Posts Tagged ‘insurance’

Insurance, Race and Poverty Affect Cancer Care, Researchers Report

Insurance, Race and Poverty Affect Cancer Care, Researchers Report
SUNDAY, Oct. 3 (HealthDay News) — Patients who don’t have private health insurance or are poor or black fare worse than others if they get cancer, three new studies find.

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Megachurch’s Cancer Ministry ‘Fills In’ Insurance Gaps

Megachurch’s Cancer Ministry ‘Fills In’ Insurance Gaps
One of the fastest growing cancer care organizations in Southern California happens to be a ministry of a megachurch known for serving the community.

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MassMutual Introduces New Underwriting Guidelines to Make Life Insurance More Broadly Available to Cancer Survivors

MassMutual Introduces New Underwriting Guidelines to Make Life Insurance More Broadly Available to Cancer Survivors
Building on a long-standing commitment to helping people before, during and after a cancer diagnosis, Massachusetts Mutual Life Insurance Company has broadened its life insurance underwriting guidelines for prostate cancer survivors. Â

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Racial disparities in breast cancer care persist despite health insurance and socioeconomic status

Racial disparities in breast cancer care persist despite health insurance and socioeconomic status
Racial disparities in the receipt of breast cancer care persist despite accounting for patients’ insurance and social and economic status. That is the conclusion of a study published early online in Cancer, a peer-reviewed journal of the American Cancer Society. The findings suggest that greater efforts are needed to better understand disparities in breast cancer care and to ensure that all …

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Increased Critical Illness Insurance for Women who Get Cancer Tests

Ladies, if your mother or any other female blood-line relatives have a history of breast or ovarian cancer then from next year onwards, you could face higher insurance premiums. You could even be refused cover altogether.

When these women apply for life and critical illness cover, the insurance industry wants to ask them whether they have been tested for the gene mutations BRCA1 or BRCA2. These are the gene complications that increase the chances of them developing these cancers. But before the insurance companies can ask these questions on their application forms, they must get approval from the Genetics and Insurance Committee, the body that advises the Government on these and similar issues.

In the coming months the Association of British Insurers (ABI) will be requesting the Committee for authority to ask women whether they have been tested positive for BRCA1 or BRCA2 gene mutations. These are the mutations that are present in 1 in 10 of newly diagnosed cases of ovarian cancer and 1 in 20 of new cases of breast cancer. Approximately 1 in 850 women in Britain inherit a faulty BRCA1 gene and of those, 14 – 18% will develop breast cancer during in their lives.

On the web site for the Genetics and Insurance Committee we found a notice saying, ” The Committee expects that the Association of British Insurers will submit in late 2006/2007 four revised and updated applications for the use of adverse results from the predictive genetic tests of the BRCA1 and BRCA2 genes (breast/ovarian cancer) in helping to determine insurance premiums for life and critical illness insurance”.

So far, application forms issued by British insurance companies are only allowed to ask for the results of predictive tests for Huntington’s disease. Even then, the question can only be asked when the application is for more than £500,000 of life insurance cover or mote than £300,000 for critical illness insurance or over £30,000 for payment protection insurance. This rule is set under an agreement entered into by the insurance industry which is due to expire in 2011 but the Chairman of the ABI’s Genetics Working Party, Harpal Karlcut, is reported in the trade insurance magazine “Cover”, as saying: –

“We are looking to get approval for the breast cancer test by the end of the year”, adding, “The two breast cancers are the next conditions that we will look at but after that we don’t see the need to look at other conditions. We do keep an eye out for what diseases may come up in the future but there is nothing else on the horizon”. We add another important rider – yet!

Can your genetic makeup stop you from buying life insurance?

By Michelle Matlock, Life Quotes, Inc.

If your grandfather was an alcoholic does that mean that you’re destined to be one as well? What about your mother and aunt who have both been diagnosed with breast cancer?

Your genetics determine more than the color of your eyes and skin, they present a detailed map that illustrates familial traits, ticks, and in some cases, the odds of being stricken by a serious illness.

Following several key court cases beginning in early 2000, genetic testing was used to make unfounded assessments of genetic risks for those seeking employment or insurance.

