Questions to Ask Your Insurer After a Cancer Diagnosis

After a cancer diagnosis, understanding your health care coverage is important. In addition to knowing what your current insurance will (and will not) cover, having a conversation with your insurer about your diagnosis can help you find the best course of action to fit your needs.

Some hospitals have a designated point person in their billing office to assist patients as they interact with their insurance company. It may be worthwhile to consult with them first. When you contact your insurer, be sure to note the name of the person that you speak with and the date and time of your conversation. This information may be helpful when there are additional questions or disputes in billing or payments. Below are some questions you may want to ask:

  1. Do I need a referral?
  2. Do I have a deductible?
  3. Can you review my coverage with me and provide me with a Summary of Benefits by email or mail that I can keep on hand? 
  4. Can you also send me the full policy description, including names of in-network doctors and hospitals?
  5. Does my plan cover the following treatments and medications [give them the names of your treatments and medications] at [give them the name of the hospital], done by Dr. [give them the name of your doctor]?
  6. What are my estimated out-of-pocket costs per visit? 
  7. What is my maximum out-of-pocket expenditure under my plan for this year?
  8. Are my hospital and doctor in-network or out-of-network? 
  9. [If your doctor/hospital is out-of-network] Can you give me the name of a doctor and hospital in-network?
  10. Can you assign a nurse case manager to my cancer care? 

The content on this website is intended to provide the best possible information for you, but should not be considered—or used as a substitute for—medical advice. If you have questions about your diagnosis or treatment, please contact your health care provider(s). For questions or comments about this content, please email us at [email protected].