately, more and more people are beating it through earlier diagnosis and the ever improving treatments available. However, treatment can be costly. Did you know an average out-of-pocket cost for cancer care is more than $1200 per month.¹ That’s where Cancer insurance can help. It supplements your medical and disability income insurance and helps protect you and your family from the financial hardship you may face while fighting the disease. Cancer Insurance pays benefits to you based on the treatments you receive related to a covered cancer diagnosis. The benefit payment is paid in addition to your medical insurance plan. Coverage is surprisingly affordable, so enroll today and get covered! ¹Duke University Medical Center, 2011 http://clearhealthcosts.com/tag/duke-university-medical-center/ What Your Benefits Cover: CANCER COVERAGE - DETAILS Option 1 Option 2 Your Monthly premium $24.36 $31.52 You and Spouse $38.06 $49.66 You and Child(ren) $34.10 $44.70 You, Spouse and Child(ren) $47.80 $62.84 INITIAL DIAGNOSIS BENEFIT - Benefit is paid when you are diagnosed with Internal cancer for the first time while insured under this Plan. Employee $2,500 Employee $5,000 Benefit Amount(s) Spouse $2,500 Spouse $5,000 Child $2,500 Child $5,000 Benefit Waiting Period - A specified period of time after your effective date during which the Initial Diagnosis benefits will not be 30 Days 30 Days payable. CANCER SCREENING $100; $100 for Follow-Up $100; $100 for Follow-Up Benefit Amount screening screening RADIATION THERAPY OR CHEMOTHERAPY Schedule amounts up to a $10,000 Schedule amounts up to a $10,000 Benefit benefit year maximum.
    [Show full text]
  • Aflac Cancer Protection Assurance CANCER INDEMNITY INSURANCE – OPTION 2
    Aflac Cancer Protection Assurance CANCER INDEMNITY INSURANCE – OPTION 2 We’ve been dedicated to helping provide peace of mind and financial security for more than 60 years. The policy is a supplement to health insurance. It is not a substitute for essential health benefits or minimum essential coverage as defined in federal law. Lack of major medical coverage (or other minimum essential coverage) may result in an additional payment with your taxes. B70275CA IC(3/18) AFLAC CANCER PROTECTION ASSURANCE 2 CANCER INDEMNITY INSURANCE – OPTION 2 Policy Series B70000 C Aflac Cancer Protection Assurance: real coverage when you need it most. Cancer treatment is changing—and Aflac is proud to be changing with it. Thanks to advances in science and treatment, more and more Americans today are living with cancer.1 Aflac Cancer Protection Assurance helps cover these innovative treatments with benefits that really care for you as a whole person. From prevention to recovery, Aflac is with you every step of the way. Our benefits are built to see you all the way through cancer treatment and they’ll stay with you for life after cancer.2 CANCER STATS YOU NEED TO KNOW FACT NO. 1 FACT NO. 2 MEN HAVE WOMEN HAVE A SLIGHTLY IN A SLIGHTLY IN LESS THAN 1 2 MORE THAN 1 3 LIFETIME RISK OF DEVELOPING CANCER IN LIFETIME RISK OF DEVELOPING CANCER IN THE UNITED STATES.3 THE UNITED STATES.3 Of course, four-in-four hope they’ll never get it. But for many—and for certain types of cancer—advances in science and treatment have transformed cancer into an illness that can be managed over a lifetime.
