Insurance and Financial

Pluta Cancer Center participates with the following insurance providers and managed-care plans. If your provider is not listed, we will work with you and your provider to manage this aspect of your care.

• Blue Choice
• Blue Shield
• Medicare
• Medicaid
• Preferred Care
• RR Medicare
• United Health Care/Empire Plan
• Aetna

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A diagnosis of cancer and its subsequent treatment can cause financial difficulties for families, especially when they interfere with the ability to work. There are government programs designed to help people in these situations. These programs are known as entitlements because those meeting the eligibility criteria have a right to claim benefits because of their tax contributions over the years.

Entitlements are available on federal, state, and local levels for individuals who are underserved, disabled, and/or elderly. Eligibility guidelines vary from state to state, but a good general rule is to contact your local Social Security Administration (SSA) office, your local social services department, and your oncology social worker for guidance. Most entitlements have long waiting periods for application processing and approval, so apply as soon as you begin to think your ability to work might be affected.

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Social Security pays monthly retirement, disability, and survivor benefits for insured workers and their dependents and survivors. Eligibility is based on number of years of employment in FICA-taxed jobs, age, and/or a disabling condition that is expected to continue at least one year and make you unable to engage in gainful employment, which is defined as earning less than $800 a month. Eligibility is not based on assets or unearned income. Applications are processed through your local SSA office. Call 800-772-1213 to begin an application, ask questions, or order publications.

Supplemental Security Income (SSI) is also administered through Social Security and is a monthly cash benefit available to those 65 and older, or of any age if blind or otherwise disabled. This benefit is not based on your work history, but rather on your current low income and asset status. Income/asset guidelines vary from state to state. Applicants may also qualify for Medicaid and food stamps.

Veterans Benefits offer pensions for low-income and disabled veterans, healthcare provided through VA facilities, vocational rehabilitation, education, home loans, disability compensation, life insurance, burial, and a range of other benefits. Dependents and survivors may also be eligible for benefits. Apply through your local Department of Veteran Affairs.

State Disability Programs can help you replace some of your lost income while you apply for federal programs, which generally require several months waiting period prior to approval. These programs are administered locally through Workers Compensation Boards. You may also qualify for unemployment insurance if you are not deemed disabled.

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Healthy NY is the product of the Health Reform Act of 2000, which promotes access to quality healthcare to small business owners, sole proprietors, and uninsured working individuals. Eligibility and participation vary by group. Contact 866-432-5849 or www.dfs.ny.gov/healthyny/ for more information and an application.

Family Health Plus is a public health insurance program for adults who are aged 19-64 who have income or resources too high to qualify for Medicaid. Contact Monroe County Department of Social Services 585-753-6960, Excellus BC/BS (585) 563-1516, or www.health.state.ny.us.

Medicare is federal health insurance for those 65 or older or those who have been receiving Social Security Disability benefits for a full two years, regardless of age. Medicare provides coverage for hospitalization, skilled nursing facilities following hospitalization, home care, hospice, physician charges, and other medical services and supplies. Deductibles and premiums do apply. Application is through the SSA. Medicare does not cover prescription costs, custodial care and many preventive services. Medigap policies, which supplement Medicare, are available for purchase. Contact the American Association for Retired Persons or your state’s insurance commission for information on Medigap policies.

For more information on Medicare, contact the Medicare Rights Center at 1460 Broadway, New York, NY 10036, or call 212-869-3850.

Medicaid is a joint federal and state run program providing health insurance to people meeting income and asset restriction guidelines. It covers prescription drugs, daycare, respite care, hospital care, nursing home care, physician fees and a variety of preventive services. Apply through your local Social Service/Public Welfare Department or the Monroe County Department of Social Services at 585-753-6440.

COBRA is a federal act allowing individuals who lose employer health insurance coverage to buy group insurance for themselves and their families for limited periods of time. This may be helpful to consider if you have a waiting period to get through before Medicare or Medicaid kicks in. To apply, contact your employer or group health insurance plan administrator.

Health Partnership of Monroe County is a program that provides Medicaid benefits to uninsured participants who have been screened and diagnosed with breast or cervical cancer through the Health Partnership of Monroe County. For more information call 585-753-5978.

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Programs that are grant dependent are subject to change.

EPIC
A New York State program to help senior citizens (age 65 and older) pay for prescriptions. Eligibility is income dependent.
800-332-3742
www.health.state.ny.us/nysdoh/epic/faq.htm

Needy Meds.org
An organization that helps individuals find resources to help defray the cost of prescriptions. Your oncology social worker can assist you with this process.
www.needymeds.org

HealthWell Foundation
Helps individuals afford out-of-pocket health care costs.
PO Box 4133
Gaithersburg, MD 20878
800-675-8416
www.healthwellfoundation.org

Patient Access Network Foundation
Provides individuals in need with assistance for out-of-pocket medical expenses associated with health insurance coverage.
PO Box 221858
Charlotte, NC 28222-1858
866-316-7263
www.panfoundation.org

Patient Advocate Foundation
Provides direct financial support to insured patients who qualify financially and medically.
421 Butler Farm Road
Hampton, Virginia
866-512-3861
www.copays.org

Modest Needs Foundation
Helps empower individuals who are willing to work but are temporarily unable to do so and have experienced a financial setback. Self-sufficiency, back-to-work, and independent living grants are offered.
115 E 30th Street, FL 1
New York, NY 10016
212-463-7042
http://www.modestneeds.org/

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Programs that are grant dependent are subject to change.

Cancer and Careers
This organization provides resources for working women with cancer.
www.cancerandcareers.org/

Cancer Legal Resource Center
Disability Rights Legal Center
These organizations provide information on cancer-related legal issues.
Loyola Law School Public Interest Law Center
800 South Figueroa St., Suite 1120
Los Angeles, CA 90017
213-736-1334
866-999-3752
www.disabilityrightslegalcenter.org/

Legal Resource Guide
This guide, developed by the Texas Young Lawyers Association, covers legal issues concerning privacy, informed consent, insurance, clinical trials, employment law, disability, liability, guardianship, estate planning, and end of life decisions.
PO Box 12487
Capital Station
Austin, TX 78711-2487
www.tyla.org/

Patient Advocate Foundation
Provides legal counseling and referrals to cancer patients regarding job discrimination.
421 Butler Farm Road
Hampton, VA 23666
800-532-5274
www.patientadvocate.org

Volunteer Legal Services Project
Provides free legal help to low-income residents of Monroe County, NY facing non-criminal legal problems; individuals with cancer are helped through a special grant.
The Honorable Michael A. Telesca Center for Justice
1 West Main Street, 5th Floor
Rochester, NY 14614
585-232-3051
www.vlsprochester.org

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