Session 1: insurance terms and concepts | |
Informational: define and explain basic insurance terms, concepts, and insurance types | |
Assessment: participant’s understanding of financial concepts related to cancer care | |
Overcoming barriers: reviewing current copay, deductible, and out-of-pocket maximum | |
Resource provision: guidance on how health insurance works within the medical realm | |
Session 2: your health insurance plan | |
Informational: learning about one’s own plan and benefits policies | |
Assessment: utilizing one’s plan, accessing benefits, and navigating resources | |
Overcoming barriers: exploring what one is entitled to in a plan and how to optimize benefits | |
Resource provision: worksheet called “Know Your Health Insurance” | |
Session 3: healthcare laws and appeals | |
Informational: learning about healthcare laws (ACA, COBRA, ADA, FMLA) and the appeals process | |
Assessment: utilizing health insurance law protections | |
Assessment: utilizing internal and external appeals process | |
Overcoming barriers: exploring when and how to appeal a health insurance claim | |
Resource provision: connecting with triage cancer information and patient advocacy foundations | |
Session 4: cost controlling strategies | |
Informational: understanding other cost-sharing mechanisms | |
Assessment: participant’s understanding of financial concepts related to cancer care | |
Assessment: estimating the costs of obtaining a needed service | |
Overcoming barriers: strategies for decreasing out-of-pocket costs | |
Overcoming barriers: options to pursue if a needed service, medication, or provider is not covered by insurance (e.g., financial counselors), difficult to access, or cost prohibitive | |
Overcoming barriers: promoting communication with medical providers about costs | |
Resource provision: connecting with state or health plan-based price transparency resources |