    [Show full text]
  • Peace of Mind and Real Cash Benefits
    Peace of Mind and Real Cash Benefits MAXIMUM DIFFERENCE ® ESSENTIALS E CANCER INDEMNITY INSURANCE MD A76175ESLTN IC(1/11) E MAXIMUM DIFFERENCE ® ESSENTIALS CANCER INDEMNITY INSURANCE Policy A761ESTN MD The Need Despite the best efforts of doctors, researchers, and countless organizations, Cancer remains a concern for many individuals and families. People from all walks of life are at risk, regardless of age, gender, or ethnic background. Here are a couple of statistics to help you understand the role Cancer plays in America’s overall health. According to the American Cancer Society:* 1 In the United States, men have slightly less than a 1-in-2 lifetime risk of developing Cancer; for women, the risk is a little more than 1-in-3. 2 About 1,479,350 new Cancer cases were expected to be diagnosed in 2009. *Cancer Facts & Figures 2009. ARE YOU PROTECTED IF SOMETHING UNEXPECTED HAppENS? 1 Your coverage is portable, which means it goes with HERE’S HOW WE CAN HELP. you if you change jobs. E Aflac’s Maximum Difference Cancer insurance policy 2 Guaranteed-Renewable – As long as your premiums helps you focus on getting well instead of being are paid, your coverage is guaranteed. distracted by the stress and costs of medical and Our policies have no deductibles, copayments, or personal bills. With Aflac, you receive cash benefits 3 network restrictions—you choose your own medical MD directly, unless assigned—giving you the flexibility to treatment provider. help pay bills related to treatment like deductibles, copayments, and travel expenses. Aflac can also help with everyday living expenses, such as car payments, mortgage or rent payments, child care, and utility bills.
    [Show full text]
  • Usable Cancercare Elite Product Manual Includes: Brochure Field Reference Manual Specimen Policy Forms
    USAble CancerCare Elite Product Manual Includes: Brochure Field Reference Manual Specimen Policy Forms CancerCare Elite F. EL S R U O Y T C E T O R P LY. I M RFA U O TY C E T O R P You’ll Choose Us For Life CE-OC-2 (5-03) CancerCare Elite provides EXTRA PROTECTIO READ YOUR POLICY CAREFULLY — This outline of coverage provides a very brief description of the important features control. The policy itself sets forth, in detail, the rights and obligations of both you and your insurance co This is a limited benefit policy and is designed to provide coverage ONLY when certain losses occur as a resu and may be limited by EXCEPTIONS AND LIMITATIONS. Coverage is not provided for basic hospital, b Outline of Coverage — Cancer and Specified Disease Policy — OPTIONS AVAILABLE FOR BENEFITS PLAN I PLAN II PLAN III Pays $100 per day for first Pays $250 per day for first Pays $300 per day for first INPATIENT 60 days, $200 for each 60 days, $500 for each 60 days, $600 for each HOSPITAL subsequent day. subsequent day. subsequent day. CONFINEMENT Successive periods of confinement are considered to be the same period of confinement unless separated by more than 30 days. Beginning on the first day of confinement, benefits double for covered children. $5,000 $10,000 $15,000 INPATIENT OR maximum per calendar year maximum per calendar year maximum per calendar year OUTPATIENT Radiation, Radioactive Isotopes Therapy and Physician Administered Chemotherapy RADIATION, Pays charges up to 100% of the calendar year maximum selected.
    [Show full text]
  • To Get the Checklist
    Cancer Insurance Checklist HOW THIS CHECKLIST CAN HELP The Cancer Insurance Checklist is designed to help you compare insurance plans and consider your health needs when shopping for insurance in your state’s Health Insurance Marketplace. The Checklist is a useful guide to help you fi nd a plan that will meet your needs. You may not need all of the treatments in the Checklist, and there may be other treatments, costs or aspects of your care that you need to consider. WHEN TO USE THE CHECKLIST: If you have cancer, a history of cancer, or are at risk for cancer When evaluating insurance plans When discussing your insurance needs with your navigator, Marketplace representative, care provider or patients in your family When discussing your cancer care needs with your health care provider Fill in the following worksheets for each insurance plan you are considering. By doing so, you will be able to tell which insurance plan best fi ts your needs and your budget.* For more information on where to go to get help with paying for health insurance and to get assistance from a navigator in choosing and applying for plan coverage, visit www.healthcare.gov or call 1-800-318-2596 or TTY: 1-855-889-4325 THIS CHECKLIST WAS CREATED THROUGH A PARTNERSHIP OF: The Assistance Fund, Association of Community Cancer Centers, Avalere Health, Cancer Support Community, Chronic Disease Fund, Cutaneous Lymphoma Foundation, International Myeloma Foundation, The Leukemia & Lymphoma Society, Living Beyond Breast Cancer, Lung Cancer Alliance, Melanoma Research Foundation, Men’s Health Network, National Coalition for Cancer Survivorship, Oncology Nursing Society, Ovarian Cancer National Alliance, Patient Advocate Foundation/National Patient Advocate Foundation, Patient Services, Inc., Prevent Cancer Foundation * Remember that no plan will pay 100 percent of your medical expenses.
