Managing the financial challenges of cancer
For many people, fighting cancer is only half the battle—paying for it is the other half. Even if you have comprehensive health insurance, cancer treatment can come with significant out-of-pocket expenses. The cost of cancer, for many, is often another challenge during an already overwhelming time.
Fortunately, there are steps you can take to make the cost of cancer treatment more manageable, from working with a financial counselor to reaching out to organizations that provide assistance with co-pays, travel and lodging. No matter how far along you are in your cancer journey—whether newly diagnosed, in treatment or in survivorship—help is available.
Connect with a financial counselor
To begin, it’s important to develop relationships with your financial counselor at your hospital, as well as your care manager and social worker, says Lauren McDonald, Financial Counselor at Cancer Treatment Centers of America® (CTCA) in Tulsa.
“As financial counselors, we help address our patients’ concerns by explaining their insurance coverage in great detail,” McDonald says. “We meet with all new patients and explain to them how their insurance will cover them at our hospital , answer their questions and help break down any barriers they may be facing.”
Several factors influence the cost of treatment, which varies per patient. They include: your cancer type, the treatments you undergo, how your cancer responds to treatment, the progression of the disease and your overall health. How much your health insurance covers impacts the amount you must pay.
“Insurance benefits, yearly out-of-pocket responsibility and individual treatment plans vary drastically,” McDonald says. “When undergoing treatment, it is very likely that you will meet your annual out-of-pocket responsibility quickly.”
Trying to decipher your insurance policies can be frustrating, as policies are not always written clearly and directly. Keep an eye out for your policy’s Summary Plan Description, which all insurance companies are required to provide, and ask questions if you need clarification. Your Summary Plan Description explains what the plan provides and how it operates, including when benefits are paid and how to file a claim.
McDonald recommends asking the following questions of a representative from your insurance company, in addition to requesting any clarification you need about your policy and Summary Plan Description:
- Is my chosen hospital in-network or out-of-network?
- What is the coverage for my chosen hospital?
- Which services must be pre-certified before they are performed?
- Do you have a cancer policy?
- Do you have travel benefits?
- What is your prescription drug coverage?
- Do you have home health benefits?
- Do you have long-term care benefits?
- Do you cover the cost of a paid caregiver?
Keep all lines of communication open
Someone from your insurance company and a financial counselor at your hospital are among the first people you should contact when getting your treatment expenses in order. But don’t stop there. Social workers or therapists can help you work through any stress you’re experiencing, and your doctors can be your advocate, as well.
Many patients are hesitant to discuss the cost of treatment with their doctors. The main reason? They worry their care will suffer, according to a study from Duke Cancer Institute. But patients who bring up money issues, the study found, believe that doing so helped reduce their costs.
Of the study participants with the highest degree of financial distress, 61 percent wanted to discuss treatment costs with their doctors, but only 25 percent did. In addition to concerns about treatment, patients were embarrassed, or they didn’t think the doctor could help or should have to worry about their financial concerns. Doctors, though, may be able to prescribe cheaper medications or refer patients to hospital assistance programs.
Social workers and therapists can help patients cope with their stress and come up with creative ways to address financial issues.
“We try to open doors, open possibilities for our patients and get them to think outside the box,” says Steve White, Mind-Body Therapist at CTCA near Phoenix. “Maybe there are other ways to handle it, maybe there are grants available or maybe they can pay the hospital back slowly but surely.”
Most hospitals are willing to put patients on a payment plan that’s appropriate for each patient’s financial situation, so be sure to ask. Alissa Backes, Financial Counselor at CTCA in Tulsa, says CTCA works with patients based on their ability to pay. For patients who cannot afford the balances on their medical bills, an assistance package can be developed, but certain guidelines must be met before assistance is granted.
Financial assistance is available
Several organizations provide financial assistance, which can help defray the cost of treatment. Every little bit helps when you’re looking for ways to cover the cost of your cancer care. Reach out to these groups to see if you qualify for assistance.
General financial and co-pay assistance
- American Cancer Society, cancer.org or (800) 227-2345
- CancerCare Co-Payment Assistance Foundation, cancercarecopay.org or (866) 552-6729
- Cancer Financial Assistance Coalition, cancerfac.org
- Chronic Disease Fund, cdfund.org or (877) 968-7233
- HealthWell Foundation, healthwellfoundation.org or (800) 675-8416
- Life Insurance Buyers, Inc., lifeinsurancebuyers.com or call (800) 936-5508
- NeedyMeds, Inc., needymeds.com
- Partnership for Prescription Assistance, pparx.org or (888) 477-2669
- Patient Advocate Foundation, patientadvocate.org or (800) 532-5274
- Patient Advocate Foundation Co-Pay Relief, copays.org or (866) 512-3861
- Patient Services, Inc., patientservicesinc.org or (800) 366-7741
- Rx Outreach, rxoutreach.org or (800) 769-3880
Travel and lodging assistance