Finances, Insurance & Employment while facing cancer
Money Talks, but Cancer Makes it Scream
It’s not surprising that many patients diagnosed with cancer experience some degree of financial toxicity. Medical bills can pile up, you may have to take unpaid time off of work, you may have inadequate or no insurance coverage, you may have to drain your savings, or you may lose employment.
Staying organized, understanding your insurance coverage, taking action before due dates pass, and asking about and applying for financial assistance early may help you avoid some common financial difficulties.
Financial Health & Insurance
- Be sure to understand and verify your health insurance coverage fully. You can review your Summary of Benefits, Certificate of Coverage, or call your insurance company directly to get access to and a walkthrough of this information.
- Take note of your copays and/or coinsurance for specialist visits, in-patient and out-patient procedures, hospital stays, prescription medications, imaging (CT, MRI, PET), lab work, and urgent care and emergency room visits. A copay is a fixed dollar amount that you pay per service, visit, or prescription, and the remaining balance is covered by your insurance. Coinsurance is a percentage that you are responsible for paying for each service, visit, or prescription, and your insurance covers the remaining balance.
- Know which doctors, facilities, and hospitals are in-network for your plan.
- Does your plan require prior authorization for any services, tests, or medications?
- What is your deductible for the year (the amount of money you have to pay for medical services before your insurance will start covering a portion) and how much have you paid toward that deductible already this year?
- What is your maximum out-of-pocket responsibility per year and how much have you already paid toward that maximum this year?
- Don’t rely on a doctor’s office or hospital to verify if they are in-network for your plan. Call your insurance company directly to confirm this information before receiving medical services.
- Seek financial assistance as soon as you think you might need it. There are many organizations and programs (local, state-wide, and national) dedicated to providing direct financial support to cancer patients and their families. Each program is unique and eligibility requirements exist for all of them to different degrees, but offerings include aid for copays, coinsurance, insurance premiums, medications, treatment costs, travel and lodging for distant treatment, living expenses (rent, mortgage, utilities, food, clothing), transportation, childcare, medical supplies, and much more. Speak with a social worker or navigator to learn more and apply. At the bottom of this page, you'll find a giant list of financial assistance resources.
- If you receive a bill that you cannot afford to pay in full, contact the biller’s accounting department right away to set up a payment plan or offer a reduced total that you can pay in full. Before doing this, make sure that the bill is correct, matches your Estimation of Benefits (EOB) for those services, and you are only agreeing to pay for expenses that are your responsibility.
- If you do not have insurance coverage or if you’re underinsured, you may be able to:
- receive free or reduced-cost medications directly from manufacturers (pharma company)
- apply for Medicaid, Medicare, CHIP (for children’s coverage), or health insurance through the Marketplace (healthcare.gov) depending on your eligibility
- apply for financial assistance through various organizations
Work & Income
- Consider the nature of your work (physical demands, stress level, emotional demands) when deciding whether or how much you will be able to work during treatment. You may only need a day or two off here and there or you may need to step away for a longer period of time. Discuss these scenarios with your doctor, employer, and family.
- Determine how much PTO (paid time off), vacation, and/or sick time you’ve earned and how you can best use it during your treatment.
- Check with the human resources department at your workplace to see if you can take advantage of any benefits during treatment and what needs to be done to get started. This could include FMLA (Family Medical Leave Act), short-term disability, long-term disability, childcare services, or a temporary work-from-home or reduced-hours arrangement.
- If you’re facing discrimination at work, visit Workplace Protections for Individuals Impacted by Cancer to learn more about your rights and what can be done to help you.
- If you lose employment and your health insurance during treatment, you may consider COBRA (temporary insurance coverage after job loss, allows you to keep the same plan but at a higher premium), Healthcare.gov, and/or applying for Medicaid (if you’re eligible) to avoid a lapse in coverage.
- If you lose employment, you may be able to:
- apply for Unemployment benefits
- apply for Social Security Disability Insurance (SSDI)
- apply for Supplemental Security Income (SSI)
- apply for financial assistance through various organizations
- receive copay assistance for medications directly from manufacturers
- To learn more about employment rights by state, visit Triage Cancer
What might you want in an insurance plan if you have cancer?
