Are Clinical Trials Covered by Insurance?

Home » Are Clinical Trials Covered by Insurance?

Clinical trials are a crucial step in the development of medical solutions that benefit the community as a whole. Their main purpose is to come up with means to either detect, prevent or treat health conditions in a safe way.

They can only be conducted after researches have exhausted all lab trials and are cleared to begin trials on willing individuals before releasing the medical solution to the public. All adult citizens are allowed to be part of healthy clinical trials in Miami, FL.

However, most people shy away since they don’t really understand who will pay for different costs that they might incur during the trials. The biggest question most people have in mind is whether the trials are covered by insurance.

Federal Law Demands

The Federal law has directed a great deal of the insurance firms and products in the market to cover clinical trial costs as long as they are within a set of predetermined standards. As long as you adhere by the conditions, your health insurance provider isn’t allowed to either stop you from being part of the trial or limit your health cover benefits.

The conditions healthcare sellers use to determine clinical trial validity include:

  • The person must be cleared for the trial. Eligibility changes depending on the trial in question
  • You can only take part in approved clinical trials
  • The trial shouldn’t involve out-of-network doctors and hospitals. You can only take part in such trials if you have an out-of-network cover

The Approved Clinical Trials Description

Patient and Doctor Talking

There are many rules your insurer uses to determine if the clinical trial you are taking part in is approved. The most outstanding conditions include:

  • The trial has applied for IND clearance from FDA or is not bound by the IND requirements
  • Is either funded or approved by the Federal Government
  • Is a test looking for ways to treat, detect or prevent life-threatening conditions, such as cancer

Health Coverage for Clinical Trials

Only grandfather health plans are exempt from the mandate to cover clinical trials costs. These, by definitions, are trials that were in place before the launch of the Affordable Care Act in March 2010 and have not changed their policy description by raising premiums or lowering benefits. State Medicaid Plans are also exempt from covering routine patient care bills arising from clinical trials.

What to Do Before Signing Up

Before signing up for any clinical trial, talk to your doctor, a member of the research team and your insurance representative. This talk will give you a clear picture of what costs shall be covered and what bills you will have to handle on your own.

Once you know what it will cost you to be part of the clinical trial, you can then weight the potential benefits against the cost and decide if it is something you are willing to try. The good thing is that sometimes, the research firms will help you cater for some of the costs you incur during the tests.

Read more at Redsave.

Scroll to Top