Finding Health Care Services

Choosing a Doctor

When choosing a doctor for your cancer care, it may be helpful to know some of the terms used to describe a doctor’s training and credentials. Most physicians who treat people with cancer are medical doctors (they have an M.D. degree) or osteopathic doctors (they have a D.O. degree). Standard training includes 4 years of study at a college or university, 4 years of medical school, and 3 to 7 years of postgraduate medical education through internships and residencies. Doctors must pass an exam to become licensed to practice medicine in their state.

Specialists are doctors who have done their residency training in a specific field such as internal medicine. Independent specialty boards certify physicians after they have met needed requirements, including meeting certain education and training standards, being licensed to practice medicine, and passing an examination given by their specialty board. Once they have met these requirements, physicians are said to be “board certified.”

Some specialists who treat cancer are:

• Medical Oncologist: specializes in treating cancer
• Hematologist: focuses on diseases of the blood and related tissues, including the bone marrow, spleen, and lymph nodes
• Radiation oncologist: uses x-rays and other forms of radiation to diagnose and treat disease
• Surgeon: performs operations on almost any area of the body and may specialize in a certain type of surgery

Finding a Doctor Who Specializes in Cancer Care

To find a doctor who specializes in cancer care, ask your primary care doctor to suggest someone. Or you may know of a specialist through the experience of a friend of family member. Also, your local hospital should be able to provide you with a list of specialists who practice there.

Another option for finding a doctor is your nearest NCI-designated cancer center. The Find a Cancer Center page provides contact information to help health care providers and cancer patients with referrals to all NCI-designated cancer centers in the United States.

The online directories listed below may also help you find a cancer care specialist.

• The American Board of Medical Specialties (ABMS), which creates and implements the standards for certifying and evaluating doctors, has a list of doctors that have met specific requirements and passed specialty exams. See Is Your Doctor Board Certified?
• The American Medical Association (AMA) DoctorFinder provides information on licensed doctors in the United States.
• The American Society of Clinical Oncology (ASCO) member database has the names and affiliations of nearly 30,000 oncologists worldwide.
• The American College of Surgeons (ACoS) lists member surgeons by region and specialty in their Find a Surgeon database. The ACoS can also be reached at 1-800-621-4111.
• The American Osteopathic Association (AOA) Find a Doctor database provides an online list of practicing osteopathic physicians who are AOA members. The AOA can also be reached at 1-800-621-1773.

Local medical societies may also maintain lists of doctors in each specialty for you to check. Public and medical libraries may have print directories of doctors’ names listed geographically by specialty.

Depending on your health insurance plan, your choice may be limited to doctors who participate in your plan. Your insurance company can give you a list of doctors who take part in your plan. It’s important to contact the office of the doctor you’re considering to be sure that he or she is accepting new patients through your plan. It’s also important to do this if you’re using a federal or state health insurance program such as Medicare or Medicaid.

If you can change health insurance plans, you may want to decide which doctor you would like to use first and then choose the plan that includes your chosen physician. You also have the option of seeing a doctor outside your plan and paying more of the costs yourself.

To help make your decision when you’re considering what doctor to choose, think about if the doctor:

• Has the education and training needed to meet your needs
• Has someone who covers for them if they are unavailable and who would have access to your medical records
• Has a helpful support staff
• Explains things clearly, listens to you, and treats you with respect
• Encourages you to ask questions
• Has office hours that meet your needs
• Is easy to get an appointment with

If you are choosing a surgeon, you will want to ask:

• Are they board certified?
• How often do they perform the type of surgery you need?
• How many of these procedures have they performed?
• At what hospital(s) do they practice?

It’s important for you to feel good about the doctor you choose. You will be working with this person closely as you make decisions about your cancer treatment.