- affordable deductible
- affordable monthly premium
- coverage that includes in-network care at an NCI-designated cancer center or other major cancer care practice near your home
- coverage for specialty pharmacies (who provide oncology drugs) and/or enrollment in Part D prescription coverage if you are on Medicare and will be using oral oncology drugs (Medicare Part B covers infused oncology drugs, but not oral)
- reasonable, affordable copays for physician visits, ER, urgent care, hospital stays, imaging, conventional pharmacy drugs, and procedures
In the next few sections, we'll cover medical expenses, seeking financial assistance, financial toxicity, laws and patient rights, and more.
Medical Expenses in Cancer Care
Nickled & Dimed
Expenses You May Encounter During Cancer Care:
- Copays or Coinsurance for blood work/labs, specialist visits, chemotherapy infusions, radiotherapy treatments, medication, imaging/scans, diagnostic tests, hospital stays, inpatient and outpatient procedures, ER visits, etc.
- Home health nurse or aide
- Housekeeping assistance, grocery delivery, prepared meal delivery
- Childcare
- Adaptive clothing, accessories, devices (wigs, prostheses, bras, etc.)
- Stay at rehabilitation, acute care, or skilled nursing facility
- Nutrition and Dietician services
- Travel for medical care (lodging, meals, transportation)
- Therapy (physical, occupational, speech, mental health, etc.)
- Integrative care (massage, acupuncture, yoga, supplements, exercise programs, etc.)
Reducing Costs & Seeking Financial Assistance
If you have financial concerns about your cancer care, you may benefit from considering some of the following:
- Most oncology practices/cancer centers have financial assistance programs in place for their patients. Ask if yours does and how you can qualify for assistance. If you are receiving care from a non-profit hospital, your care may be covered in part or in full if you meet eligibility requirements. Speak with a social worker, patient navigator, or billing specialist at your hospital to learn more.
- Ask about telehealth visits when possible to streamline care and reduce expenses (time off work, parking, travel, etc.).
- Scheduling a call with your health insurance provider for details on your plan coverage, in-network providers and services, and your personal financial responsibility so you're not surprised by copays, coinsurance, deductibles, or out-of-network charges.
- Changing or upgrading your health plan may reduce your medical costs overall by lowering deductibles, premiums, or copays, for example. Open enrollment periods and "major life events" may dictate when and how changes can be made to your health plan so be sure to find out your plan's requirements.
- Contacting billing departments immediately upon receipt of bills to discuss payment plans or assistance if you are unable to pay the bill in full by the due date.
- Seek out patient assistance programs offered by non-profit organizations.
- Seek out patient assistance programs offered by industry companies (pharmaceutical/biotechnology/medical device/medical supplies). These programs will apply specifically to the products or services offered by that company.
- Check with your insurance plan to see if they will reimburse for wigs, special adaptive clothing, prostheses, etc. If they do, ask your doctor for a prescription for what is needed and submit that, along with your purchase receipt, to your insurance company for reimbursement.
- Call 2-1-1 for help locating local financial assistance resources in your community.
- Scroll to the bottom of this page for links to patient financial assistance programs and funds. They may offer funds for copays; health insurance premiums; medical treatment; diagnostic testing; basic needs like food, rent/mortgage, utilities and other living expenses; transportation and lodging for cancer treatment; fertility preservation; genetic and genomic testing; end-of-life expenses like cremation or memorial services; prescription medication; cancer screening and more.
Medical Debt & Credit Reports
As of 2023, Equifax, Transunion, and Experian (credit reporting bureaus) removed paid medical debt and any unpaid medical debt under a year old or under $500 from credit reports. This change resulted in the removal of nearly 70% of all medical debt on consumer credit reports. Check your credit report to be sure these changes were made, if applicable.
