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Dealing With The Financial Burdens of Cancer
Paying for cancer care is serious business. In the US, medical bills are the number one reason that families are forced to declare bankruptcy, with over 500,000 doing so in 2019. More than 42 percent of the 9.5 million people diagnosed with cancer from 2000 to 2012 drained their life's assets within two years. Cancer patients are 2.65 times more likely to file for bankruptcy than those without cancer, and bankruptcy puts them at a higher risk for early death. Google “financial toxicity of cancer” and you will find many articles on the subject. Here’s a recent one from KHN: In America, Cancer Patients Endure Debt on Top of Disease
With that in mind, I have posted some information below that may point you to ways to save some money, and allow you to focus your time and energy on the healing process, where it belongs. One place you can start is with the Cancer Financial Assistance Coalition, which has a searchable database of financial resources covering housing, transportation, medicines, utilities, meal delivery, etc.
If you’re a low income senior, you can also check out the Center for Benefits Access at the National Council on Aging for the resources they offer.
You may one day get an enormous bill from the hospital for your cancer care. The bill will have been sent to you from the chargemaster, which is the hospital’s financial office that sends out the bills. These bills are different from the ones you receive from your electric utility, or from the folks who fixed your broken washing machine. These bills are actually negotiable, and your ability to negotiate these bills is especially important for those who self-pay (i.e. lack insurance). Think of these hospital bills as the starting price in a negotiation, but you can bargain your way down from there. Check out this excellent article, Bitter Pill: Why Medical Bills Are Killing Us, by reporter Steven Brill that describes exactly how charge masters function, and how you can appeal the amount that they are asking for. Check out this article on how to appeal your hospital medical bills. I also recommend taking a look at Hospital Chargemaster Insanity from the Pepperdine Law Review for more details.
One other option is to employ the services of a company that will revue your medical records for discrepancies, and then help you fight to reduce your bills. As an example, there’s a company, Triage Cancer, that will review your bills and advise you how to proceed if any problems are noted. The service costs $99/year, and only deals with bills of more than $500. As I have not used this service, I can’t recommend it, nor would I say it’s bad. Just pointing out that it exists. Visit their website and ask lots of questions if you might be interested in this service.
Paying for Medicines
The high price of many drugs is a major healthcare concern of patients in the US. I do have a few suggestions for you to obtain lower priced drugs:
Ask for a lower price at the drug store
1) Any time you buy a drug at a pharmacy using your insurance, ask if the price would be LOWER if you paid for it on your own. This is sometimes the case, but pharmacists have been forbidden by law from telling you that the drug would be cheaper if you paid for it yourself. I believe that this law is going to be repealed soon, but it never hurts to ask your pharmacist this question. You might get a pleasant surprise. The key point here is you have to ASK this question; pharmacists are NOT allowed to tell you this because of certain regulations. The worst that can happen is that the pharmacist simply tells you it is cheaper with your insurance. Nothing ventured, nothing gained.
Seek help from non-profit groups
You can get this information from NeedyMeds, which provides assistance for medications as well as other healthcare costs. You can also call their helpline at 1-800-503-6897. Also check out the Cancer Financial Assistance Coalition, which has a searchable database of financial resources.
Go online to find the cheapest local pharmacy
2) You can try looking for your drug on the GoodRx website. Simply type in the name of the medication you are looking for, along with your zip code, and the site will tell you the prices at nearby pharmacies. You can also get free downloadable coupons that will save you money at those pharmacies.
Buy your drugs at Costco
3) If you’re a member, check out drug prices at Costco. Their prices often beat those of neighborhood pharmacies.
Get your drugs from Canada
4) If you live near the Canadian border, you might be able to buy your drugs at a substantial discount in Canada (except that the border has been closed to US residents due to the COVID-19 pandemic). Be careful, however, of online ads that tout themselves as Canadian pharmacies. Many of these are fake, and the medications you buy might either never arrive or be counterfeit and of dubious quality.
Get help from a drug company patient assistance program
5) Many drug companies have patient assistance programs that can offer you discounts or rebates on certain of their medications. How would you find out about these? You can start by going to the Partnership for Prescription Assistance website. Look at the responses and then read them closely to figure out whether or not you would qualify for them. You can also look for help from RxAssist, which is an online database of drug company assistance programs. Try RxHope, which provides a similar service. Try RxOutreach, which provides a mail order pharmacy for folks who don’t have insurance coverage. You can also Google “prescription help” along with the name of your medication, and see what pops up. Finally, go to the drug manufacturer’s website for any particular drug, and you might find more info there.
