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Breast Cancer Treatment: What Your Insurance Covers

After a devastating diagnosis such as breast cancer, the last thing one thinks about is insurance. But sadly this is a true reality for most. How to pay for it, what your coverage is and what to do if you don’t have insurance are all things that run through one’s mind. Today, we’re going to discuss what your insurance covers when it comes to breast cancer prevention and treatment.
Mammograms are a major diagnostic test used for the detection of breast cancer. Since the enactment of the Affordable Care Act, all insurance policies are required to cover one routine mammograms for women over 40 years of age per, at no out of pocket cost to them. So take advantage of this tool every year.
If your physician suggests a mastectomy as part of your treatment it will likely be covered. Even better yet, due to an act passed in 1998 any insurance company that has mastectomy coverage must also cover breast reconstruction coverage, if you wish to have it done. Not only does this include implants but it can also include surgery to correct asymmetries (i.e. only one breast was removed) as well as treatment for any surgical complications.
Chemotherapy and radiation are two major treatments for any form of cancer, specifically breast cancer. Coverage for these two types of treatment are going to be plan specific. So make sure you look over your insurance to see what type of coverage you have. Often times they come with high deductibles and copay’s, but it’s better than nothing.
Other prescription medications will be billed the same way as chemo and radiation, which is considered a medication. For instance, cancer suppressing medications, such as tamoxifen, fall under this category.
If you don’t have insurance there are several institutions that can provide you with the care you need. You can head over to www.komen.org to learn more.
Or, if you’re interested in enrolling in a health insurance plan for 2018 stay tuned for next weeks post, we walk you through everything you need to know about Obamacare.
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How to Find Out if Your Doctor is “In Network”

Are you switching health insurance plans? If so, one of the first things you will want to check is which physicians are “in network.” This is especially important if you have a particular physician or specialist that you see would prefer to continue with him or her rather than switching to a new doctor.

Insurance plans often have preferred doctors and may refer to that list of physicians as in network. There may be a separate list of physicians that are out of network. Some health plans may refer to these levels with different terminology like Tier 1 and Tier 2. Whatever language is used, it’s important to pay attention to these lists, because the difference could impact your wallet.

In network or preferred doctors are those that have accepted arrangements with your particular health insurance to be reimbursed for payment. These doctors generally have low, or sometimes no, copay and usually all or most of the work by that physician will be covered by your insurance.

Out-of-network doctors do not have these same benefits. Be sure to carefully read what is covered for visits with out-of-network physicians. These visits may have higher copays, higher deductibles, and you may receive a bill for some or all of the costs. For example, a visit to an in-network primary care physician may have a $15 copay and the rest of the visit cost may be fully covered by insurance, meaning you don’t have to pay anything further. The same visit to an out-of-network primary care physician may have a $30 copay, and the insurance plan may only cover 80% of the cost of the visit, meaning you will get a bill for the other 20%. Out-of-network costs can really add up over time.

So, how do you know if your favored doctor is in network? There are several ways you can find out. A good place to start is the health plan’s website. Most health plans have a “find a doctor” search tool. Search for your doctor there and see if they show up as in network (or preferred or Tier 1) or out of network.

You can also call your doctor’s office directly and ask if your doctor participates in the health plan. They will be able to tell you if the doctor and facility are fully or partially covered.

Once you have your answer, you’ll be able to make a decision about which insurance plan is right for you.

 

Looking for tips on wellness? Pick up the Women’s Mind Body Wellness Summit. The summit contains 6 interviews from top female health professionals plus three videos from MyHealthSpin Founder Lori-Ann Rickard, as well as two bonus workout videos. Use promo code “BEWELL” to recieve 50% off!

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6 Health Habits to Teach Your Children

Did you know that one in three kids are overweight or obese? Obesity is an epidemic that is now affecting children as young as 3 years old. September is National Childhood Obesity Awareness Month, and it’s never too early to start to teach your kids about how to live a healthy lifestyle. If they learn these things from a young age they will be less likely to become overweight and, therefore, lower their risk of developing type II diabetes, sleep apnea or bone and joint disorders. Today, we’re sharing 6 health habits to teach your children.

Breakfast is the most important meal of the day
Kids need to eat breakfast in order to keep them full and focused while at school. Aim for something high in protein to hold them over. Studies have also shown that children who eat breakfast have a lesser occurrence of obesity than those who don’t. Plus it prevents bingeing when it comes to lunch or after school snacks.

Eat the rainbow
An easy way to teach kids about eating a wide variety of healthy foods is to tell them to eat the rainbow. Having a plate that’s full of many different fruits and vegetables in vibrant colors provides a lot of different vitamins and minerals.

Exercise is fun
A big mistake some parents make with kids is forcing them to play sports. I understand the idea behind it, but this philosophy may backfire. Let them try a sport; if they don’t like it, don’t force it. They need to learn that exercise is fun, not a punishment. If your child isn’t athletic encourage them to stay active in other ways. Activities such as playing tag or jumping rope are great ways to get the heart pumping.
Look at labels
Kids are never too young to know what’s in their food. Teach them about ingredients they should avoid eating such as high fructose corn syrup. If you give them the tools they need to eat healthy, they will make good food choices when you’re not around to help them.
Sleep is super important
Stress the importance of sleep. Make sure they know that electronics or TV are not allowed right before bed.
Self-love
One of the most important healthy habits to teach your children is the idea of self-love. Kids can be so hard on themselves and have no sense of self-worth. Teaching them to have love and respect for themselves is a huge key to success.
To learn more about nutrition for children, as well as how to get them set up for a healthy school year, pick up the Women’s Mind Body Wellness Summit. Dr. Jennifer Shell discusses how dangerous sugar is for kids and Alyssa Sullivan discusses nutrition programs in daycare. This summit also includes four other interviews from top female health professionals as well as two bonus workout videos, plus three inspirational videos from myself, MyHealthSpin Founder Lori-Ann Rickard.