The No Surprises Act
Per CMS, "The No Surprises Act is a federal law that went into effect on January 1, 2022. It applies to most types of health insurance, and protects you from unexpected out-of-network medical bills from:
- Emergency room visits
- Non-emergency care related to a visit to an in-network hospital, hospital outpatient department, or ambulatory surgical center
- Air ambulance services
Usually, if you don't have or use health insurance, providers must give you a good faith estimate of what your care will cost. You get the estimate when you schedule care in advance or if you ask for one. You may be able to dispute your bill if it’s at least $400 more than the estimate. You can submit a complaint if you believe that your facility, provider, or insurer isn't following these rules."
Health Insurance State Laws: No Surprises Act and Surprise Billing (Triage Cancer)
This chart indicates whether the federal or state process is used by each state for disputes related to medical billing under the federal No Surprises Act. Note that some states used a mixed system where the system used depends on the type of complaint. Use the links in the chart to be directed to the complaint system chosen by your state for consumer complaints. This chart summarizes surprise billing laws in different states. Check back often, as these charts are updated frequently.
https://triagecancer.org/state-laws/health-insurance-no-surprises-act
Federal Poverty Level & Financial Assistance Eligibility
Many organizations use the Federal Poverty Level (FPL) to determine eligibility for financial assistance programs. FPL is based on annual income and the number of people in your household. In 2024, for those living in the 48 contiguous states or DC, the HHS Poverty Guidelines indicate that a 1-person household has an annual income of $15,060 or less, a 4-person household has $31,200 or less, and a 6-person household has $41,960 or less in annual income.
Some organizations may apply FPL "as-is" and other programs may use a multiplier or percentage of FPL for eligibility. In reading through financial assistance eligibility guidelines, you may see something like, "eligible patients must be at 165% of the federal poverty level or below to qualify for assistance through our foundation." Using this guideline for a 1-person household in 2024, the income threshold would be $24,849 ($15,060 x 1.65) or less in annual income to qualify for this theoretical program.
Each year the Department of Health and Human Services puts out new guidelines. You can access the complete 2024 Federal Poverty Levels here.
Financial Toxicity in Cancer Care
Cancer's Impact on Your Wallet
Debilitating medical costs related to cancer care can lead to worse health outcomes, discontinuation or delay of treatment due to cost, depletion of savings, bankruptcy, and reduced quality of life.
The term "financial toxicity" was introduced to the cancer zeitgeist by S. Yousuf Zafar, MD and Amy P. Abernathy, MD in their 2013 paper in Oncology titled Financial Toxicity, Part I: A New Name for a Growing Problem. Zafar published an additional article on the topic in JNCI in 2016 (Financial Toxicity of Cancer Care: It's Time to Intervene) in which he states, "Evidence suggests that a considerably large proportion of cancer patients are affected by treatment-related financial harm. As medical debt grows for some with cancer, the downstream effects can be catastrophic, with a recent study suggesting a link between extreme financial distress and worse mortality...As with any adverse effect of cancer treatment, the experience of financial toxicity is diverse and can range from subjective distress resulting from monthly copayments that prompt changes in household spending to personal bankruptcy."
In a more recent article from 2023, the author, Ezekiel J. Emanuel, an oncologist, shares some startling statistics. "Cancer care is expensive. By one 2020 estimate, the average cost of medical care and drugs is more than $42,000 in the year following a cancer diagnosis. To complicate matters, up to 85% of cancer patients leave the workforce during their initial treatment. Consequently, more than 40% of patients spend their entire life savings in the first two years of treatment, while roughly 30% of Americans with a cancer history report having had problems paying their medical bills, having to borrow money, or filing for bankruptcy protection because of their cancer."
While financial toxicity is a broad problem for US cancer patients, some populations are at a greater risk of developing financial toxicity and face greater detrimental consequences. Financial toxicity disparities exist among a number of vulnerable groups including racial and ethnic minorities, low-income and low-socioeconomic status, low educational attainment, low health literacy, housing insecure, and rural/geographically disadvantaged populations.
