Insurance & Finances

If you live in the United States, unfortunately, one of the first questions you may have after diagnosis is How will I afford treatment? You probably didn’t include cancer in your budget plans, but it’s time to get on top of your finances and consider all the costs of treatment. Medication, treatment, and appointments may be some of the more obvious expenses, but unfortunately, there are additional costs associated with transportation, home care, and or lost income from time off work.

Keep track of all your medical bills, insurance claims, travel receipts, and payments. Organization is your friend! Don’t just shove receipts in a shoebox; file things in a proper folder or binder for easy reference. A social worker, caseworker, or financial counselor in the hospital may be able to help you navigate challenges you have with payment and claims.

Understand the terms of your insurance policy, including what is covered if you are treated by an out-of-network provider.  It might feel like you have to learn a new language of insurance terms that you were happy to ignore before…like the difference between premiums and copay and coinsurance and deductibles. (Cheat sheet: your premium is what you pay each month just to have insurance, copay is what you pay at each doctor’s visit, deductible is the amount of money you have to pay before your insurance benefits kick in, and coinsurance is the amount you’re responsible for after you’ve hit your deductible, usually a percentage of the cost of a service.)

If you are in danger of losing your insurance after leaving work, you may qualify for short-term or long-term disability insurance, Supplemental Security Income, or Social Security Disability Insurance. It’s important to speak with your healthcare team and medical institution’s billing department anytime you switch insurance to understand how the change will affect your coverage. Things like genetic testing, some fertility treatments, and clinical trials may not be covered by your insurance, but in some cases, there are resources available to help navigate the costs.

Questions for your provider...

Is there a less-expensive generic drug that I can be prescribed?

How long will my treatment last and how much is it projected to cost?

What other prescriptions might I need with this treatment (for nausea, pain, etc)?

Do you have any low-cost or free transportation or lodging while I attend treatments?

Are there clinical trials available for my treatment and what is covered/not covered by the trial?

Questions for the billing department...

How long will my treatment last and how much is it projected to cost?

Can we discuss a payment plan for my treatment?

Questions for your insurance provider...

How much is my copay and/or coinsurance for each visit?

How much of this treatment plan will my insurance cover, are there any options that have greater coverage?

Do I need prior approval from my insurance before I begin treatment?

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