Medical Insurance Appeals and Cancer

Medical Insurance Appeals and Cancer
This page was originally published June 18, 2022 and updated August 30, 2022.

If you have been diagnosed with cancer, one of the last things you want to do is deal with insurance companies and denied claims. However, it is important to understand your rights and how to fight for the coverage you deserve. If you have been denied treatment, it’s time to assert your rights. The task does not have to be overwhelming. We understand you have enough on your plate right now. Reach out to the free programs below to get the help you need today!

Gather Your Records

Insurance companies deny claims for a variety of reasons, but the most common reason is that they do not think the treatment is medically necessary. They may also claim that the treatment is experimental or investigational. Regardless of the reason though, you have the right to appeal the decision. The appeals process can be confusing and frustrating, but it is to remember that you are not alone. There are many resources available to help you navigate appeals process. The first step, however, is gathering your records.

One of the best resources in gathering paperwork is your cancer treatment team. They can help you gather the necessary documentation to support your appeal. Call the office and let them know you need help with a claim denial. They have experts on staff who can guide you in not only obtaining your medical records but also providing support and evidence that your medical claim is valid and should be paid.

Get Support

Once you have your medical records and support of your care team, there are agencies that can help you fight your claim denial step by step. Here are two with contact information to get started:

Triage Cancer

Triage Cancer Help with Medical Appeals

Triage Cancer is a national non-profit organization that provides free information and support to cancer patients and their families. Triage Cancer offers a variety of financial assistance education and support programs. To get help with your medical claim denial and appeal, visit their website and complete the questionnaire here https://triagecancer.org/legal-and-financial-navigation-program. For more on insurance claims and denials visit https://triagecancer.org/cancer-health-insurance-finances-cost#hi-appeals. If you or a loved one has been diagnosed with cancer and are fighting with the insurance company, Triage Cancer can help. Visit their website today.

The Patient Advocate Foundation

PAF Help with Medical Appeals

The Patient Advocate Foundation (PAF) offers free nationwide professional case management services by telephone for cancer patients in the US in active treatment or have had treatment within the past six months. This no-cost program pairs you with a case manager who will help you manage your insurance claims denials and get the best possible outcome. Visit the PAF cancer patient advocacy program to learn more and sign up for this completely free service.

You Can Do This!

The appeals process can be time-consuming and stressful, but it is important to remember that you have the right to appeal a denied insurance claim. With the help of your cancer treatment team and the no-cost programs above, you can get the coverage you need to fight cancer.

If you or a loved one has been diagnosed with cancer, we understand how overwhelming it can be. Cancer Care News is here to help. We offer a variety of resources, including financial assistance programs, emotional support services, and gifts for patients. Visit our national directory of free programs and services for cancer patients to learn more about how we can help you through this difficult time.

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Cancer Care News is a non-profit 501(c)(3) sharing evidence-based cancer updates & the latest free nationwide resources for patients & families. Please share the information you find helpful with others in need.

6 Comments

  1. Once you have all your documents and you are ready to contact a support agency to help, how long does a process like this typically take? I am asking for a family member currently going through this. Her husband lost his job and they lost their insurance and every place they have contacted has rejected them for coverage because of her existing cancer diagnosis.

    • Hi Amber,

      Depending on the situation it can be as quick as 48 hours or as long as 30 days. The insurance company must respond timely. The agencies above can tell you specifically based on your personal circumstances. The best to you and your family.

    • Thank you for your kind words, Dave. If you would, please share these posts so we can reach even more people in need. Thank you so much for your comments and we are happy our program information has been useful.

  2. I think this is fantastic information and very helpful for anyone doing through this process. Fighting cancer is hard enough. There is no reason finding coverage should be made even more difficult for people.

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