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Many cancer patients have found themselves in the same devastating situation, with a “pre-existing condition” that makes them uninsurable or facing high health insurance premiums to cover their care.

Mellisa Wheeler LCSW, Patient Navigator

Like so many others during challenging economic times after being laid off from his construction company job, Derrick found himself in search of a way to pay the bills and keep food on the table. He opted to start his own home improvement business and, although quite successful, he never got around to finding health insurance. So, when the shocking diagnosis of cancer came, Derrick found himself scrambling to pay for care. He thought his cancer would keep him from getting insured and even considered not having treatment at all.

Sound familiar? Many cancer patients have found themselves in the same devastating situation, with a “pre-existing condition” that makes them uninsurable or facing high health insurance premiums to cover their care. Now, Derrick and patients like him have found hope with special state legislature programs called Health Insurance High Risk Pools.

Each state runs their program differently; though most generally function as a non-profit organization governed by a board. The program typically contracts with a previously well-established private health insurance provider to administer benefits and collect premiums. Plans are based on competitive market rates and offer benefits similar to most basic private insurance.

The North Carolina High Risk Health Insurance Pool (NCHIRP) was established in 2007 as a program called Inclusive Health. The program provides health insurance coverage to North Carolinians who do not have access to an employer health plan and have been denied coverage for pre-existing medical conditions, or who have been offered coverage with a conditional rider or at a very high rate.” There are two coverage options: Inclusive Health Federal Option for those who have been uninsured for more than six months, and the Inclusive Health State Option for everyone else. Varying criteria and premiums exist for each option and financial assistance is available for those who may struggle with the cost. The premium subsidy program, called IH Assist, offers substantial discounts from 20-40 percent based on income and household size.

High risk health insurance pools ensure that Derrick and patients like him can easily find coverage and focus on what really matters: getting well. Levine Cancer Institute staff recognize the importance of assisting patients with access to the care they need to get well. Our team of experienced social workers, financial counselors and an American Cancer Society Patient Resource Navigator are available to answer questions and provide guidance on high risk pool and other insurance resources that may be an option.

For information on high risk pools and other potential insurance options call 704-355-2884 and ask to be connected with a support team members or visit www.healthcare.gov. To learn more about the Inclusive Health Program in North Carolina, visit www.inclusivehealth.org.

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