High insurance premiums, deductibles, and copayments for patients are some of the strategies insurance companies are using to lower their cost of cancer care. This means that the cost is shifting from the insurance company to patients with cancer, who are increasingly facing significantly high out-of-pocket expenses. Experts have termed this “financial toxicity,” the new type of side effects associated with cancer therapy.
The result is that some patients skip their medications or take fewer doses because they can’t afford the payments, and some have to choose between paying their utility bills or their medical bills. Some patients even had to file for bankruptcy because of a debt related to their cancer diagnosis.
High Debt Among Patients with Cancer
A new study conducted by the LIVE-STRONG Foundation of patients with cancer (aged 18-64 years) was published in January 2016 in Health Affairs, showing the high financial burden of cancer care among working-age patients with cancer and cancer survivors. Most of those included in the survey were well educated and were employed full time. Of the 4,719
individuals included in the survey:
- 3,002 (64%) worried about the large bills for their cancer diagnosis
- 1,864 (40%) had to make financial sacrifices to pay for treatment
- 1,583 (34%) had to borrow money or go into debt to pay for therapy
- 144 filed for bankruptcy
Of those who reported going into debt because of cancer, 55% said they owed $10,000 or more. Patients who went into debt or filed for bankruptcy were usually younger, had lower household income or were unemployed, and had 2 or more cancer diagnoses. Patients were more likely to file for bankruptcy 2 or more years after their cancer diagnosis than in the first year of their treatment.
Take Steps to Prevent Financial Disaster
According to this study, the average annual cost of care for a patient with cancer in the first year of diagnosis is currently $17,170, which decreases to $9,369 after the first year.
To help prevent accumulating large debt or even bankruptcy, it is important that you and your family identify sources of financial assistance soon after the cancer diagnosis, when more financial assistance options exist from different sources.
Furthermore, to be able to make informed decisions about the cost of treatment, patients must have open discussions with their care providers about the cost of different treatment options, as well as any financial difficulties they may have. Despite the growing costs of cancer therapies, however, many patients and doctors are not having these discussions. Patients and doctors often avoid the topic, for different reasons.
Remember that there is often an alternative treatment that may cost less and is just as effective as the more expensive therapy your doctor prescribes. If your doctor is not aware of your financial difficulties, he or she may prescribe a more expensive treatment for a variety of reasons. It is your responsibility to tell your doctor of any financial difficulties, and ask if a less expensive option is available for your specific type of cancer, or if any financial assistance is available.
Your doctor is not trained to discuss costs with patients, so take the initiative and don’t wait for your doctor to bring it up. If you are more comfortable discussing your finances with your navigator, don’t hesitate to do so.
Get Help from Nonprofit Organizations
Many nonprofit foundations and government organizations provide financial assistance to patients with cancer. Eligibility criteria usually involve demonstrating financial need and low household income.
The following is a select list of organizations providing financial support to patients with cancer:
- CancerCare (www.cancercare.org);
- Cancer Support Community (www.cancersupportcommunity. org);
- Patient Access Network Foundation (www.panfoundation.org);
- Patient Advocate Foundation (www.patientadvocate.org);
- Patient Services, Inc (www.patientservicesinc.org).
A complete list will be published in CONQUER in April. Future issues of the magazine will also provide information about drug companies that offer financial assistance for their cancer drugs to eligible patients.
Turn Your Life Insurance into Cash
For patients with advanced cancer, another source of financial assistance is emerging for those who have life insurance (usually a minimum policy size is required). This may seem heartless, but in reality, it may offer some patients a more attractive option than bankruptcy, loss of a house, other life-altering consequences, or even a chance to fulfill a lifelong wish that requires money and would not be feasible otherwise.
No out-of-pocket-cost loan. Some companies are using the patient’s life insurance policy to provide immediate money in the form of a loan that is paid back directly from the life insurance, so there’s no out-of-pocket cost to the patient or the family at any time. The money can be used for medical expenses or for anything else, including mortgage pay-ments or a vacation. Examples of this type of companies include Fifth Season Financial (www.fifth seasonfinancial.com) and Life Credit Company (www.lifecredit.company.com).
Selling your life insurance. Other companies are buying the patient’s life insurance policy from the patient, which provides immediate cash for the patient. The life insurance company will make an offer to the patient for the life insurance policy; the policy will be transferred to the insurance company and the patient will receive the cash amount agreed upon with the insurance company. Examples include American Life Fund (http://americanlifefund.com) and Sell Your Insurance (http://sellyourinsurance.com).
Studies show that financial hardship for patients with cancer is associated with negative outcomes, such as lowering their chance to get care, or to receive the best treatment available, which can affect their overall health. If cost issues affect your treatment, let your care team know about it, and be sure to ask for help.