“We are incredibly vulnerable when it comes to our DNA,” says Dr. Deborah Peel, a practicing physician, boarded psychologist and founder and chair of the non-profit consumer health privacy advocacy organization, patientprivacyrights.org. “I don’t think we realize that when we walk around a room we shed DNA everywhere. This information can be lifted from a glass of water or a soda can. If you can lift off enough microscopic material you can find out a great deal about that person’s genetics.”

Some fear that as genetic testing becomes a routine practice in medical treatment, insurers will find ways to use the information to deny, limit or cancel insurance.

Others fear that the possibility of discriminatory practices concerning genetic tests will bring advancements in human genetics to a grinding halt.

Nowadays, consumers and advocacy groups alike are looking for stronger protections when it comes to who can access their medical records.

In May 2008, former President Bush signed the Genetic Information Nondiscrimination Act of 2007-2008 (GINA) to protect Americans from being discriminated against by heath insurers and employers based solely on their DNA. The United States Department of Health and Human Services, issued a March 2009 guide that tackles GINA in detail. According to the guide: “When making determinations required under 45 CFR 46.111 (a), GINA’s provisions prohibiting discrimination in health coverage based on genetic information do not extend to life insurance, disability insurance, or long-term care insurance. GINA’s provisions prohibiting discrimination by employers based on genetic information generally do not apply to employers with fewer than 15 employees.”

“I find GINA a bit disconcerting,” says Linda McCabe, author and Adjunct Associate Professor of Human Genetics and Pediatrics at the David Geffen School of Medicine at UCLA. “On the one hand it is a very limited step toward providing some protections for individuals who are asymptomatic and would like to have genetic testing done. I’m very concerned that anyone who actually has a disorder or develops a disorder will not be protected. GINA does not protect you if you have symptoms.”

Even after GINA was passed, the American College of Medical Genetics reported receiving a high number of phone calls from physicians about whether patients can pay for genetic testing out of pocket, worried that such information may be used against them by insurers.

A February 2008 survey by the Genetics and Public Policy Center in Washington D.C., showed that an overwhelming majority of the 1,199 Americans surveyed support genetic testing for research and advancements in health care, but a whopping 92 percent were concerned about genetic tests being used to profile their health. While a large majority trusted their doctor’s handling of genetic test results (86 percent), only 16 percent trusted employers who have access to this data. An even lower percentage trusted their insurers with the same information. 

Ninety three percent felt genetic testing shouldn’t be used to make decisions to deny or limit insurance coverage or decisions related to hiring and promotion in the workplace.

Of late, the topic has been addressed in regard to health insurers, but very little has been mentioned about what this information could mean to someone applying for life insurance — particularly in the individual market.

Life insurance is of special concern because underwriters assess mortality risk to determine how to rate or deny a policy to those who have a pre-existing medical condition.

“Insurers generally are not quick to embrace new technologies such as genetic testing,” says Whit Cornman, spokesperson for the American Council of Life Insurers (ACLI). “Instead they tend to look at things that have a long proven track record.”

“The run-of-the-mill approach to life insurance involves evaluating factors such as weight, height and a history of chronic disease, insurers are not necessarily looking at genetic information. Also, those factors are certainly less expensive to gather,” says Amanda Arnold, Health Policy and Legislative Analyst for the National Human Genome Research Institute at the National Institutes of Health.

Arnold adds that to date, the NHGR has not received any cases involving genetic discrimination, patient privacy and life insurance, but she understands why genetic testing might interest insurers.

“I can imagine a scenario that it would be in their interest to gather such information when it comes to establishing premiums, but they have better ways to determine a person’s health and set rates,” says Arnold. “In the meantime, we will continue to monitor the issue. If problems emerge at some point in the future, then we would encourage the policy community to look at the implications of the practice and make additional recommendations as it becomes necessary.”

Currently, 43 states have recognized the importance of maintaining the privacy of genetic information. But each state approaches the issue differently. GINA does not trump more expansive state laws.

“State legislatures do so many things at the state level regarding insurance and there are some protections regarding genetic discrimination and patient privacy on the federal level but none apply specifically to life insurance,” says Arnold. “The state level could be where this topic bubbles up, especially if the states start parsing more laws regarding this issue.”

