The most common manifestation of cancer in our country, over 3.5 million skin cancers in over 2 million people are diagnosed each year. There are several different types of skin cancer, the most common of which are basal cell carinoma (BCC), melanoma, and squamous cell carcinoma (SCC). The most common precancer is actinic keratosis, which affects more than 58 million Americans, is caused by sun damage, and can lead to SCC if untreated. Skin cancer usually develops in the epidermis, which causes tumors to be easily detectable at an early stage.
Melanoma skin cancers are the most dangerous, and although a small percentage of those diagnosed with skin cancer die from the disease, it is the most likely to cause death. The majority of cases are caused by overexposure to the sun’s harmful ultraviolet rays or indoor tanning. Non-melanoma skin cancers are the most common, the majority of which are basal cell carcinomas. An estimated 2.8 million cases of BCC are diagnosed annually in the U.S., while 700,000 new diagnoses of squamous cell are reported each year.
Symptoms of skin cancer include changes in the skin that do not heal, ulcering, discolored skin, and changes in existing moles, such as jagged edges and enlargement of the mole. Basal cell carcinoma usually appears as a raised, smooth, pearly bump on the head, neck and shoulder regions exposed to the sun. Squamous cell carcinoma is typically a red, scaling thickened patch on skin exposed to the sun. Melanomas appear as brown to black-looking lesions, though some can be pink, red or fleshy in color. Melanomas indicate themselves as malignant when changes occur in the size, shape, color, or elevation of a mole. Other symptoms may include are the appearance of a new mole as an adult, or unfamiliar pain, itching, ulceration or bleeding.
Basal cell carcinoma can be treated and eliminated, usually without scarring, as can squamous cell, even though it is more serious than basal cell. Malignant melanomas must be removed immediately. Preventing melanoma and squamous cell skin cancer is as obvious as wearing sunscreen, while it is unknown whether it has an effect on basal cell carcinoma. Wearing protective clothing when exposed to the sun, avoiding sunburn, and trying to avoid peak periods of sun exposure are also recommended. Avoiding the use of tobacco products and tanning beds are also effective.
Skin Cancer & Individual Health Insurance
Depending on your level of risk for further health problems or recurring incidences of skin cancer, as well as how recently your case of skin cancer occurred, health insurance will become more expensive or in some cases unavailable. Rate adjustment or decline will also vary based on their insurer with which you apply. Some are more lenient than others in their underwriting, and allow people with health conditions to obtain coverage. Even those that are more loose in their underwriting can issue an instant decline upon seeing a history of melanoma.
Based on the guidelines of an insurer in Florida (where skin cancer is surely prevalent), the intensity and type of cancer you have had is assessed. If your skin cancer has been present in the past year to two years, it is likely to expect increased rates or even a full rejection. However, those who have had melanoma without surgery or recurrence between 3 and 5 years prior to applying may be in the clear. Age is also a factor, as no one under age 19 can be declined for coverage, though they can have their rates increased up to 150 percent.
Here is an example of this carrier’s current underwriting guidelines for skin cancer, which includes general skin cancer, specific cases related to melanoma, as well as BCC and SCC. They firstly mention that a pathology of skin biopsy, history of treatment, and current status are required before proceeding with further assessment. Once they have received medical records from an oncologist, the insurer will evaluate your eligibility according to their guidelines. As indicated, certain cases may result in a mild premium increase, while others are fully declined.
Health Plan Alternatives for Skin Cancer
Individuals who have a history of skin cancer may be decided as uninsurable in certain cases, though their options for coverage have not necessarily run dry. Public health insurance for low-income Americans is available to specific groups of people through Medicaid, and for those who are above the threshold and can afford a moderate payment, there is PCIP. Also, if you have not yet considered getting health benefits through your employer, it is an opportune time to investigate that possibility. Here are the current health plan options available to people with skin cancer.
PCIP
If you applied for individual health insurance and were rejected, chances are you can afford to pay for coverage and it is not offered by your workplace. In this case, you may be able to apply for the Pre-Existing Condition Insurance Plan, which is basically self-explanatory. People who have been declined coverage for a health condition and are uninsured for a minimum consecutive six months may be eligible. PCIP was created by the Affordable Care Act to help individuals who are unable to receive coverage on an equal basis for their health.
This plan works like a private health plan, with the same payment and provider network models, but it is administered either by the federal government or at the state level. Those who are accepted for PCIP will not have any type of necessary care made unavailable to them, or have to wait to receive certain benefits. Once enrolled, all care is offered upfront, and can be accessed through any participating provider. Preventive care is free, though payment is required for other medical care.
Employer-Sponsored Coverage
Those who have access to insurance through their employer should most likely take it. They cannot discriminate against any applicant for their health, and therefore have to accept you and cover your care. There will be a screening process which can take up to several months initially, which may be a good time to buy a short-term health insurance plan. This is to make sure you are not simply going to run off to the hospital with your coverage, run up the bill, and quit your job.
Once you are enrolled, many types of treatment you may require may be covered by your plan. Prior to receiving a medical service, make sure your doctors are in-network and the service will be covered. At times, going to specialists for conditions as specific as skin cancer is required. Check your plan’s list of providers and covered benefits. Being charged in full for any health care service is obviously not ideal when you pay for coverage, so staying in-network is usually a good choice.
Medicaid & CHIP
Those who have a very low income may be able to receive Medicaid coverage if they fall into an eligibility group. Medicaid’s covered groups usually include children, families, pregnant women, aged, blind, and disabled persons. The program is different in every state, some of which have a wider range of acceptance, while others restrict their benefits to a smaller population. In a few select states who are supportive of health reform, non-disabled adults without any children are able to apply, as well. Medicaid will cover any medical needs a person has, including treatment and surgery for skin cancers.
Though the disease usually affects older individuals, the Children’s Health Insurance Program (CHIP) will also accommodate any child under age 19 who has skin cancer. This program is open to children whose families have a higher income than Medicaid allows, with the same Medicaid benefits. If skin cancer is a recurring problem and leading to unmanageable medical bills, the Medically Needy program may be able to offer assistance through Medicaid. This program does not offer a full health plan, but will help pay for your expenses if you meet the criteria.
Medicare
If you are spending your later years soaking in the sun and growing leathery, skin cancer may have made its way into your life, and Medicare is the most viable option for health insurance. Private insurers will not sell plans to anyone over 64, as Medicare is the most widespread option for the elderly. Any surgeries, consultations, and other health care will be provided through your provider network, whether you have a fee-for-service plan or Medicare Advantage through AARP or another carrier.
Health Reform and Skin Cancer
The Affordable Care Act has already impacted those with skin cancer, or will in the near future, by providing a greater number of options for coverage. When the law is fully in place, more states will offer Medicaid to a larger group of people, and provide coverage for people with a low income who have has this condition. The law will also eliminate all of that underwriting business mentioned above, allowing anyone with any stage or type of skin cancer to purchase a health plan from the carrier of their choice.
With PCIP as a preview, all health plans will no longer be permitted to contain elimination riders or exclusion periods for coverage. Every type of covered service will be available immediately, and the insurers will learn to love the influx of sick policyholders in order to create a healthier nation. The ACA also helps those who are in between Medicaid income level and being able to afford a private health plan by providing subsidies to cover premium costs. Overall, this law will break any barrier between individuals with skin cancer and getting the coverage they should have.
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