Abstract
Cancer is the second most costly medical condition in the U.S., putting many patients at risk for financial hardship. Cancer patients spend more on healthcare, have greater productivity losses, and are more likely to declare bankruptcy than people without cancer. Financial hardship has devastating consequences for cancer patients including lower quality of life, treatment delay or discontinuation, and increased mortality. Understanding what types of services are covered and how to select an insurance plan may be beneficial for cancer patients and help reduce financial hardship. The purpose of this study was to assess health insurance literacy in patients with head and neck cancer.
Newly diagnosed Head and Neck Cancer Patients were prospectively recruited prior to starting their treatment. Health Insurance Literacy Measure (HILM) scale was administered to patients at the time of enrollment. HIL comprises of 4 different sections – choosing insurance plan, comparing insurance plan, understanding insurance plan, and using insurance plan. The scale is rated from 1 (not at all confident) to 4 (very confident).
A total of 42 patients completed HILM questionnaire. When patients were asked about their ability to: choose an insurance plan – 40.08% (26.19% – 66.67%) responded as not confident or slightly confident; compare insurance plans – 31.75% (26.19% - 38.10%) responded as not confident or slightly confident; understand insurance plans – 47.14% (40.48% - 50.0%) responded as not confident or slightly confident; and use their insurance plan – 40.47% (33.33% - 57.14%) responded as not confident or slightly confident. From each category, top question which patients did not feel confident or slightly confident included: “You know where to go for help if you were having trouble affording health insurance outside of an employer?” (choosing insurance plan); “Understand what you would have to pay for specialist visits?” (comparing insurance plans); You know how to find out what is and is not covered before you receive a health care service? (understanding insurance plans); and “Look into what your health plan will and will not cover before you get health care services?” (using insurance plans).
A significant portion of patients demonstrate limited understanding in their ability in choosing, comparing, understanding, and using their insurance plans. Educating patients and their caregivers to improve their health insurance literacy may help patients with their financial toxicity and alleviate anxiety associated with financial distress.