 In January 2008,The National Conference of State Legislatures compiled a list of states that strictly prohibit the use of genetic information for risk selection and classification by life insurers. Those states include:

Arizona: Requires “actuarial” justification to use genetic information in life insurance and informed consent to use genetic information.

California: Requires informed consent to use genetic information. Note: In California, an insurer can only require a person to undergo a genetic test if the life insurer explicitly pays for the cost.

Florida: No insurance company shall refuse to issue, fail to deliver, or charge a higher rate solely because a person has a sickle-cell trait.

Maine: Requires Informed consent and allows actuarial justification

Maryland: Allows actuarial justification.

Massachusetts: Allows actuarial justification. Forbids insurance companies from requiring a genetic test.

Minnesota: Requires informed consent and allows actuarial justification.

Montana: Allows actuarial justification.

New Jersey: Allows actuarial justification and requires informed consent.

New Mexico: Allows actuarial justification and requires informed consent. Must notify applicant that genetic test may be used.

New York: Requires informed consent

North Carolina: Restricts discrimination based on genetic information in life insurance, but only applies to “sickle-cell trait, thalassemia-minor trait, hemoglobin C trait and Tay-Sachs trait.

Oregon: Allows actuarial justification and requires informed consent.

Vermont: Restricts discrimination based on genetic information in life insurance.

Notes: An actuary has to “justify” the reason for requiring a policyholder to provide genetic test results

Informed consent. A potential policyholder must agree to take an genetic test through a written informed consent for the test, it must include a description of the test, the reason, potential uses, and other limitations, it must also provide the meaning of its results, and the express right to confidential treatment of the results. The written informed consent must inform the individual that they should consider consulting with a genetic counselor prior to taking the test and must state whether the insurer will pay for the consultation. An informed consent disclosure form must also be approved by the state’s insurance commissioner prior to its use.

Inconclusive

While there are fears that genetic testing has the ability to open a Pandora’s box for those applying for life insurance, authorities in the medical community continue to question the reliability of DNA tests.

Concerned with the possibility that test results are misleading, the FDA and the Federal Trade Commission have also started to question the accuracy of genetic testing.

“DNA shows certain predispositions to illness, but it is not 100 percent precise in determining this predisposition,” says Peel. “Predilection, preferences and behavior are in the gene, but the legitimate studies are just not there yet to actually predict with any confidence if you will become ill, even if you are susceptible to a certain condition.”

The National Institutes of Health have pointed out that clinical genetic tests are available through physicians, genetic counselors and labs, for more than 1,300 diseases, with hundreds more under research.

Harking back to the nature versus nurture debate, geneticists are swimming in a muddy pool of uncertainty when it comes to predicting the full course of a genetic abnormality.

“I don’t know if genetic tests are misleading, but I do know that we don’t have enough data. Most disorders are not caused by a single gene interaction, it’s an interaction of multiple genes combined with our environment,” says McCabe.

Even if you received a positive result for being presymptomatic (when symptoms have not appeared), a genetic test cannot accurately establish the risk of developing an illness. Physicians cannot use your results to predict the course or the severity of a condition. The information a test provides is even more limited when it comes to a condition that is inherited.

Also, DNA testing can miss a disease-causing anomaly because some tests cannot detect all the genetic changes that would jumpstart a particular illness, requiring further testing to confirm a negative result.

“Everyone has common, natural variations in their DNA, (polymorphisms) that have no effect on health,” says McCabe, “If there is a change in the DNA that isn’t associated with the disorder, it can be difficult to determine if it is a natural variation or not.”

She adds, while a result can rule out a specific diagnosis, it cannot show if the person has a higher risk of developing a disease or illness. When this happens, generally family members are also tested to rule out a certain disorder, says McCabe.

McCabe opined that she feels it is not question of accuracy when it comes to genetic tests.

“It’s more about genetic determinism… I don’t think anyone should place too much emphasis on one genetic test result,” she says.

McCabe suggests if you are thinking about submitting your DNA to a genetic test you should work with a board certified genetic professional who specializes in genetic counseling before deciding to go through with a test.

