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  • Living with cancer blog

  • April 14, 2012

    Managing the finances of cancer care

    By Sheryl M. Ness, R.N.

14 comments posted

Living With Cancer

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Dealing with the financial aspects of cancer can be an added stress during a time when you need it the least. Having cancer adds stress to your financial situation. The expenses associated with cancer care are high, usually higher than anyone anticipates. No one plans to be diagnosed with cancer, it just happens.

If you are employed and have insurance coverage, you are in a better situation for support. There are laws in place that help to protect you. Many times, your employer will offer paid sick leave for a certain amount of time. Also, the Family and Medical Leave Act (FMLA) entitles you to take up to 12 weeks of unpaid leave from your work and ensures that your job and health insurance coverage are protected.

The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows you the right to continue your employee health insurance benefits for a limited time (normally up to 18 months) if you lose benefits due to a job loss.

The Health Insurance Portability and Accountability Act (HIPAA) prohibits discrimination against an employee because of health conditions and provides options for insurance coverage limiting exclusions and pre-existing conditions.

If you do not have health insurance, you may need support and assistance to cover costs. Arrange a meeting with a social worker or patient advocate to ask for assistance in navigating the system and help in finding sources of financial support. Ask the hospital about charity care programs that are in place to cover certain costs.

Explore financial support for medications from patient assistance programs (offered by pharmaceutical and biotech companies to help cover the costs of medications).

Here are a few ideas to help you get started:

  • Ask for help. Find a social worker or advocate to assist with navigating the health care system.
  • Meet with the business office. They can help you understand and estimate costs of care at the hospital or treatment facility planning your care.
  • Be organized. Take notes and make copies of paid items. Keep a file with all of your bills and correspondence.
  • Track and document. Write down and keep all of your conversations with your insurance company.
  • Be prepared. Organize any documents you need for eligibility requirements for patient assistance programs, such as tax returns showing income levels and documentation from your health care provider.

Here are some resources:

  • Patient Advocate Foundation (www.patientadvocate.org)
  • Cancer Care (www.cancercare.org)
  • American Cancer Society (www.cancer.org)
  • The Chronic Disease Fund (www.cdfund.org)
  • National Patient Travel Center (www.patienttravel.org)
  • The Sam Fund for Young Adults (www.thesamfund.org)
  • Needy Meds Prescription Assistance (www.needymeds.org)

What have you found helpful? Please share any comments or resources that may help others.

Follow me on Twitter at @SherylNess1. Join the discussion at #livingwithcancer.

14 comments posted

blog index

  • April 25, 2012 12:28 p.m.

    Be careful when going on COBRA. My premium was over $400 a month when I went on it. When the next fiscal year started, they raised it to almost $1300,and this is without outpatient prescription coverage. When I questioned the HR department I was told it was because their costs for those on COBRA were so high. Premiums for the employees was raised only a fraction of that. Seems this would be a form of discrimination. Also, with the Affordable Care insurances you have to go 6 months without any insurance before you can get it. Hard to do when you have cancer. I ended up with ICHIP which is an Illinois BCBS High Risk group and is extremely expensive but less than COBRA. Plus I had a 6 month pre-existing condition exclusion on my cancer. Luckily I had a small retirement fund to help me although it has been mostly exhausted.

    - Linda

  • April 24, 2012 7:37 p.m.

    I went to Mayo for a second opinion and I did not need to do anything but fioo out paperwork and also pick up my x rays and take themwith me. The doctor's office did absolutely everything. They took care of making the appointment, sent all the reports that were requested. When i arrived they had already reviewsed all the reports andbiopsies, doctor's notes etc. It was as if I had been a patiaent there all along. They knew and was familiar with my case. Along with the reports they received they did some referals within their own facility but no repeats. Going to Mayo for a second opinion put my mind at ease as they agreed with my oncologist and also made some suggestions. If I ever feel I am not getting the treatment I need I will not hesitate to return to Mayo Clinic. Everyone there starting from the volunteers to maintenance to housekeepers, receptionists,piano players, nurses and , of course, act as if you arae their only patient they have for the day. I did not have to check with my insurance but my doctor's office did; However, either you or someone needs to do that. My experience was good and worth it.

    - Anna

  • April 24, 2012 7:17 a.m.

    Ken- I encourage you to call Mayo Clinic for an appointment. The appointment office will walk you through the process and ask about your insurance coverage. You may need a referral for the second opinion, so a call to your insurance company may be a good idea as well. Normally, with rare conditions, a second opinion is covered, but ask about this when you speak with them. The number for appointment office for Mayo Clinic in Minnesota is (507)538-3270, Arizona 800-446-2279 or Florida is (904)953-0853. I wish you the very best in your care and treatment.

    - Sheryl Ness

  • April 24, 2012 12:43 a.m.

    I was just diagnosed with AMYLOID AL it is in the very first signs. I have Kaiser ins can i go to Mayo clinic for a second opinion? Do I have to pay or will Kaiser cover this. I have a very strange case as it has been detected very very early. Thanks to my wife who worked in a laboratory for 18 years.

    - Ken

  • April 23, 2012 6:06 a.m.

