With some new medications, especially cancer medicines, having out-of-pocket monthly costs of $500 to $1,000 or more, it’s not surprising that medical debts make up half of all debt collections in the United States, according to a 2014 report from the Consumer Financial Protection Bureau. And another report suggests that 1 in 3 Americans has a hard time paying their medical bills, although most of these patients have health insurance.
However, financial help exists. You should feel empowered to play an active role in your own care, and know that you can utilize many different resources for the care you need.
Lash Group works with pharmaceutical manufacturers to assist you if you’re underinsured or uninsured, and provides information on access options for your medication. With more than 20 years of experience in healthcare, here are 9 tips that can help you afford your medication.
1. Understand Your Insurance
You often don’t know you’re underinsured until you need to use your health insurance. It’s important to know who provides your insurance, whether it’s Medicare, Medicaid, TRICARE, or a commercial health plan.
You also need to know what your out-of-pocket costs are, including copays and deductibles. Understanding the difference between primary and secondary coverage, and determining if the costs will fall under your plan’s medical or pharmacy benefit is a critical factor in figuring out how much you will need to pay for your treatment.
2. Your Pharmacy Matters
To avoid unnecessary costs, it’s critical to use an in-network pharmacy. Sometimes, your physician does not administer your medication. In this case, you may need to get your medication from a specialty pharmacy, which is different from a local retail pharmacy.
Your physician should verify where the prescription should be filled, and route it appropriately, especially if the physician is using a drug manufacturer reimbursement program or a hub service.
Be careful with online pharmacies; the first rule is to skip any website that is selling cures or talking about things that “doctors don’t want their patients to know.” Steer away from nonlicensed or online pharmacies that offer to ship drugs from outside of the United States. This is not a reliable way to receive the accurate medication in the correct dosage.
3. Consider Crowdsource Funding
The rise of crowdfunding, defined by Merriam-Webster as “the practice of obtaining needed services, ideas, or content by soliciting contributions from a large group of people and especially from the online community rather than from traditional employees or suppliers,” also has benefits for you if you’re struggling to afford your treatment.
New crowdsource funding is a great way to help you and your caregivers raise money for medical expenses.
4. Get to Know Needymeds.org
Needymeds.org is a great resource and clearinghouse of information on 400 programs, offering nearly 4,000 free or discounted drugs. This website can benefit you regardless of your type of cancer, or whether you’re insured, underinsured, or uninsured.
Some scholarships are also offered for students with specific medical conditions, and for students who have a parent or family member with a specific diagnosis.
5. Research Manufacturer Support Programs
Find out who manufactures your medication, and check online to see if the manufacturer provides a support program. Support programs help you afford and gain access to critical therapies.
You can search the medication’s name and the terms, such as “patient assistance,” “copay assistance program,” “patient support,” or “patient services,” to find the drugs you need.
Some programs will help with more than just the drug, by providing transportation and additional resources, including wigs, household bills, and groceries. This varies significantly by manufacturer, drug, and disease state, and is often an underutilized way for you to save time, effort, and money.
6. Connect with Caseworkers
If you receive treatment in a hospital, or in a practice that is affiliated with a larger health system, your healthcare provider can connect you with a caseworker or financial advisor.
These experts may be able to help you qualify for financial assistance, and evaluate different payment options, including credit. If you have expenses and you’re having trouble making payments, you should consider medical mediation.
7. Research Foundations that Provide Grant Funding
You should research foundations that are committed to providing grants to you if you can’t afford your life-extending and life-saving medications. Online is an excellent place to start, and many grants are specifically focused on patients with cancer.
8. Find a Patient Advocacy Group
Many private- or government-funded organizations offer patient advocacy programs that can help you with the costs associated with your specific cancer medications. Organizations can cover one specific diagnosis, or whole categories, such as cancer or chronic medical illnesses.
Some of these organizations are national in scope, while others are limited to certain states. Most organizations have eligibility requirements that are usually financially driven.
Diagnosis-based assistance programs may cover many types of expenses, including drugs, insurance copays, office visits, transportation, nutrition, medical supplies, and child or respite care.
9. Stay on Treatment
Continue taking your medication for the full duration of treatment, even if you start to feel better.
If you’re taking an oral drug, don’t skip a dose or cut it in half without explicit instructions from your doctor. If you’re using a therapy that requires injection or infusion at a doctor’s office, be sure to keep your appointments on schedule. If transportation is an issue, there are resources to help. If the cost of treatment is overwhelming, discuss this with your oncology care team.
Having cancer can be overwhelming not only emotionally but also financially. Many patients are unprepared for such a life-changing moment, and immediately worry about the expensive treatments they may need.
Reach out to your navigator and your care team if you need financial support.