“There are pros and cons that need to be addressed and often patients find it’s really unnecessary,” says McCabe. “Everyone is at risk for a genetic disease, we just may not know what the specific genes are for every DNA mutation in their family. It is very difficult to reach any real conclusions because the number of disorders which we have genetic testing for is still limited.”

This article was originally published at Life Quotes, Inc.

Administration Announces Regulations Requiring New Health Insurance Plans to Provide Free Preventive Care

Administration Announces Regulations Requiring New Health Insurance Plans to Provide Free Preventive Care
WASHINGTON—-The Departments of Health and Human Services , Labor, and the Treasury issued new regulations today, requiring new private health plans to cover evidence-based preventive services and eliminate cost sharing requirements for such services.

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Life Insurance – Women Furious Over Insurer Gene Testing

Thousands of women with family histories of breast and ovarian cancer could pay higher insurance premiums or even be denied cover altogether under new proposals from the insurance industry.

The Association of British Insurers (ABI) is expected to lodge an application for permission for its members to ask women whether they have been tested for the BRCA1 and BRCA2 mutations.

The faulty BRCA genes are responsible for about five per cent of the 41,700 new cases of breast cancer and 10 per cent of ovarian cancers diagnosed in Britain each year.

If the insurers are granted permission by the Genetics and Insurance Committee (the organisation that advises the Government on the issue), women who have tested positive could be forced to pay higher premiums. Some companies may even refuse high value life or critical illness insurance.

A notice published on the GIC’s website said, “The Committee expects that the Association of British Insurers will submit in late 2006/2007 four revised and updated applications for the use of adverse results from predictive genetic tests of the BRCA1 and BRCA2 genes (breast/ovarian cancer) in helping to determine insurance premiums for life and critical illness insurance.”

At present, the only predictive genetic test the committee has allowed insurance companies to ask about is for Huntington’s Disease. This is because of the lack of environmental influences on its development.

However, across Europe, several countries have banned insurers from using genetic tests to decide premiums. Also, in 2005, a voluntary agreement to avoid using such tests by British insurance companies was extended until 2011.

Under this agreement, insurers can ask potential customers only about genetic testing results for Huntington’s Disease. However, they can only ask for the information for policies that are worth more than £500,000 for life insurance, more than £300,000 for critical illness and more than £30,000 a year for payment protection.

But the association’s genetics working party has indicated that it would like to bring about a change seeking permission to ask about two cancer genes and wants approval by the end of the year.

Approximately one in 850 women in Britain inherits a faulty BRCA1 gene. Those women will have a 14 to 18 per cent chance of developing breast cancer at some point in their lives.

Meanwhile insurers are not allowed to ask prospective policyholders if they have HIV, but they can ask them if they have exposed themselves to the risk of infection through unsafe sex or sharing needles.

An alliance of 45 leading charities, unions, scientists and lawyers have called on the Government to ban this genetic discrimination.

A study carried out by the charity Breakthrough Breast Cancer found 28 per cent of women with a family history of breast cancer said the would be deterred from having a genetic test if insurers had access to the results.

Buying Life Insurance After Being Diagnosed With Cancer

The American Cancer Society estimates doctors will diagnose over 1.4 million new cases of cancer in the U.S. in 2007, with more than 559,650 cancer-related deaths. If you are among the majority of cancer patients and survive for at least five years following your diagnosis, you may face another fight: buying life insurance.

Buying life insurance for cancer patients is challenging, but not necessarily impossible. Your chances for securing a policy depend greatly on the type, stage and grade of the cancer, and even on the treatment plan. There is a relationship between the rate you’ll receive and the curability of your cancer. Certain types of skin cancer, for example, are considered very low risk by life insurance companies and a skin cancer history may not even impact premiums.

Applicants with common and treatable forms of breast and prostate cancer may be able to get a “standard” rating under ideal circumstances. But patients with a history of leukemia or colon cancer may fall into a “substandard” or “high substandard” rating at best, or receive declines. Anyone with cancer that has metastasized likely won’t be able to obtain a policy.

