Insurance denial for pre-existing conditions is soon to be a thing of the past. In some states, with some insurance companies, it already is.
A year after my first breast cancer, the company I worked for closed. I didn’t just lose my only source of income, I lost my insurance; the insurance that paid 80% of my cancer treatment costs.
If you had cancer, you know that 20% of treatment is a chunk to money to come up with on your own, but not nearly as much as trying to cover 100% of treatment.
All I could think of was, what if, when I got a new job, my employer’s health plan denied me coverage, I’d live in fear of a recurrence. A private-pay health care plan would be out of my league, the cost being prohibitive. A new bout with breast cancer, with no insurance, would bankrupt me.
I got a job two months later. The company plan gave me coverage for everything but my cancer. It would be a year before they would pick up anything related to my breast cancer such as mammograms and surgeon and oncologist visits, as well as my monthly prescription for tamoxifen.
It was a long year but, fortunately I had no health problems related to my cancer.
Hours after the Supreme Court’s decision on the Affordable Care Act, press releases and messages arrived in my email. I will share one that speaks to another coverage safety net provided for in the Affordable Care Act.The following content comes from the Cancer Legal Resource Center (CLRC):
Health Care Reform’s 2014 elimination of lifetime limits and pre-existing condition denials will save countless lives. Jamie Ledezma, a staff attorney at the CLRC, relates her personal story:
“As a young 20-something year old, I never dreamt that I’d be in jeopardy of exhausting my employer-provided health benefits, which provided a $1 million lifetime limit. At 27 years old, and 14-weeks pregnant, I was diagnosed with triple-negative breast cancer. In less than a year’s time, I had nearly blown through the $1 million limit on my health insurance. My first surgery came with a $250,000 price-tag and I’d have five more surgeries, 10 months of chemotherapy, and a pregnancy with high-risk doctors and specialists to follow. Like many cancer survivors, once my treatments ended, I faced a fear of recurrence. Believe it or not, much of my fear and anxiety about a recurrence was whether I could “afford” another round of chemotherapy and surgeries as I was approaching the $1 million lifetime limit. As a 27-year old, new mother battling cancer, my husband and I were teetering on financial ruin if faced with a recurrence. Thankfully, the SCOTUS decision on the Affordable Care Act reassures my family and me that if we are faced with cancer again, my access to care will remain intact.”
The Supreme Court’s decision means that 30 million Americans will be able to access coverage for the first time.
Jamie Ledezma and others who are currently insured will be able to get more out of their existing coverage. In the coming weeks, more information and analysis will be available on the CLRC’s website, www.cancerlegalresourcecenter.org.