The guest post series continues with Scott Sanders from Cancer Well. In this helpful piece, he discusses how to deal with the financial side of a cancer diagnosis.
Ask Questions, Know Your Options: Covering the Costs of Cancer Care
By: Scott Sanders
Receiving a terminal cancer diagnosis is a shattering experience. At a loss for what to do, not knowing what to expect in the short term, and in a state of emotional shock, the last thing you want is to worry about money and how you’ll cover the costs of treatment you don’t even fully understand yet. But you’ll need to understand what kind of treatment you’ll need, what the associated costs and coverage options are, and what out-of-pocket expenses to expect. These are important issues, and even more so if you’re facing a long, protracted treatment regimen. Don’t be shy about asking questions or discussing costs and how to finance treatment with your healthcare team.
If you’re facing treatment for cancer, there are certain things you can pretty much count on, treatment expenses that may or may not be covered under your health insurance plan (most have some coverage gaps where cancer treatment is concerned). There are costs for visits to your provider and to the clinic for treatments, lab and imaging tests, radiation therapy, costs for cancer drugs, surgery, and hospital stays. Touch on these items with your oncologist to get a feel for what expenses lie in store and which of them will require you to cover the costs.
At each step, ask whether treatments are covered under your insurance and how much you can expect to pay yourself. As a patient, you’re well within your rights to ask if there are viable, alternative treatments that are less expensive, where and how treatment will be administered, and where you might be able to get assistance in paying for each treatment that isn’t covered.
Local assistance and other options
Research payment assistance options available through local services like the United Way program. The United Way may be able to help with information about and referrals to programs that can help with daily needs. LIVESTRONG Cancer Navigation Services can help you locate financial assistance with out-of-pocket costs. Many older adults opt for a reverse mortgage to help cover the high costs of treatment by borrowing against the value in their home, which comes to them in payments from their lender, which are determined based on a percentage of their home equity.
Planning for payment
This is one time you’ll need to be very familiar with the terms of your health insurance policy. It might be worthwhile to sit down with an agent or to meet with someone at your provider’s office who coordinates health insurance issues and can answer questions. If they can help you maneuver through the claims and claims resubmittal processes, so much the better. Even if they don’t have the answer, they may know someone who can answer your questions. In any event, don’t be afraid to ask.
Maintain careful records in case you need to resubmit claims or dispute charges, and understand what going to out-of-network doctors, hospitals, or clinics will mean to you from a financial standpoint. If you find yourself at a loss, you can reach out to the American Cancer Society 24 hours a day at 1-800-227-2345.
If you’re age 65 or older or have a disability, you can apply for enrollment in Medicare, which helps pay for certain kinds of care, some outpatient care and medically-necessary physician services, and medication costs. It may also cover hospice care if an individual has six or fewer months to live. If you’re 65 and meet certain financial guidelines, you can apply for Medicaid.
Take an active role in your cancer treatment plan. Be well-versed in the terms of your health insurance policy, and investigate payment and payment assistance options for out-of-pocket costs. Above all, be up front with questions and concerns.