HEALTH

Malignant brain tumor and health insurance coverage

Malignant brain tumors, also described as gliomas, meningiomas and schwannomas, have a general incidence of 4.5 per 100,000 of the population. The disease can cause changes in the central nervous system by invading and destroying tissues, as well as side effects that are mainly compression of the brain, cranial nerves and cerebral vessels or increased intracranial pressure.

Tumors can occur at any age. In adults, the incidence is highest between 40 and 60 years. These tumors usually appear above the lining of the cerebellum tissue and are called supratentorial tumors. Most tumors in children occur before the early age of 1 year or between 2 and 12 years. The most common are astrocytomas, medulloblastomas, ependymomas, and brainstem gliomas. Brain tumors are one of the most common causes of death from cancer or death in children.

With respect to a potential health insurance applicant with a history of malignant brain tumors, insurers hesitate to issue a policy even after a complete remission due to the risk of possible life-threatening complications resulting from increased intracranial pressure, coma, respiratory or cardiac arrest, and brain hernia

This article was intended to help applicants diagnosed with a malignant brain tumor obtain an approval for a health insurance policy in the individual private health care market.
Most insurers will not consider issuing and placing a policy if a malignant tumor was diagnosed within a 10-year interval. Some carriers will consider that the case depends on the responses received through the detection and also if the respective tumor was benign and received a medical authorization within the previous 2 years. The following are questions that are asked specifically when submitting a health insurance application and helpful advice to obtain an affirmative subscription decision or at least prepare a prospective applicant to request a plan to be approved.

Health insurance subscription questions about malignant brain tumors.

(1) When was the malignant brain tumor diagnosed?

Tip: Most major medical insurers analyze any cancer that is malignant and not benign in the last 10 years. Simplified emission plans would generally challenge cases in the last 5 years. As a general rule, the maximum comprehensive coverage in terms of benefit levels is classified in descending order, with the best doctor being the best, the second being the best and the last being the guaranteed plan. If a case of cancer occurred more than 10 years ago and has been in complete remission during the time without the use of antineoplastic drugs, the applicant would be in its legal right not to disclose this at the time of submission of the request. There have been many cases in which applicants are prematurely denied coverage unjustly only because of a casual mention of cancer when, in fact, they have exceeded the time periods of medical authorization in accordance with the subscription guidelines.

(2) Was the tumor primary or secondary to another cancer somewhere in the body?

Tip: If the malignant tumor was a primary lesion, the best scenario would be a possible consideration after 3 years. However, in the most favorable cases in which it was a well-differentiated tumor that was less than 5 cm in size, there is a possibility that it is considered. If the malignant brain tumor was secondary or metastatic to a primary tumor of another organ, the minimum period in which the medical authorization would have to be obtained is 5 years determined from the date of service of the last treatment. This means that the end of treatment produced a complete remission for primary and secondary tumors. As a final note, the aforementioned deadlines apply to simplified problem plans and not to all major medical plans.

Tip: Treatment for a malignant tumor is made up of several methods that include radiotherapy, chemotherapy or surgery. A surgery without radiation or chemotherapy will likely result in a positive and positive subscription decision. The combination of the three treatments will definitely constitute a decline for major medical coverage and in this case a simplified problem plan would be more appropriate. If only one or, at the most, two of the treatments were used together and there have been complications such as recurrence, incomplete removal, postoperative symptoms

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