Dr. Charles Levy, senior vice president and chief medical director of AIG American General Domestic Life Insurance Cos., says, “We’re better and better able to differentiate the risks of individual cancers.” Life insurers like AIG American General have sophisticated tables to determine premiums, where they can factor in cancer types and treatments. The end result is better premiums because applicants aren’t lumped together as an “average.”

Most insurers will not offer a policy to someone who is still undergoing treatment for cancer. Depending on your type of cancer, the life insurer may also want to add a surcharge, also called a temporary flat extra. For example, AIG American General sometimes charges temporary flat extras for two to five years, depending on the applicant’s cancer and treatment. The good news is that although these extra premiums can be expensive, they will automatically disappear after a set period of time.

Cancer insurance risk specialists

While a dedicated life insurance agent will search cancer insurance companies to find insurers that will sell you a life insurance policy, in some cases you may be better off seeking out a broker who specializes in finding life insurance for people who have a history of cancer.

These brokers will know the specific questions underwriters will want answered when considering your application. Many brokers have developed relationships with several insurers, so they know which companies offer the best-priced life insurance policies for cancer survivors. Some brokers have experts who specialize in gathering your medical records and organizing them.

By directing your application to life insurers that will view your application most favorably, these brokers will help you find the most accurate price quotes and the lowest premiums for life insurance. Always check the financial strength of the insurer before you buy any policy and be sure that the agent or broker you choose is licensed in your state.

Life insurance strategies for cancer survivors

If you are a healthy cancer survivor, life insurance is even more feasible. There are things you can do to ensure you’re getting the best premium offers possible for your situation.

1. Gather all possible medical records before you apply, from the first pathology report to medical records to treatment records. That ensures medical underwriters have the most complete picture of you, your health, and your cancer history. Having all those records before you apply for cancer insurance will reduce delays in your application process, because your life insurer is going to request them and will wait for them. The information you provide can garner you better premiums in the end: The less life insurer underwriters knows about you, the more likely they are to have to assume you are the highest risk and offer you high premiums accordingly. According to Levy, “If it’s fuzzy, we’re more likely to err on the side of conservatism.”

2. Make sure you have complied with your doctor’s treatment plans. For example, says Levy, if your doctor asked to see you back in one year and you haven’t been back in four years, get to your doctor for your check-up before you apply for life insurance. Your life insurer is not going to offer you a policy without before seeing the results of that check-up. Similarly, if you’ve had breast cancer and you’re due for a mammogram in December and you apply for cancer insurance in October, your life insurer will likely wait for the results of your next mammogram.

3. Get prices from several companies. Policy costs can vary a great deal among companies.

4. See if you can get group life insurance through a professional, fraternal, membership, or political organization to which you belong.

5. Consider a “graded” policy (one with limited benefits) if you cannot get full death benefits. In the first few years of a graded policy, the company pays only the premiums and part of the face value if the insured person dies of a condition, such as cancer, that existed before the policy took effect. If the insured person dies after the specified grading-in period, the company will pay the full face amount of the policy.

If your cancer has been successfully treated, and you are otherwise in good health, you can likely obtain a cancer life insurance policy. If you can show that you are healthy and your treatments have gone well, several insurers may compete for your business.

Life, and insurance, after breast cancer

Breast cancer strikes fear in women’s hearts. It is the leading cause of cancer in women, with 207,090 women expected to be diagnosed with the disease this year alone, and is expected to claim the lives of more than 40,000 women in 2010, according to the American Cancer Society. Many of its victims are scarred by the trauma of going through treatments and possibly losing part of their womanhood.

But there is cause for hope. The likelihood of surviving the disease and subsequently getting life insurance has improved over the last several years.

As a result of earlier detection, improved treatment and decreased incidence, death rates from breast cancer have been steadily decreasing since 1999, according to Cancer Facts & Figures 2010—Atlanta: American Cancer Society report.

Survivors can obtain life insurance after they’ve been successfully treated for the disease. How long after depends on a number of factors including the stage or severity of the cancer, whether it spread to other organs and if it is a repeat cancer, says Anna Hart, principal and consulting underwriter with ARH Consulting in Eastland, Tex.