In 2021, Panzone, et al., reported, "Compared with Blacks, Whites were found to have a higher rate of insurance (95.4% v 90.0%), were more likely to receive cancer treatment (93.9% v 85%), and had a higher rate of surgical treatment than Blacks (77% v 60%), Hispanics (55%), and others (77%, 60%, 55%, and 74.2%, respectively, P < .001). On multivariable analysis, Blacks were more than five times as likely to be denied insurance and more than twice as likely to report being hurt financially because of cancer than Whites."
Downstream consequences of financial distress affect physical, financial & psychosocial well-being.
Laws Related to Healthcare & Cancer Care
Cancer & Healthcare-Related Laws & Statutes
- HIPAA Health Insurance Portability and Accountability Act, 1996 (Re: patient health information privacy)
- FMLA Family and Medical Leave Act (Re: unpaid, protected leave for specific health and family needs) The American Cancer Society has more information here on the ADA.
- ADA Americans with Disabilities Act (Re: protection of people with disabilities from discrimination) The American Cancer Association has information here on how the ADA applies to people with cancer.
- ACA Affordable Care Act, 2010 (Re: health protections for people, removal of pre-existing conditions, cost-reducing measures for consumers, expansion of Medicaid, creation of Health Insurance Marketplace, etc.) The American Cancer Society has more information here on how the ACA applies to people with cancer.
- CARE Caregiver Advise, Record & Enable Act (Re: discharge from the hospital)
- National Cancer Act 1937 (Re: the creation of the National Cancer Institute and the National Cancer Advisory Board)
- National Cancer Act 1971 (Re: the "war on cancer" and large government investments in cancer research)
- Drug Efficacy Amendment 1962 (officially known as the Kefauver–Harris Amendments to the Federal Food, Drug, and Cosmetic Act) (Re: manufacturer burden of proof of effectiveness and safety of drugs and accurate advertising)
- US Food, Drug, and Cosmetic Act 1938 (Re: the safety of drugs)
- Inflation Reduction Act of 2022 (Re: negotiating and capping some drug prices, lowering costs to health care consumers, capping Medicare Part D out-of-pocket expenses for patients, etc.)
- GINA Genetic Information Nondiscrimination Act of 2008 (re: prohibit discrimination on the basis of genetic information with respect to health insurance and employment)
- FDARA FDA Reauthorization Act of 2017 (Re: fees collected by FDA from industry companies used to fund and streamline research and innovation)
- HITECH Act of 2009- Health Information Technology for Electronic and Clinical Health (Re: patients' access of their own medical records)
- The Cures Act (or the 21st Century Cures Act of 2016) (Re: speeding up drug/device development, FDA reforms, and refining and diversifying clinical trials)
- CLIA Clinical Laboratory Improvement Act of 1988 (Re: clinical laboratory regulations, safety, quality improvement, and guideline development)
- No Surprises Act (Re: surprise bills from out-of-network providers at hospitals for patients with private health insurance)
- COBRA Consolidated Omnibus Budget Reconciliation Act (Re: continuation of health insurance coverage following loss of job/benefits)
- Women's Health and Cancer Rights Act (WHCRA) (re: protections to patients who choose to have breast reconstruction in connection with a mastectomy)
- ACA (Affordable Care Act) requires hospitals to have widely-publicized, written Financial Assistance Policies (FAP) and written Emergency Medical Care policies.
- CCPCA Cancer Care Planning and Communications Act of 2021 (Re: the improvement of doctor-patient communication and the development of cancer treatment plans for patients to ease their navigation of cancer therapy and survivorship)
- Henrietta Lacks Enhancing Cancer Research Act of 2019 (Re: access to and enrollment of diverse and underrepresented patients in federally funded cancer clinical trials)
- Women's Health and Cancer Rights Act (Re: health insurance coverage of mastectomies and reconstructive surgery for women with breast cancer)
- Emergency Medical Treatment and Labor Act (EMTALA, 1986) (Re: access to emergency medical care regardless of a patient's ability to pay for services)
- Fraud & Abuse Laws including the False Claims Act, the Anti-Kickback Statute, & Stark Law (Re: physician behavior and practices related to fraudulent billing, receiving "gifts" in exchange for patient referrals, and referral of patients for health services with regard to personal or familial financial relationships.)