Getting a Second Opinion

After you talk to a doctor about the diagnosis and treatment plan for your cancer, you may want to get another doctor’s opinion before you begin treatment. This is known as getting a second opinion. You can do this by asking another specialist to review all the materials related to your case. The doctor who gives the second opinion may agree with the treatment plan proposed by your first doctor, or they may suggest changes or another approach. Either way, getting a second opinion may:

• Give you more information
• Answer any questions you may have
• Give you a greater sense of control
• Help you feel more confident, knowing you have explored all your options

Getting a second opinion is very common. Yet some patients worry that their doctor will be offended if they ask for a second opinion. Usually the opposite is true. Most doctors welcome a second opinion. And many health insurance companies pay for a second opinion or even require them, particularly if a doctor recommends surgery.

When talking with your doctor about getting a second opinion, it may be helpful to express that you’re satisfied with your care but want to be certain you’re as informed as possible about your treatment options. It’s best to involve your doctor in the process of getting a second opinion, because he or she will need to make your medical records (such as your test results and x-rays) available to the doctor giving the second opinion. You may wish to bring a family member along for support when asking for a second opinion.

If your doctor can’t suggest another specialist for a second opinion, many of the resources listed above for finding a doctor can help you find a specialist for a second opinion. You can also call NCI’s Cancer Information Service at 1-800-4-CANCER (1-800-422-6237) for guidance.

Choosing a Treatment Facility

As with choosing a doctor, your choice of facilities may be limited to those that take part in your health insurance plan. If you have already found a doctor for your cancer treatment, you may need to choose a treatment facility based on where your doctor practices. Or your doctor may be able to recommend a facility that provides quality care to meet your needs.

Some questions to ask when considering a treatment facility are:

• Does it have experience and success in treating my condition?
• Has it been rated by state, consumer, or other groups for its quality of care?
• How does it check on and work to improve its quality of care?
• Has it been approved by a nationally recognized accrediting body, such as the ACoS Commission on Cancer and/or The Joint Commission?
• Does it explain patients’ rights and responsibilities? Are copies of this information available to patients?
• Does it offer support services, such as social workers and resources, to help me find financial assistance if I need it?
• Is it conveniently located?

If you belong to a health insurance plan, ask your insurance company if the facility you are choosing is approved by your plan. If you decide to pay for treatment yourself because you choose to go outside of your network or don’t have insurance, discuss the possible costs with your doctor beforehand. You will want to talk to the hospital billing department as well. Nurses and social workers may also be able to give you more information about coverage, eligibility, and insurance issues.

The following resources may help you find a hospital or treatment facility for your care:

• NCI’s Find a Cancer Center page provides contact information for NCI-designated cancer centers located throughout the country.
• The American College of Surgeons (ACoS) Commission on Cancer (CoC). The ACoS website has a searchable database of cancer care programs they have accredited. They can also be reached at 1-312-202-5085 or by e-mail at CoC@facs.org.
• The Joint Commission evaluates and accredits health care organizations and programs in the United States. It also provides guidance about choosing a treatment facility, and offers an online Quality Check® service that patients can use to check whether a specific facility has been accredited by the Joint Commission and to view its performance reports. They also can be reached at 1-630-792-5000.

For more information or assistance about finding a treatment facility, call NCI’s Contact Center at 1-800-4-CANCER (1-800-422-6237).

Getting Treatment in the United States if You Are Not a U.S. Citizen

Some people who live outside the United States may wish to obtain a second opinion or have their cancer treatment in this country. Many facilities in the United States offer these services to international cancer patients. They may also provide support services, such as language interpretation or help with travel and finding lodging near the treatment facility.

If you live outside the United States and would like to get cancer treatment in this country, you should contact cancer treatment facilities directly to find out whether they have an international patient office. The NCI-Designated Cancer Centers Find a Cancer Center page offers contact information for NCI-designated cancer centers throughout the United States.

Citizens of other countries who are planning to travel to the United States for cancer treatment must first obtain a non-immigrant visa for medical treatment from the U.S. Embassy or Consulate in their home country. Visa applicants must show that they:

• Want to come to the United States for medical treatment
• Plan to stay for a specific, limited period
• Have funds to cover expenses in the United States
• Have a residence and social and economic ties outside the United States
• Intend to return to their home country

To find out the fees and documents needed for the non-immigrant visa and to learn more about the application process, contact the U.S. Embassy or Consulate in your home country. The U.S. Department of State provides a list of links to the websites of U.S. Embassies and Consulates worldwide.

