A cancer diagnosis of any kind is a jolt. But after the tidal wave of anxiety about your physical future subsides, other daunting questions stare you in the face.
How do you pay for this? Can you be denied cancer treatment based on your ability to pay? Does Medicare pay for cancer treatments?
The cost of treating cancer can be enormous. Prescription medications for some cancers can cost tens of thousands of dollars per month. The total cost of treatment is virtually impossible to calculate up front because so many variables are in play.
And most insurance plans only go so far. The thought of paying the balance can be crippling. You might even consider ignoring your doctors or skipping treatments. Stephanie Wilfong, manager of Patient Financial Clearance for OSF HealthCare, says don’t skip treatment because there are options.
“Don’t think that costs will prohibit you from getting cancer treatments,” Stephanie said. “We don’t want anyone in a situation where they have to decide not to have treatment because of financial concerns. There are many resources available, and we’re here to provide financial help and find assistance programs.”
The cost of cancer
It’s important to understand what goes into figuring out the total cost of cancer care.
That first visit with your primary care provider, screening and diagnostic tests are only the beginning. Once cancer is confirmed, you’ll visit specialists and determine a treatment plan.
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Treatment can range from simple outpatient procedures to chemotherapy, radiation and surgery. Specialists, prescriptions and fees for equipment, facilities and labs all get added to the bill. Next are follow-ups, which are spread over months and years and can last a lifetime.
Then there are the so-called “other costs.” They don’t always show up on a bill, but they are very real:
- Basic transportation costs to and from your treatments and provider visits
- Overnight travel, lodging and food costs if your treatment is not close to home
- Lost wages from time off work, which can range from treatment days to temporary disability or permanent job loss
- Specialized grocery lists to help you maintain a healthy diet
“Cancer treatments can be costly, overloading the best insurance plans and biggest saving accounts,” Stephanie said. “We don’t want cancer to ruin your life savings and impact your quality of life. We want to make sure you are focusing on the future. And we’re connecting you to resources that can help you through treatment and into survivorship.”
Financial guidance program
Restoring your health is the No. 1 priority. So the first questions you ask your provider after a cancer diagnosis should be about your treatment plan.
But then, ask about financial counseling to help you deal with the billing and insurance process and out-of-pocket expenses. It’s possible your provider will bring it up first. But if they don’t, you should ask.
OSF HealthCare provides patient financial navigators to help guide you through this part of your survivorship journey.
“We have a robust program, and we’ve dedicated a lot of time and effort and training to make sure we can help people with cancer through this process,” Stephanie said.
We can assist with:
- Reviewing your insurance benefits and deductibles
- Determining your out-of-pocket responsibilities
- Estimating out-of-pocket costs
- Identifying “hidden” expenses
- Finding less expensive prescription options
- Referring you to a financial planner for budgeting assistance
Finding resources to cover expenses
If you get a cancer diagnosis, you might discover your health insurance plan doesn’t cover as much as you thought it would. However, Stephanie says there are possible solutions – don’t panic.
“Don’t assume nothing can be done,” Stephanie said. “You might be in a situation where a financial navigator can find another coverage. Maybe you can look to other options, like Medicaid. Or if there’s a disability involved, you can qualify for Medicare or Medicaid.”
Stephanie added: “Some private insurance coverages are harder to change, but some are just a quick call. Our staff is trained in Medicare Parts A and B, and we understand what those supplements are.”
Risk-based supplemental cancer insurance
One thing you can do while you’re healthy is determine your risk factor for common cancers – breast, colon, lung and prostate. Know your family medical history. Schedule an exam with a health care provider and ask them about your cancer risks and any special cancer screenings. Or talk to a genetic counselor.
If you have a heightened risk for cancer, you may consider finding an insurance company that provides supplemental cancer insurance that covers chemotherapy and radiation therapy.
“Not everybody can afford one, but a cancer policy that helps supplement your regular health insurance can be huge,” Stephanie said. “If you’re at higher risk and can afford the premiums, consider investing in that type of policy.”
Can you be denied cancer treatment?
No. If uninsured, you may be eligible for special grants or prescriptions at little to no out-of-pocket cost.
“Cancer is traumatic. We’re here to help with every aspect of your care – mind, body and soul,” Stephanie said. “So we don’t want you to skip treatment because you think you can’t afford it. We’re about making sure you get the care you need, and we’ll work with you through the financial impact of your cancer.”
Last Updated: July 6, 2022