    Great discussion everyone! I also want to mention a couple of additional excellent resources. The Cancer Financial Assistance Coalition (www.cancerfac.org) is a website where patients can search for financial help based on their type of cancer or specific financial need. The American Society of Clinical Oncologists (ASCO) has a site with a list of resources, podcasts and videos for patients with practical suggestions on managing costs (available from www.cancer.net).

    - Sheryl Ness

  • April 22, 2012 4:13 p.m.

    Insurance companies were originally conceived to protect you from unexpected medical costs.Over the years , rather then the medical industry allowing insurance comp's to be a part of their world, they now control the medical world. The prices that you are given, unless controlled by medicare or other Government Agencies is skewed about 2.5 - 4 times its' actual profitable cost. ( They ask you for the Insurance ID code for costs esatablished by insurance comps.)They have set up a system that sustains their high profits by having hospitals, doctors, procedures, etc.charging us ridiculous high rates that are then "negotiated down" to where your copay pays for alot more of the actual cost so they are More Profitable. We are paying and they are bleeding us dry.. NEGOTIATE with all medical bills to get the medicare rate , even if you're not on medicare. It's a closer rate to there profitable cost anyway. Insurance companies aren't needed they only exist for themselves, not for us. Pre-existing condition has been a way to discriminate against people like us so they can extort more money from us . Hopefully the people will realize that and allow it to go away with the new healthcare laws.

    - Jeff

  • April 20, 2012 3:46 p.m.

    In addition to the other entry re:FMLA. Even working for a large corporation, FMLA is only available if you work a certain minimum hours, basically full time. I work in a benefited 60% position, but if I take any sick days or vacation days I do not reach the minimum work hours required to qualify for FMLA

    - Tami

  • April 20, 2012 12:39 p.m.

    I am amazed at the difficulty of financial problems for people with cancer. That maI have medicare and a supplement. I started chemo treatment in October and have not paid one cent. Medicare is covering 80 per cent and my supplement the balance. To my surprise I was devastated when I found out what the medicine cost in the thousands for some of the shots and when it was discovered the medicine was not working I was given an oral chemo to take. This was $180.00 a pill I ATAKE SIX A DAY. oUR HOSPITAL HAS A PHARMACY AND TOLD ME i WOULD HAVE TO PAY UP cash as my insurance would not pay. Wrong...My oncologist told me what pharmaacy to go to and they put it thru Medicare B instead of D and it ws totally covered. Also, I would like to say do not be afraid of going to Mayo because they do not accept Medicare. When we got our bill what it meant they billed it for us we just had to pay the balance and for the care and service we received it ws not much in fact in comparing the MRI , labs, were less expensive than our local hospital. So heads up there is help out there.

    - Anna

  • April 20, 2012 4:54 a.m.

    This response is related to the HIPAA question that John mentioned. The HIPAA laws protect the portability, privacy and security of your health coverage and medical information. Title I of the HIPAA law protects health insurance coverage as people change or lose their job. This part of HIPAA also limits restrictions that a group health plan can place on benefits for pre-existing conditions as a person is enrolled in a new health insurance plan. This is the portability part of HIPAA. John mentioned the Affordable Care Act, which is a new health insurance reform act which was signed by President Obama in 2010 (see www.healthcare.gov). The new law puts in place comprehensive health insurance reforms that will be rolled out in stages from 2010 to 2014. One of the features of the new law is that insurance plans can not discriminate against people for preexisting conditions.

    - Sheryl Ness

  • April 19, 2012 7:39 p.m.

    My wife has been treated by a major cancer hospital. The charges presented to us were over the top. They have added charges of a vain finder and Doctors names we have not seen. When we complained. They said they would audit the charges. Guess What? They didn't find anything wrong. I found a website called Healthcare Blue Book. All charges by hospital are 400% of what a self pay patient should pay. The business office of this hospital has not given any help on how to understand any CPT code charge to us. We made them a offer based on fare charges per Healthcare Blue Book. They did not accept.

    - Arnie

  • April 19, 2012 7:18 p.m.

    Well done article.. After you come back to work from a concer episode, pay particular attention to your reviews. Watch for the slightest change in your assesments.. Demand a written copy of all reviews and make a hard copy of all emails relating to performance. Find out if your company is "self insured". This means an insurance co. may over see the billing but your company ultimately pays your medical bills themselves.From an HR perspective, they know if you relapse it will cost them alot of their profits.. Just be aware and pay attention. Companies are like this because all costs for medical care are so skewed high, to fit in the insurance company profits, that employers are forced to think like insurance companies.. Deny coverage, high maitenance employee, deny their job..Insurance companies have outlived their usefullness due to their own greed for tremendous profits at Americas expense. Sorry if I went into it to deeply.. .. 17 years chronic leukemia,,,

    - Jeff

  • April 19, 2012 12:08 p.m.

    I think you mean the Affordable Patient Care Act and not HIPAA that addresses "insurability" etc. I don't think HIPAA is the proper reference for this in your article. Therefore you might want to correct it. John

    - John

  • April 19, 2012 10:57 a.m.

    Please be aware that not all companies offer the FMLA and not all employees qualify. I work for a small company and they are not required to offer MFLA due to the size of the company.

    - Joann

  • April 16, 2012 12:16 a.m.

    I just wanted to say thank you for the information listed here. It's comforting to know that in times of trouble there is so much help available.

    - Cunedia

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