Access to Health Care

ACS CAN advocates for policies that provide access to treatments and services people with cancer need for their care - including those who may be newly diagnosed, in active treatment and cancer survivors.

Access to Health Care Resources:

Having health insurance is important for everyone, even if you’re healthy.

Financial assistance may be available to help people with lower incomes afford their health insurance.

Provides information on health insurance options, tax credits and subsidies in every state. Consumers may be able to submit an application for health insurance directly through this site.

Provides information about enrolling in Medicare, including Part D prescription drug coverage, what Medicare covers, and how to contact Medicare with questions

Resources and information from the American Cancer Society about understanding health insurance, particularly for cancer patients and survivors.

The American Cancer Society operates a call center available to all cancer patients and their families, that includes resources and specialists who can help patients with questions about health insurance, enrolling in a plan, and issues accessing care.

ACS CAN filed extensive comments expressing deep concern with the proposed Medicare Part B Drug Payment Model and noting that in its proposed form the Part B Drug Model Model failed to protect cancer patients' access to life-saving medications.

On November 10, 2015, ACS CAN hosted the first National Summit on Health Equity in St. Louis, Missouri.

These comments were submitted by ACS CAN to the U.S. Department of Health and Human Services regarding changes to the template Summary Plan Document that health insurance plans must provide to consumers.

Workforce Resources:

These comments submitted to the Institute of Medicine’s Committee on the Governance and Financing of Graduate Medical Education address ways to ensure an adequate and appropriate cancer care workforce to treat cancer patients.

Private Health Insurance Resources:

ACS CAN provided comments on CMS' Draft 2016 Letter to Issuers in the Federally-facilitated Marketplaces, including comments related to network adequacy, provider directories, nondiscrimination provisions, and other issues.

ACS CAN filed comments on the 2016 Notice of Benefit and Payment Parameters proposed rule, including comments related to Special Enrollment Periods, prescription drug benefits, nondiscrimination, cost-sharing requirements, network adequacy standards, and other issues.

As the National Association of Insurance Commissioners (NAIC) updated its Managed care Plan Network Adequacy Model Act (Network Adequacy Model Act), ACS CAN filed comments urging the NAIC to adopt policies that would ensure that health plan networks  are sufficient to provide enrollees with acces

In this 2014 white paper, ACS CAN explored, from a cancer patient's perspective, the adequacy of provider networks, the transparency of provider network information for new qualified health plans offered in the Marketplace, and the availability of out-of-network coverage.

The Affordable Care Act (ACA) expanded access to health insurance through reforms of the private health insurance market, including income-related premium support and cost-sharing subsidies and establishment of Health Insurance Marketplaces.

ACS CAN filed extensive comments in response to CMS' proposed rule implementing changes to the Medicare Part C and D programs, including opposing proposed changes to the Part D six protected classes.

Information about prescription drug formularies

It is critically important for cancer patients to be able to access clear, consistent, and comparable information on prescription drug coverage, including coverage of physician-administered drugs, in order to choose a health plan. Prior to the Affordable Care Act (ACA), such information was not widely available, but various ACA provisions aim to improve the comprehensiveness, comparability, and transparency of health plan benefits.

In this 2014 white paper, ACS CAN examined the extent of coverage and cost-sharing for cancer drugs in silver Marketplace plans in selected states and whether information on the coverage of cancer drugs can be readily obtained, compared, and understood by patients.

Medicare Resources:

ACS CAN provided comments on the proposed rule implementing changes to the Medicare Shared Savings Program in which we urged CMS to provide additional beneficiary education and require greater specificity on wasy to improve care coordination for beneficiaries.

ACS CAN provided comments on CMS' initiation of a national coverage analysis for cervical cancer screening with a combination of HPV and cytology (Pap) testing.

ACS CAN commented on the Medicare CY2015 Physician Fee Schedule, in which we urged, among other things for CMS to designate screeming colonoscopioes that resule in polyp removal or biopsy as a preventive service.

