What are some financial issues related to cancer care?
Cancer can be a huge financial burden on families, and money can be a major concern. Many treatment-related costs are not covered by insurance. You may also have additional non-medical expenses like transportation, in-home care, or childcare. And, both you and the person with cancer may be unable to work as much during treatment and recovery - if at all. Handling health care bills and finances can also be overwhelming.
How can we deal with financial issues related to cancer care?
Here are some tips:
- Ask the insurance company to assign a case manager to your loved one. This may give you a single point of contact for questions about coverage and out-of-plan benefits.
- Talk with a social worker, as they often have strategies that work. Ask the social worker if there are some non-profit agencies that can help pay for items that may not be covered by insurance companies, such as wigs, head wraps, and even transportation.
- Find out if supplies and equipment (walkers, wigs, slings, dressings, etc.) are covered under the insurance plan. (Sometimes insurance companies will cover part or all the cost if a healthcare provider writes a prescription).
- Make sure you and your loved one understand what treatments need to be pre-approved by the insurance company and get the necessary approvals.
- Make sure you understand how much and how long the insurance will pay; some reach a dollar limit, and others have limits within a year.
- Keep detailed records when either you or your loved one speak with the insurance company. Write down: who you spoke to, what was said, and when you were in contact.
- Understand your co-pays, deductibles, and other payments, and keep track of them.
- If the insurance declines to pay for something, ask again. Often it takes several tries; try appealing their decision.
- Check out your state’s Health Insurance Assistance program.
- Check to be sure that medical bills are accurate. Consider asking for an itemized hospital bill because billing errors happen. Call the hospital billing department if you have questions or concerns about charges.
- If your insurance does not pay a particular charge, call the doctor’s office/hospital for help verifying the correct billing codes are in place. Sometimes there are errors on the medical professional’s part (e.g., the wrong diagnosis code was placed for the procedure).
- Arrange for a meeting with someone from the hospital's billing department or talk to a hospital social worker or case manager about payment plans, reduced rates, "charity care," or "indigent care" programs.
Out-of-pocket prescription costs can add up quickly. Ask the oncology provider or the hospital’s patient services representative (often a case manager or social worker) if the company that makes the patient's medicine has a copay assistance program or a patient foundation to help pay for it. The patient may need to meet eligibility criteria to qualify. You can also find out about prescription assistance programs on these websites:
- Medicine Assistance Tool
- Needy Meds
- Healthwell Foundation
- Patient Access Network Foundation
- Cancer Financial Assistance Coalition
- Patient Advocate Foundation's Co-Pay Relief Program
- Accessia Health
- Leukemia & Lymphoma Society Patient Financial Assistance
- Home healthcare services other than skilled care can cost a lot and are often not covered by insurance.
- Skilled home care may have a limited number of visits.
- Talk to a hospital discharge planner or social worker about home care options and expenses.
- Get help from a hospital social worker to figure out what services are needed and get help contacting a home healthcare agency.
- Check to see what your loved one’s insurance covers and what’s needed to qualify for coverage. For example, you may need a doctor’s prescription for home care.
- Check to see if there are applicable state and federal medical assistance programs that can help.
- Compare different home healthcare agencies. Look at what each agency provides and the cost of their services.
- Look into borrowing home care equipment that’s not covered by insurance, like a wheelchair, walker, or hospital bed. Often community agencies and drug stores have the equipment to borrow. Or consider obtaining home care equipment second-hand, such as Salvation Army, Goodwill, or Facebook Marketplace.
Family financial planning
- Figure out your monthly expenses. Include rent or mortgage, phone and utility bills, transportation, insurance premiums, food, clothing, child-care and elder-care costs, medical expenses, any monthly loan payments, taxes, tuition, legal and accounting fees, and anything else. Complete a budget.
- Prioritize your bills. Determine if there are any monthly expenses that could be reduced or eliminated for a while.
- Ask utility companies, such as gas, electric, and phone, about available assistance programs or ways to reduce the costs.
- Meet with a financial advisor to help make a plan for your family's finances.
- Let your creditors know about your financial situation, if you are having trouble paying your bills.
- Look at possible Social Security and Pension benefits including compassionate allowances from the Social Security Administration. (You may need power-of-attorney to talk to others about the patient’s financial and health matters.)
- Make sure you and other family members have healthcare coverage, and consider long-term care insurance but investigate carefully.
- Tips for taxes for caregivers (check state tax plans for family caregivers)
- Relatives may be eligible to claim a dependent on a tax return
- Nonrelatives can also be claimed as a dependent
- Cost for food, housing, medical care, clothing, and transportation may be deductible out-of-pocket costs, and copays may be deductible
- Flexible spending accounts may be used.
Where can I get more information about cancer-related financial issues?
Here are some helpful websites:
- Cancer Financial Assistance Coalition
- Cancer Support Community
- Cancer Care
- Financial Planning Association
- Insurance & Financial Assistance (Live Strong Foundation)
- Managing Cancer Costs (National Cancer Institute)
- Social Security Administration
- American Cancer Society
- Coumoundouros, C., Ould Brahim, L., Lambert, S. D., & McCusker, J. (2019). The direct and indirect financial costs of informal cancer care: A scoping review. Health & Social Care in the Community, 27(5), e622-e636.
- Iragorri, N., de Oliveira, C., Fitzgerald, N., Essue, B. (2021). The out-of-pocket cost burden of cancer care – a systematic literature review. Current Oncology, 28(2), 1216-4128. doi: 10.3390/curroncol28020117
- Nightingale, C.L., Canzona, M.R., Danhauer, S.C., Reeve, B.B., Howard, D.S., Tucker-Seeley, R.D., Golden, S.L.S., Little-Greene, D., Roth, M.E., Victorson, D.E., Salsman, J.M. (2022). Financial burden for caregivers of adolescents and young adults with cancer. Psychooncology, 31(8), 1354-1364. doi: 10.1002/pon.5937