How Surest helps when the diagnosis is cancer
Did you know that health insurance plays a major role in how people survive cancer?
It’s true.
A 2019 study of colorectal cancer diagnoses by the American Cancer Society found that uninsured patients with a stage I diagnosis have a lower survival rate than people diagnosed with stage II—more advanced cancer—who had private insurance.
So, even when their cancer was discovered at a more advanced stage, people with health insurance survived at a higher rate than people without it. Insurance coverage, of course, helps people afford the cost of cancer care. But insurance companies could be doing more to help people facing cancer.
Cancer is a far-reaching problem.
- In 2019, almost 17 million Americans had been diagnosed with cancer.
- 40% of Americans will be diagnosed with some form of cancer in their lifetimes.
The good news is we’re getting better at treating most types of cancer.
Advances in chemotherapies, radiation, surgery and other types of cancer treatments are extending lives. The majority of cancer cases in the US—67%—were diagnosed over five years ago. And 18% of Americans with cancer were diagnosed over 20 years ago. The five-year survival rate is improving over the last several decades.
Still, a cancer diagnosis is unsettling, to say the least. And cancer treatments—chemotherapy, radiation therapy, surgery—have a reputation for being unpleasant. Uncertainty becomes a huge factor. People who are newly diagnosed with cancer face a great deal of uncertainty. How will the disease impact their life? How will the treatments and side effects make them feel? How will treatments impact their finances? Does their insurance offer coverage? There’s a lot of anxiety.
The first issue cancer patients face is understanding the diagnosis.
There are many different kinds of cancers. Each has its own set of symptoms and impacts. And each cancer may respond to several different methods of treatment. In some cases, chemotherapy works well. In others, radiation therapy or immunotherapy may be more effective.
Unfortunately, the overwhelming and uncertain nature of the diagnosis sometimes makes it difficult for people to make the best treatment choices for them. That’s where some traditional health insurance plans are dropping the ball.
Evaluating treatment options
"Cancer is a completely different kettle of fish," says Marcus Thygeson, MD, chief health officer at Surest. "Early in a cancer diagnosis, patients have to figure out where to go for the best care. The more complicated and life-threatening the problem, the more people tend to defer to the physician and the more they feel overwhelmed and unable to engage as decision-makers and agents in their own therapy and health care."
Most people, Thygeson says, have a strong sense of self-advocacy when they’re dealing with minor health conditions. But cancer is confusing. There is no disease studied more than cancer, but findings are often contradictory, or quickly outdated by the next study. Even highly trained doctors sometimes disagree on the best therapy or treatment path.
Thygeson says one of the first things a new cancer patient should think about is a second opinion. "There’s plenty of evidence that this is true for rarer cancers, but it’s also the case for more common types that a second opinion can lead to a materially different diagnosis and treatment path. It happens often enough that it’s worth considering."
And then, of course, there’s medical expenses.
The uncertainty around how much cancer treatments are going to cost can distract from the focus on recovery.
Surest cancer coverage removes at least that part of the uncertainty by offering members the ability to see how much their care will cost in advance.
Planning for health care costs
"With the Surest plan, members can look at the Surest app or website and see, if they need a chemotherapy, what the price is going to be. Whereas with traditional health insurance, with deductibles and coinsurance, it’s unknown," Thygeson says. "With Benefits, health care costs are much easier to plan for."
"We had a member a few years ago who wrote a letter to us. She sent a picture of a stack of medical bills she got for her husband’s cancer treatment. The letter said she then switched to Surest, and she was able to easily understand the coverage and what her financial responsibility was for her husband’s care."
When you’re diagnosed with a life-threatening illness, the last thing you want to worry about is whether or not your claims were paid. Everything I was told, everything I read was exactly as they said it would be. I didn’t have to worry about anything. - Lakesha, Surest member
Surest tries to remove administrative barriers that cancer patients face, things like deductibles and coinsurance.
The company’s approach to cancer care is to offer price transparency and certainty, but also to give people the opportunity to choose providers that give high-value care.
From the start, Surest encourages individuals facing a cancer diagnosis to seek decision support through programs like 2nd.MD, which offers consultations about diagnoses. Working with 2nd.MD, Surest members can ask questions about whether they have been diagnosed correctly, and what their treatment options might be.
"What we want to do is highlight where the opportunities are for people to engage constructively with their cancer diagnosis," Thygeson says. "There are certain points where people with cancer can engage and improve their chances of getting high-value care."
"Surest wants to give our members the opportunity to approach their cancer care with resources that can make it easier for them to explore the different treatment options that might be available to them."