Understanding Health Insurance

Learning you have cancer is stressful.

Suddenly, you face many important decisions, including which treatment plan to follow and where to receive the best care. And you can think only about getting better.

At Roswell Park, we are here to help you reduce your stress and allow you to focus on becoming well again. The information here will help you in planning how to cover the cost of your care.

Am I Covered?

Questions about your coverage?

Call our financial counselors at 716-845-4782

Your first step will be to find out if you have the right health insurance plan. You need to choose a plan that covers your cancer treatment, the hospital where you are treated, and the services of the doctors treating you.

You can call us at 716-845-4782 or email askroswell@roswellpark.org with questions. Our financial counselors can answer your questions about insurance coverage and help you understand what you will need in the days ahead.

In-network Coverage

Your insurance company will tell you if you have in-network coverage of services at Roswell Park. You want to make sure your primary care doctor, specialists and hospitals also are contracted with your insurance company so the treatments and services they provide you are covered. Out-of-pocket costs, like co-pays, typically are lower with an in-network provider.

You may still be able to receive services at Roswell Park with an out-of-network insurance plan; however, pre-approval from your insurance carrier may be required before you are treated here. Also, insurance plans often pay less for out-of-network services, leaving you responsible for a larger portion of your bill.

If you have an out-of-network plan, ask your insurance company if they provide out-of-network benefits and if authorizations are required for out-of-network care at Roswell Park. Other questions you should ask include:

  • How much will I pay for the deductible and coinsurance?
  • What is the out-of-pocket maximum?
  • Will there be balance billing?

How do I find a better plan?

Two major factors to consider when choosing a health insurance plan are coverage and cost. As you compare plans offered by different companies, you will see that not all have in-network access to Roswell Park Comprehensive Cancer Center and its providers. Find out by scrolling to the green button to view health plans and networks to find out which ones are in-network with Roswell Park.

  • For plans with in-network access, review your benefit options carefully. Different plans come with different out-of-pocket costs for specialist office visits, outpatient surgery, chemotherapy, radiation therapy, medical imaging and inpatient care.
  • For out-of-network plans, ask if they provide out-of-network benefits and if authorizations are required for out-of-network care at Roswell Park. How much will you pay for the deductible and coinsurance, and what is the out-of-pocket maximum?
  • For more information, contact the insurance provider you are considering, and ask if Roswell Park and its providers are part of its network. You may need to provide Roswell’s tax ID number (161552370) and NPI numbers (Hospital 1548315401 and Physicians 1720036593).
  • If you have other questions, call a Roswell Park financial counselor at 716-845-4782.

Open Enrollment: Time For a Change

You also can obtain new healthcare coverage during open enrollment, a period from late fall through early winter in which you can enroll in a new insurance plan. This period is the time when patients can enroll in or change plans without a qualifying life event: loss of insurance, loss of a job, permanent move, a divorce or marriage, birth of a child, or aging out of a parent’s insurance plan.

There are a number of things to consider when choosing a new plan. Asking the right questions and understanding industry terms will help simplify the process and make you a savvy consumer.

Whether you're selecting a health insurance plan at work, or purchasing one on your own, here are three important questions to ask before picking a plan:

  • What does the policy cover?
  • Can I have a list of participating physicians and facilities?
  • Is the plan in-network with Roswell Park and its providers?

Open enrollment dates vary from October through January. If you miss these deadlines, you will have to wait until the following year’s open-enrollment period to make a change.

Roswell Park wants you to receive the high quality of care you deserve

Learn more about your options to change healthcare plans during open enrollment time.

Are You Covered?