Change insurers, or appeal the decision, if a drug you take is dropped from your formulary
6) Formularies. These are the lists of drugs that various insurance companies will, and will not, cover. Medicare patients signing up for drug plans are advised to check the formularies of the different plans to see which ones provide the best coverage for the drugs they take. Cancer patients, though, will not be able to predict which drugs they might need in the future. Drugs get added and dropped by formularies all the time, and what happens if you are responding well to a particular drug, and then your insurance won’t cover it anymore because the formulary has dropped it, and put a substitute in place. You can try the substitute drug, but if it doesn’t work well, you have two basic choices. Pay for the drug yourself out of pocket, change insurers (if possible) to one that does cover the drug, or appeal to the formulary to get them to make an exception for you. That last option will require the help of your doctor. Look here, here, or here for advice on how to appeal the insurance companies decision.
Set up a GoFundMe page
7) It’s sad that I have to even list this as an option, but many people are depending on the kindness of friends and strangers to help them pay for their medicines and medical bills.
Travel and Temporary Housing
I was fortunate to be able to receive my cancer care in my hometown, but I know others are not so fortunate. There are a number of groups that have resources that you can tap into to help pay for your and family members incidental expenses. Below I have links to many of these resources.
The WhatNext website has a page with a number of helpful Tips For Traveling For Cancer Care. They also have a page on Free Flights for Cancer Patients. Finally, they also have a page with advice for other free or discounted services, including gas, headscarves, wigs, housing, legal assistance, and more.
Cancer Care - www.cancercare.org (800) 813-4673
Provides financial assistance in addition to counseling and support.
Cancer Financial Assistance Coalition - www.cancerfac.org (online resource directory)
CFAC is a coalition of financial assistance organizations joining forces to help cancer patients experience better health and well-being by limiting financial challenges
HealthWell Foundation - www.healthwellfoundation.org (800) 675-8416
The HealthWell Foundation offers financial assistance for under-insured patients with chronic or life-threatening diseases, including cancer. Their financial assistance can help eligible individuals to pay coinsurance, copayments, health care premiums, and the deductibles associated with some medications and therapies.
Patient Access Network - www.panfoundation.org (866) 552-6729
This group helps under-insured people with cancer and other life-threatening, chronic and rare diseases get the medications and treatment they need. They do this by helping pay out-of-pocket costs.
Patient Advocate Foundation - www.patientadvocate.org (800) 532-5274
This is a non-profit organization that serves as a liaison between the patient and their insurer, employer and/or creditors to resolve insurance, job discrimination and/or debt crisis matters relative to their diagnosis. They use professional case managers to do this.
Free or Reduced Price Temporary Housing
Many hospitals offer free or reduced price housing for loved ones to stay at when a patient is being treated. Ask about this at the hospital if you have traveled to a city away from your home for treatment.
In addition, here are some websites to check out if that hospital does not have a family member housing program:
American Cancer Society Patient Lodging Programs
Hosts for Hospitals puts you up with local families, not at a hotel.
The Head and Neck Cancer Alliance offers gas cards ($50; one-time only) to help defray the cost of your medical travel.
Free or Reduced Airfare
Note: these are services for adults. There are a number of separate organizations that provide flight assistance to children.
All of these services have specific criteria that you need to meet in order to qualify. See the individual websites for further details.
The National Patient Travel Center (NPTC) can help connect cancer patients with the flight resource available for the date and the destination patient needs to travel. They will not charge you for this referral, and also you have the option to contact the organizations and groups providing the flights for the cancer patients directly. They are primarily set up to help patients with rare diseases, and I’m not sure if they provide help to HPV cancer patients.
Angel Flight has a map where you can click on your state and find out if they have pilots in your area who can help you with transport.
The Corporate Angel Network can also help arrange your transportation to a treatment site.
Angel Flight at NIH flies cancer patients throughout the USA, but only for the cancer patients who are involved in a research study or clinical trials.
Angel Wings for Veterans helps veterans seeking treatment (and wounded warriors).
Footprints in the Sky can help provide patients with transportation to and from various cities where patients seek care.
Patient Airlift Services (PAL) covers flights for cancer patients as well.
Air Charity Network is comprised of a network of member organizations who cover specific geographical service areas and coordinate volunteer pilot
flights in the continental United States, as well as Alaska and Hawaii.
Free Flights for Cancer Patients is part of the What’s Next website.
A "Make A Wish" Type Program for Adults With A Terminal Cancer Diagnosis
Just to be clear: I am NOT a doctor. The information contained in this website is NOT intended as a recommendation for the self management of health problems, medical conditions, or wellness. It is not intended to endorse or recommend any particular type of medical treatment, physician, or treatment facility. Should any reader have any health care related questions, I strongly suggest you call or consult your physician or healthcare provider before looking into other things on the internet. The information contained in this website should NOT be used by any reader to disregard medical and/or health related advice or provide a basis to delay consultation with a physician or a qualified healthcare provider. HPV Cancer Resources disclaims any liability based on information provided in this website.