- Recalcitrant Cancer Research Act of 2012 (Re: development of scientific frameworks for cancers with relative 5-year survival rates under 50%, spurs cancer research for hard-to-treat, high-mortality cancers)
- Executive Order on Promoting Competition in the American Economy (Fact Sheet) The Order includes 72 initiatives by more than a dozen federal agencies to promptly tackle some of the most pressing competition problems across our economy. Highlights: lower prescription drug prices, allow hearing aids to be sold OTC, increase support for generic and biosimilar drugs, issue comprehensive plan to combat high prescription drug prices and price gouging, and to support existing hospital price transparency rules, among others.
- Hospital Price Transparency Enforcement Updates (April 2023) Hospitals are required to make these standard charges public in two ways: (1) A single comprehensive machine-readable file with all standard charges established by the hospital for all the items and services it provides. (2) A consumer-friendly display of standard charges for as many of the 70 CMS-specified shoppable services that are provided by the hospital, and as many additional hospital-selected shoppable services as is necessary for a combined total of at least 300 shoppable services. This requirement can be satisfied through the release of a shoppable services file or by offering a price estimator that generates a personalized out-of-pocket estimate that takes into account the individual’s insurance information.
Related Topics of Interest
CANCER MOONSHOT
The Cancer Moonshot, initially funded through the Cures Act, "was launched in 2016 to accelerate scientific discovery in cancer research, foster greater collaboration, and improve the sharing of cancer data. By focusing on areas of cancer research that are most likely to benefit the American people as a result of new investment, the Cancer Moonshot has brought together a large community of patients, advocates, researchers, and clinicians who are dedicated to advancing research to end cancer as we know it." Learn more about the goals, initiatives, and progress of the Cancer Moonshot here.
PATIENT BILL OF RIGHTS
There are a variety of Patient Bill of Rights issued by different organizations, insurance companies, and state and federal agencies. These are designed to provide guidance and expectations for patient care, and some are legally enforceable. There are several examples hyperlinked below, and you can also ask your doctor’s office if they have one of their own, or you can Google your state plus “patient bill of rights,” to find others.
Breast Cancer Bill of Rights (Komen)
JCO Oncology Practice Journal, 2020, Proposing a Bill of Rights for Patients with Cancer
According to the US Office of Personnel Management, "The Patients' Bill of Rights and Responsibilities has three major objectives:
- First, to strengthen consumer confidence by assuring the health care system is fair and responsive to consumers' needs, provides consumers with credible and effective mechanisms to address their concerns, and encourages consumers to take an active role in improving and assuring their health.
- Second, to reaffirm the importance of a strong relationship between patients and their health care professionals.
- Third, to reaffirm the critical role consumers play in safeguarding their own health by establishing both rights and responsibilities for all participants in improving health status."
(Re: patient choice and involvement in medical decision-making, access to understandable information, access to emergency care, respect and nondiscrimination, confidentiality, rights to complain & appeal, and patient responsibilities)
INFORMED CONSENT
Informed Consent is a requirement that relevant information about medical procedures, medications, and treatments be shared with a patient in advance to allow them time to make an informed decision, and that the procedure or treatment cannot begin until the patient has given legal permission to proceed (their consent).
- American Cancer Society on Informed Consent: "Informed consent is a process of communication between you and your health care provider that often leads to agreement or permission for care, treatment, or services. Every patient has the right to get information and ask questions before procedures and treatments. If adult patients are mentally able to make their own decisions, medical care cannot begin unless they give informed consent. The informed consent process makes sure that your health care provider has given you information about your condition along with testing and treatment options before you decide what to do."
