Do you need an insurer’s approval for every chemotherapy session?

livemint.com:

—Name withheld on request

In some cases, insurers may require approval for the overall treatment plan rather than each individual session. Once they concur on the initial treatment plan, you might not need to take more approvals for follow-up sessions at the same hospital. Also, there are some insurers who provide a single approval for all sessions at the start of the treatment provided the treatment takes place in the same hospital as per physicians’ advice. But just to be on the safer side, it is a good idea to check with your insurer.

Some insurers may require pre-authorization for each chemotherapy session. This process involves submitting necessary documents, including the treatment plan, medical reports, and other relevant information, to the insurer for review and approval. It is essential to follow the process as per the insurer’s guidelines.

Regardless of the approval process, it is crucial to maintain open communication with your health insurer. Keep them informed about the prescribed number of chemotherapy sessions and ensure swift provision of any required documentation promptly to facilitate coverage and prevent potential delays in reimbursement.

Familiarise yourself with the scope of coverage and limits set by your insurance company concerning chemotherapy treatment. Ensure that the number of sessions recommended by the doctor falls within the coverage limits specified by the policy. If there are any limitations, discuss potential alternatives with the insurer. Also, there might be some exclusions for mode of treatment, which will vary depending on the insurer.

If there are any modifications or adjustments to the treatment plan during the course of chemotherapy, such as changes in medication or dosage, you