    [Show full text]
  • Loyal American Life Insurance Company® Administrative Office: 815 W Ash, PO Box 1604, Duncan, OK 73534-1604 Toll Free: 1-800-366-8354
    Loyal American Life Insurance Company® Administrative Office: 815 W Ash, PO Box 1604, Duncan, OK 73534-1604 Toll Free: 1-800-366-8354 GROUP CANCER EXPENSE INSURANCE POLICY This policy offers Limited Benefit Supplemental Health Insurance Coverage. THIS IS NOT A MEDICARE SUPPLEMENT POLICY. If any proposed Insured Person is eligible for Medicare, such person should review the “Guide to Health Insurance for People with Medicare” available from the Company. PART A INSURING CLAUSE Loyal American Life Insurance Company (hereinafter referred to as We, Us or Our) agrees with the Policyholder to cover each Insured Person identified in an issued Certificate of Cancer Insurance and any associated riders (hereinafter, “Certificate”) for any covered loss described in said Certificate in return for payment of premiums and subject to the provisions, limitations and exclusions that follow. This group policy is executed as of the Policy Effective Date and from which anniversary dates are measured. This group policy takes effect at 12:01 A.M. Standard Time on the Policy Effective Date at the address of the Policyholder. IMPORTANT NOTICE ABOUT A MEMBER’S STATEMENTS IN THE ENROLLMENT FORM The issuance of a Certificate of Cancer Insurance will be based upon the member’s responses to the questions on the enrollment form. A copy of the enrollment form will be attached to each issued Certificate. If the member’s answers are materially incorrect or untrue, We may have the right to deny benefits or rescind the Certificate, subject to the Time Limit on Certain Defenses provision. Upon Certificate issue the member will be advised to review the enrollment form and to contact Us if the answers on the enrollment form are incorrect for any reason.
    [Show full text]
  • Cancer Insurance Checklist
    Cancer Insurance Checklist HOW THIS CHECKLIST CAN HELP The Cancer Insurance Checklist is designed to help you compare insurance plans and consider your health needs when shopping for insurance in your state’s Health Insurance Marketplace/Exchange. The Checklist is a useful guide to help you find a plan that will meet your needs. You may not need all of the treatments in the Checklist, and there may be other treatments, costs or aspects of your care that you need to consider. WHEN TO USE THE CHECKLIST: If you have cancer, a history of cancer, or are at risk for cancer When evaluating insurance plans When discussing your insurance needs with your navigator or Marketplace/ Exchange representative When discussing your cancer care needs with your health care provider Fill in the following worksheets for each insurance plan you are considering. By doing so, you will be able to tell which insurance plan best fits your needs and your budget. For more information on where to go to get help with paying for health insurance and to get assistance from a navigator in choosing and applying for plan coverage, visit www.healthcare.gov or call 1-800-318-2596 or TTY: 1-855-889-4325 THIS CHECKLIST WAS CREATED THROUGH A PARTNERSHIP OF: The Assistance Fund, Association of Community Cancer Centers, Avalere Health, Cancer Support Community, Chronic Disease Fund, Cutaneous Lymphoma Foundation, International Myeloma Foundation, The Leukemia & Lymphoma Society, Living Beyond Breast Cancer, Lung Cancer Alliance, Melanoma Research Foundation, Men’s Health Network, National Coalition for Cancer Survivorship, Oncology Nursing Society, Ovarian Cancer National Alliance, Patient Advocate Foundation/National Patient Advocate Foundation, Patient Services, Inc., Prevent Cancer Foundation www.CancerInsuranceChecklist.org 1 MY CARE Will the insurance plan cover my provider visits, hospital stays, care centers and medicines? ARE THEY COVERED? in-network out-of-network My primary care doctor is: My specialists are: Be sure to include all your doctors.
    [Show full text]