More information about non-immigrant visa services is available on the U.S. Department of State Visitor Visa page. If you are planning to travel to the United States, make sure to check the page for any possible updates or changes.

Finding a Treatment Facility Outside the United States

Cancer information services are available in many countries to provide information and answer questions about cancer. They may also be able to help you find a cancer treatment facility close to where you live.

The International Cancer Information Service Group (ICISG), a worldwide network of more than 70 organizations that deliver cancer information, has a list of cancer information services on their website. Or you can email ICISG for questions or comments.

The Union for International Cancer Control (UICC) is another resource for people living outside the United States who want to find a cancer treatment facility. The UICC consists of international cancer-related organizations devoted to the worldwide fight against cancer. These organizations serve as resources for the public and may have helpful information about cancer and treatment facilities. To find a resource in or near your country, you may send the UICC an email or contact them at:

Union for International Cancer Control (UICC)
62 route de Frontenex
1207 Geneva
Switzerland
+ 41 22 809 1811

Finding Health Insurance

The Affordable Care Act changes how health insurance works in the United States, with implications for the prevention, screening, and treatment of cancer. Under this health care law, most Americans are required to have health insurance.

If you do not have health insurance or want to look at new options, the online Health Insurance Marketplace lets you compare plans in your state based on price, benefits, quality, and other needs you may have. To learn about the Health Insurance Marketplace and your new coverage options, please go to Healthcare.gov or CuidadoDeSalud.gov or call toll-free at 1-800-318-2596 (TTY: 1-855-889-4325).

Home Care Services

Sometimes patients want to be cared for at home so they can be in familiar surroundings with family and friends. Home care services can help patients stay at home by using a team approach with doctors, nurses, social workers, physical therapists, and others.

If the patient qualifies for home care services, such services may include:

• Managing symptoms and monitoring care
• Delivery of medications
• Physical therapy
• Emotional and spiritual care
• Help with preparing meals and personal hygiene
• Providing medical equipment

For many patients and families, home care can be both rewarding and demanding. It can change relationships and require families to cope with all aspects of patient care. New issues may also arise that families need to address such as the logistics of having home care providers coming into the home at regular intervals. To prepare for these changes, patients and caregivers should ask questions and get as much information as possible from the home care team or organization. A doctor, nurse, or social worker can provide information about a patient’s specific needs, the availability of services, and the local home care agencies.

Getting Financial Assistance for Home Care

Help with paying for home care services may be available from public or private sources. Private health insurance may cover some home care services, but benefits vary from plan to plan.

Some public resources to help pay for home care are:

• Centers for Medicare & Medicaid Services (CMS): A government agency responsible for the administration of several key federal health care programs. Two of these are
  • Medicare: A government health insurance program for the elderly or disabled. For information, visit their website or call 1-800-MEDICARE (1-800-633-4227).
  • Medicaid: A joint federal and state health insurance program for those who need help with medical expenses. Coverage varies by state.

Both Medicare and Medicaid may cover home care services for patients who qualify, but some rules apply. Talk to a social worker and other members of the health care team to find out more about home care providers and agencies. For more information contact the CMS online or call 1-877-267-2323.

• Eldercare Locator: Run by the U.S. Administration on Aging, it provides information about local Area Agencies on Aging and other assistance for older people. These agencies may provide funds for home care. Eldercare Locator can be reached at 1-800-677-1116 for more information.
• Department of Veterans Affairs (VA): Veterans who are disabled as a result of military service can receive home care services from the U.S. Department of Veterans Affairs. However, only home care services provided by VA hospitals may be used. More information about these benefits can be found on their website or by calling 1-877-222-8387 (1-877-222-VETS).

For other resources for home care, call NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237) or visit cancer.gov.