- The National Cancer Institute on Informed Consent for Clinical Trials: "Before involving a human subject in research covered by this policy, an investigator shall obtain the legally effective informed consent of the subject or the subject's legally authorized representative." 45 CFR 46.116(a)(1)
AMA - AGAINST MEDICAL ADVICE
AMA (Against Medical Advice)
- What Does It Mean to Leave “AMA” (Against Medical Advice)? (GoodRx Health)
- Why Do Patients Leave against Medical Advice? Reasons, Consequences, Prevention, and Interventions (Albayati, Asseel et al. “Why Do Patients Leave against Medical Advice? Reasons, Consequences, Prevention, and Interventions.” Healthcare (Basel, Switzerland) vol. 9,2 111. 21 Jan. 2021, doi:10.3390/healthcare9020111)
"In 2019, in the United States, patients with cancer lost nearly $5 billion due to time costs— value of time that patients spend traveling to and from health care, waiting for care, and receiving care—and paid an estimated $16.2 billion in out-of-pocket costs for cancer care." (source)
Life Insurance After a Cancer Diagnosis
Life Insurance After a Cancer Diagnosis: Is It Possible?
The general understanding is a cancer patient/survivor must have reached at least 5 years in remission before an insurer will approve them for a life insurance policy. It’s been rumored that some cancer types, possibly those with lower mortality rates, have shorter waiting periods, though there is no hard-and-fast rule as every insurer is different. Some insurer's may require longer waiting periods or may not insure cancer survivors at all. Pre-existing condition consumer protections for health insurance do not apply to life insurance. There are a few types of life insurance policies, including guaranteed issue or burial insurance, available to people with cancer who may be in active treatment or recently diagnosed, though they are often small in value and high in price.
Cancer insurance is separate from life insurance and can be used to cover medical expenses related to a cancer diagnosis. However, this type of insurance is meant to be purchased in advance of a cancer diagnosis. Companies offering these policies usually follow waiting periods similar to those for life insurance (5+ years of remission).
“Depending on your age and type of cancer, you could pay four times more for a life insurance policy for several years, depending on how long you have been cancer-free, Pugh cautions.
'I had a $500,000 life insurance policy in place before my cancer diagnosis. It cost me $100 a month, even after being diagnosed and treated for cancer,' says Coffman. 'I got quoted for a second identical $500,000 life insurance policy after having cancer, but the cost went to $800 per month, which would have been unattainable to purchase.' Hallett of Quotacy agrees that five years after a cancer diagnosis and successful treatment, you can probably expect to pay two to four times more for a term life or whole life insurance policy than a healthy individual without cancer.” (source)
Learn About Different Types of Life Insurance
When you think of life insurance, you’re likely thinking of term life insurance or whole life insurance. These policy types typically offer the most affordable options and the greatest benefits, but also require disclosure of your full financial, family, and medical history, a medical exam and possibly lab tests or imaging, and involve a thorough underwriting process (detailed, possibly lengthy application and approval process). These are the hardest types of policies for cancer survivors to secure and insurer's often insist upon a long remission period to qualify for coverage, if they are willing to cover a cancer survivor at all.
Guaranteed issue life insurance and end-of-life/burial insurance are some types of life insurance that may be worth consideration for cancer patients. You may not be required to complete a medical exam, reveal your medical history, or endure a lengthy application process, but these policies often have high premiums with low and/or limited benefit value (i.e. a max policy value of $25,000 versus $250,000). These policies may also include provisions for “graded” benefits, meaning your beneficiaries would only get a certain amount/percentage or nothing if you were to pass away within the first few years of the policy's initiation.
If you're currently employed, ask your employer if they offer any group life insurance plans or benefits. If they do, the policy may not require disclosure of pre-existing conditions, medical history, or a medical exam, and usually won't cost you much or anything at all.
Gather Personal, Financial & Medical Information
Before speaking with an insurance agent, you’ll want to gather some personal information, so you’re prepared to complete an application and don’t have to scramble. If you apply for a policy with detailed underwriting, you’ll likely run around looking for documents anyway but here’s a heads up of what you may need to be aware of and/or collect:
- Your Full Medical History (all diagnoses—regardless of how long ago, prescription medications, procedures, surgeries, smoking habits, mental health, history of substance misuse, etc.) Request and review your medical records PRIOR to application in case you find something that needs to be corrected or something you’ve forgotten over the years.
