Published on March 27, 2020
Cancer can be scary, overwhelming and life-changing. It also can be incredibly expensive. One drug can cost more than $10,000 a month.
Even with “really good” health insurance, co-pays, coinsurance, deductibles and surprise out-of-network charges can leave patients (and care partners) in financial distress. Add income disruption to the mix, and it’s a recipe for financial ruin.
Cancer patients are 2½ times more likely to declare bankruptcy than healthy people, according to a study conducted by investigators at Fred Hutchinson Cancer Research Center in Seattle. In a study published in The American Journal of Medicine, 42 percent of 9.5 million cancer patients aged 50 or older had exhausted their life savings and all their other assets two years after diagnosis. Worse, patients experiencing financial distress requiring bankruptcy protection are at a greater risk of dying from their disease.
“Out-of-pocket expenses might have such an impact on the cancer experience as to warrant a new term: ‘financial toxicity,’” wrote physicians S. Yousuf Zafar and Amy P. Abernethy in an article published in the journal Oncology. “Out-of-pocket expenses related to treatment are akin to physical toxicity, in that costs can diminish quality of life and impede delivery of the highest quality care.”
Try not to worry, and whatever you do, don’t stop treatment, cancel your next appointment or skip a scan or test because of costs.
Below are some tips to help you cope with “financial toxicity.”
Ask for help. “Cancer-related financial toxicity is not the patient’s fault,” said Jackie Lake, a licensed social worker and senior manager of programs innovation for Family Reach, a nonprofit that works to eliminate the financial barriers that accompany a cancer diagnosis. “Sometimes there can be a bit of stigma. ‘I don’t want to tell my doctor, friends, family I’m struggling financially.’” Reach out to your cancer center’s social worker or patient navigator, family and friends or a nonprofit like Family Reach for help, she said. The American Cancer Society also has a list of resources on its website.
Prepare and plan. Medical bills will change depending on the length of treatment, a relapse, whether the cancer recurs, a sudden scan or surgery, according to Family Reach’s Financial Handbook. This can make it hard to plan. Upon diagnosis, track your spending, set up a budget and reach out to your creditors to set up a payment plan, Family Reach advises.
Understand your treatment. How will your daily life be impacted? Will you be out of work? Will your care partner be able to work? How long will you be at the hospital if surgery is required? What additional expenses will you incur (i.e., additional childcare)?
Know your insurance. What are your co-pays? Do you have a deductible? What is your maximum out-of-pocket cost? Make sure your doctors and cancer treatment center are within the network of your insurance provider.
Connect with the billing department. If you have a large medical bill, ask if you can be put on a payment plan without interest. Some hospitals also offer interest-free loan programs. “A lot of patients and caregivers are at times scared to bring it up to the billing department: ‘This is outside of what I can pay,’” Lake said. “That is because of the stigma and shame and just feeling like, ‘What will happen if I can’t pay these bills? Will I stop being treated?’ That’s not true. Doctors are still going to give you the best care.”
Consider consulting a financial planner. You may think you don’t have enough money to benefit from a financial planner, but that’s not true. “No matter where you are, the planner will be able to take a look at your overall finances and make some recommendations,” Lake said.
Review medical bills carefully. If you are being denied coverage, appeal the denial, Lake said. It can be a tedious and long process so you may want to consider enlisting family and friends or your center’s social worker or patient navigator to help.
Look into prescription savings programs. Two good ones to try are GoodRx and NeedyMeds, Lake said. Some pharmaceutical companies also offer financial assistance programs to help with treatment costs, such as co-pay and discount cards. (Note: Co-pay cards generally cannot be used by people enrolled in federal or state healthcare programs, such as Medicare or Medicaid.) Also, be sure to ask your pharmacist if there is a generic version of a brand name drug. If there isn’t one, ask your doctor if there is a generic alternative.
Bottom line: “You are not alone,” Lake said. “If you ask for help early enough, you may be able to reduce the risk of cancer-related financial toxicity and manage the financial side effects of cancer.”
To learn more about financial toxicity, visit Patient Power’s Financial and Insurance section.
Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.
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