Treatment and follow-up is key

“Those with small, early stage, good risk breast cancer can get life insurance as soon as they have completed treatment and had a follow-up visit. For a later stage breast cancer, the postpone period may be 2-5 years. For more advanced breast cancer and recurrent breast cancer, the postpone period may be 5-10 years,” says Dr. Ann Hoven, chief medical director of The Hartford’s Individual Life Division. She says insurance companies don’t look at the type of treatment used to cure the cancer—mastectomy versus chemotherapy—but at its overall success.

Life insurance companies base their charges on several rating categories, with preferred plus being the best and cheapest and substandard the lowest and most expensive. Hart says most survivors would be offered standard rates. Some companies will offer preferred rates for Stage 1 cancer and after a minimum of 10 years without reoccurrence, she says. She says those with recurring cancer are generally uninsurable.

Those with cancer in both breasts have a higher risk and therefore, a higher rating, than those with cancer in just one breast, Hoven adds. Hart says family history is considered as a screen for preferred exclusion, but not for possible denial. Hart says both men and women breast cancer survivors receive the same rates. Survivors could be eligible for both term and whole life insurance.

If you’ve been denied life insurance in the past, Hart and Hoven recommend you try again, provided your treatments are completed and you’ve undergone the wait period. Hoven urges women to get annual mammograms and screenings for other cancers, following a healthy diet and exercise routine and taking care of other health issues like high blood pressure to improve your chances of getting life insurance.

If you’re still undergoing treatment, Hoven says The Hartford can often offer a joint life policy if your spouse/partner is in good health.

Debunking breast cancer myths

Using antiperspirants and shaving your underarms increase a person’s risk of developing breast cancer.

The American Cancer Society, National Cancer Institute and U.S. Food and Drug Administration agree there is no good scientific evidence to support this claim. The ACS says an epidemiologic study of this issue published in 2002 found no link between breast cancer risk and antiperspirant or deodorant use. Another study published in 2003 reported younger women who were diagnosed with breast cancer said they used antiperspirants and started shaving their underarms earlier and more often than women who were diagnosed when they were older. But this study did not include a control group of women without breast cancer and has been criticized by experts, the ACS reports.

Wearing a bra for a whole day compresses the lymphatic system of the breast, resulting in accumulation of toxins that cause breast cancer.

The ACS says there are no scientifically valid studies that show wearing bras of any type causes breast cancer. The claim making its way through e-mails appears to be based on the writings of a husband and wife team of medical anthropologists who link breast cancer to wearing a bra. However, their study was not conducted according to standard principles of epidemiological research and did not take into consideration other variables, including known risk factors for breast cancer, the ACS notes.

Paget’s disease, which looks like a rash around the nipple, is a rare form of breast cancer that can be misdiagnosed as a dermatological condition.

This e-mail myth is actually a very plausible description of a case of this rare disease, says the ACS’s medical editor, Ted Gansler. “I do not doubt that some cases of Paget’s disease might be initially overlooked and attributed to a benign skin condition,” Gansler states. Paget’s disease starts in the breast ducts and spreads to the skin of the nipple and then to the areola, the dark circle around the nipple. Paget’s disease accounts for only 1 percent of all cases of breast cancer. The skin of the nipple and areola often appears crusted, scaly, and red, with areas of bleeding or oozing. The woman may notice burning or itching. See a doctor if any change occurs, such as development of a lump or swelling in the breast or underarm area, skin irritation or dimpling, nipple pain or retraction (turning inward), redness or scaliness of the nipple or breast skin, or a discharge other than breast milk, the ACS recommends.

Power lines, microwave ovens and TV could cause breast cancer.

There have been several studies over the past 15 years evaluating children’s and adults’ residential exposure to electro-magnetic fields in relation to breast cancer, brain cancer and leukemia, most of which have been inconclusive, the National Cancer Institute says. Still, the National Institute of Environmental Health Sciences recommends increasing the space between devices that emit EMFs, including TVs, microwaves and electric blankets, and yourself and discouraging children from playing near power lines. EMFs are emitted from devices that produce, transmit or use electric power.

You can only inherit breast cancer from your mother’s side of the family.

Not true, says the NCI. Genes related to breast cancer can be inherited from your father’s side, too.

This article originally published on www.lifequotes.com.