- Family Medical History of known blood-related parents, grandparents, siblings, children, aunts, uncles, and cousins
- Monthly Expenses and Monthly Income for your household (all sources of income and monthly payments for mortgage/rent, utilities, loans, credit cards, outstanding bills/collections, etc.)
- Assets (checking, savings, investments, retirement accounts, homes and other real estate, vehicles, fine art, etc.)
- Credit Report & Credit Score
- Criminal Record
- Driving Record
- Immigration Status and Documentation, if applicable
- Be prepared to discuss your occupation, lifestyle, health habits, leisure activities, travel tendencies, etc.
Find a Local, Independent, Licensed Life Insurance Agent
Identify one or two potential life insurance agents by searching online or asking for recommendations from others. Ideally, this person will be local to you, independent, and licensed in your state. You can use the NAIC search tool to verify licensure of individual agents. You can also lean on your state’s Department of Insurance for directories of licensed insurance providers in your state.
Before you meet with an agent, if you're not already familiar, review the resources at the bottom of the page regarding different types of life insurance policies (whole life/permanent, term life, variable, guaranteed issue whole life, final expense/burial insurance, etc.), preparing to apply, handling a denial, and more. It will be helpful to have a basic understanding of life insurance, terminology, various policy types, and what may best suit your needs before your meeting. Most independent agents represent multiple insurers so they can help you sift through and find companies that may be willing to insure you and can walk you through all options available to you.
Be honest and thorough. If your application is incomplete, it may be denied, meaning you’ll have to file an appeal for reconsideration OR start from scratch with a new application through another insurer. If your application contains fraudulent or misleading statements or if your responses don’t match your medical and financial records, the policy can be revoked. Don’t go through all the hard work just to risk losing your coverage (and all the money you’ve invested in premiums) over a little fib or major deception.
Ask questions and insist upon complete answers. Selecting a life insurance policy is an important decision and deserves the same thoughtful consideration and investigation as other impactful life decisions.
Questions You May Ask Your Agent
1. What type of insurance policy would be best to meet my goals? Why? What would be the 2nd best option for me?
2. How much will the policy cost each month (monthly premium)?
3. What does the policy include or cover? What does it NOT include or cover?
4. Is there a waiting period before my policy will be able to be paid out in full upon my death?
5. What do my beneficiaries need to do to file a claim for disbursement of the death benefit upon my death?
6. Will my policy change in the future? What would cause a change in the policy’s terms?
7. If my health declines or I’m diagnosed with a new health issue, will my policy remain active? Will I need to update the insurer with any health or financial changes that occur in the future? If so, what information do they need and how do I notify them?
8. What happens if I miss a payment or my payment method is declined or expired?
9. Can this policy be cashed out during my lifetime? If so, can you share more details with me?
10. What are the pros and cons of this policy versus another I’m eligible for?
If something feels off or if you’re being pushed aside, mistreated, or discriminated against, look elsewhere for insurance services and consider filing an official complaint if warranted.
Denials, Complaints & Concerns
Application Denials
If receive a denial, you can ask the company for a detailed explanation of why you were denied coverage. If you were denied due to incorrect or insufficient information, you may be able to file an appeal. If you were denied whole or term policy coverage, you can also ask if you’d qualify for a guaranteed issue whole life, burial, or other policy and what the expenses and benefits would look like.
Complaints & Concerns
If you’re having an issue with your health insurance or life insurance company, don’t be afraid to reach out to your state’s insurance commissioner. Whether you’re being denied coverage for necessary services, medications, or care; your coverage was dropped or cancelled without cause; you’ve been taken advantage of, misled, or mistreated, you may want to bring in some muscle at the state level. Each state has a Department of Insurance (DOI) led by a State Insurance Commissioner (or Director, CEO, or similar title). There is a state directory and a full list of contact information for all US Departments of Insurance accessible in the resources section at the bottom of the page.
Resources
Please take advantage of the Life Insurance resource collection below for more information and support.
