The psychosocial aspects of health insurance in general, and inadequate coverage in particular, have received scant attention from psycho-oncology professionals. However, with the dehospitalization of cancer treatment, and the longer survival time for patients with cancer, the economic and social burden of cancer has shifted to the patient and family. This article explores several domains of the life of the patient with cancer that can be affected by insufficient health insurance. These include the physical, emotional, financial, social, and employment consequences of inadequate insurance coverage, which can be far-reaching. Health insurance can influence the patient's decision making regarding treatment, choice of physician, and hospital. The unmet needs that arise from deficient insurance coverage can cause strain and distress for the family and the patient. These areas of concern are discussed, and recommendations are made for clinical, educational, and research activities.