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No one should face hereditary cancer alone.

Thinking about cancer or dealing with cancer risk can be scary or overwhelming, but we believe that receiving information and resources is comforting, empowering, and lifesaving.

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Health Insurance Appeals

Locate medical experts and find information on insurance coverage and financial assistance for risk management, treatment and follow up care.

Insurance coverage for treatment

The Patient Protection and Affordable Care Act (ACA) guarantees that no one will be denied health insurance coverage and prohibits insurance plans from charging sick people—including those with cancer—more for coverage than healthy people. It also ensures that health insurers cannot impose yearly or lifetime limits on care and benefits.

Additionally, ACA requires health insurance companies to cover routine costs associated with approved clinical trials. Health insurance companies are not required to cover the cost of the treatment or procedure being researched; however, the clinical trial’s sponsor may cover these costs.

The Women’s Health and Cancer Rights Act (WHCRA) is a federal law which requires group health plans to pay for the following services after mastectomy:

  • Breast prostheses
  • Breast reconstruction
  • Surgery to the other breast to achieve a symmetrical appearance
  • Treatment for complications from mastectomy or reconstruction

Your health insurance policy ultimately defines the costs you will pay throughout cancer treatment and recovery. Insurance companies may deny payment for certain treatments if:

  • They limit the selection of drugs that doctors can use for chemotherapy
  • They are not aware of new treatments
  • They consider treatments experimental
  • The use is outside of those approved by the Food and Drug Administration (off-label use)

If you need assistance with filing an appeal for cancer treatment that was denied by your health insurance company, please visit our health insurance appeals page

Updated 04/27/16

FORCE:Facing Our Risk of Cancer Empowered