ACS CAN commented in the FY2015 Medicare Hospice payment rule, in which we urged, among other things, for Medicare to develop a workable solution to better clarify when a prescription drug is covered under the Hospice or Part D benefit.

ACS CAN commented in the FY2015 Medicare Hospice payment rule, in which we urged, among other things, for Medicare to develop a workable solution to better clarify when a prescription drug is covered under the Hospice or Part D benefit.

ACS CAN filed comments in response to the Center for Medicare & Medicaid Innovation's (CMMI's) request for information on specialty practitioner payment model opportunities.

In a letter to CMS Administrator Tavenner, ACS CAN joined other organizations urging CMS to reqire Medicare Advantage plans to provide coverage for clinical trials.

ACS CAN filed extensive comments in response to CMS' proposed rule implementing changes to the Medicare Part C and D programs, including opposing proposed changes to the Part D six protected classes.

In this 2013 report ACS CAN explored the relationship between Medicare and cancer, including how cancer affects the elderly and the financial impact the disease has on the Medicare program and its beneficiaries.

Disparities Resources:

Hispanic/Latina women have the highest incidence of cervical cancer compared to other races/ethnicities. In 2015 approximately 2,000 Hispanic/Latina women in the U.S. were expected to be diagnosed with cervical cancer and 600 were expected to die from the disease. This factsheet discusses the cervical cancer health disparities found in Hispanic/Latina women and way to reduce this disparity.

 

Breast cancer is the second leading cause of cancer deaths among women in the United States. African American women have the highest death rate of all racial and ethnic groups, and are 42 percent more likely to die of breast cancer than white women. This factsheet discusses breast cancer disparities in African American women and solutions to help reduce this disparity. 

On November 10, 2015, ACS CAN hosted the first National Summit on Health Equity in St. Louis, Missouri.

The National Institutes of Health (NIH) and the National Cancer Institute (NCI) are the foundation of our national  cancer research program and support research in every state.

Health Care Delivery Resources:

The health care law has several provisions that help prevent individuals from experiencing gaps in health insurance coverage, including the requirement that private health insurance plans allow dependents to remain on their parents’ insurance until age 26.  This provision is important for keeping survivors of childhood and young adult cancer insured, and helps to ensure young adults receive preventive services and screenings.  This provision is a crucial patient protection that must be a part of a health care system that works for cancer patients and survivors.

Consumers need access to health insurance policies that cover a full range of evidence-based health care services – including prevention and primary care – necessary to maintain health, avoid disease, overcome acute illness and live with chronic disease.  Any health care system that works for cancer patients must have standards ensuring that enrollees have access to comprehensive health insurance.

Medicaid is the health insurance safety-net program for lower income Americans. Currently, 64 million people – many of whom are cancer patients and survivors – rely on Medicaid for affordable health care coverage.

 

Many patients with complex diseases like cancer find it difficult to afford their treatments – even when they have health insurance.  Current law establishes a limit on what most private insurance plans can require enrollees to pay in out-of-pocket costs.  These limits protect patients from extremely high costs and are essential to any health care system that works for cancer patients and survivors.

 

Current federal requirements prohibit most insurance plans from limiting both the lifetime and annual dollar value of benefits.  This ban is one of several important patient protections that must be part of any health care system that works for cancer patients.

 

 

Current federal requirements provide crucial protections that ensure health insurance coverage is comprehensive, not arbitrarily limited, available to all and more affordable.  These protections are especially important for cancer patients, survivors, and those at risk for cancer.  This fact sheet contains a list of the most important provisions in current law for the cancer community.

If you are enrolled in Medicare you have the opportunity – between October 15, 2016 and December 7, 2016 – to renew your existing Medicare Prescription Drug Plan (also known as Medicare Part D).

If you are a person living with cancer or a cancer survivor making sure that the health insurance plan you choose covers the prescription drugs you need is particularly important.

Between November 1, 2016 and January 31, 2017, you may have the opportunity to renew your existing health insurance plan or buy a new plan through the insurance marketplaces.