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The financial costs associated with a cancer diagnosis can quickly impose an economic strain on you and your family. Having health insurance doesn’t necessarily guarantee you’ll be able to afford treatment. The costs for surgery, other treatments and medication can add up, even if you have insurance. The cost of treatment can also negatively impact other financial aspects of life. Therefore, it is advisable to start researching financial options as soon as possible, following a cancer diagnosis. Here are some tools and resources available to people with cancer. Check with each agency or organization to see if you qualify for financial assistance. Knowledge is power; resources are available.
Know Who to Connect With:
First, most medical offices today have social workers, patient advocates or financial counselors available to discuss your individual situation and financial needs. Connect with one of these people at your medical facility so they can assist you in understanding and managing the cost of care.
Know Your Health Insurance Policy:
Review your health insurance policy’s explanation of benefits to determine which procedures and therapies need pre-authorization before they can be paid and get all approvals in writing. In-network providers may offer cost savings over out-of-network providers. Ask your health insurance carrier if you can have a case manager assigned to help you learn about programs, treatment costs, manage your bills and payments and offer other suggestions. Working with the same case manager can offer advantages with your individual situation which ultimately helps you be more organized and less stressful. Consider asking a family member or friend to help with the organization of paperwork too.
Expenses and Billing Statements:
Talk to your healthcare provider about which out-of-pocket expenses you may be responsible for and ask if they will reduce their fees. Both private and public insurance providers have medical hardship provisions.
Request itemized statements from all your healthcare providers and double check the statement to make sure you received all the services stated. Errors are common and if you don’t understand or recognize an item listed call the billing department and ask for an explanation.
If you are unable to pay a bill, talk to your provider about making smaller payments until the total is paid off. Many providers are willing to work with you but you need to initiate the conversation. If you ignore a bill, it may be turned over to a collection agency.
Additional Financial Resources:
Miles of Hope Breast Cancer Foundation - The Medical Gap Care Fund was established to help individuals residing in one of the nine counties of New York’s Hudson Valley who experience life emergencies and/or costs not covered by health insurance while they are undergoing treatment for breast cancer. These expenses could include, but are not limited to, the following: insurance co-pays, medication / medical equipment not covered by insurance, post-surgery.
- BreastCancer.Org – A national nonprofit organization dedicated to providing the most reliable, complete and up-to-date information about breast cancer. They offer a comprehensive list of topics and resources for individuals and their caregivers who are dealing with a breast cancer diagnosis including financial information.
- Cancercare.org – Assistance with legal, rent, food, copay, and transportation expenses.
- Good Day Chronic Disease Fund – Assistance with medication, transportation, and co-pays.
- HealthWell Foundation – when health insurance isn’t enough. Helps with copays, deductibles, and health insurance.
- Managing the Known and Hidden Costs of Breast Cancer
- Patient Access Network Foundation – 866-316-7263 – this organization helps patients afford their co-payments and can provide small grants to patients who meet financial and medical criteria.
- Patient Advocate Foundation – 800-532-5274 - copay relief, insurance assistance, case manager assistance, job retention, arbitration, mediation, and negotiation to settle issues with medical debt related to their illness.
- The Pink Fund - 877-234-PINK (7465) The Pink Fund provides financial support to help meet basic needs, decrease stress levels and allow breast cancer patients in active treatment to focus on healing while improving survivorship outcomes. Their 90–day grant program allows us to meet their critical expenses for housing, transportation, utilities, and insurance.
Get Your Rack Back - GYRB, local to the Capital Region, helps families in crisis by providing restaurant, gas and grocery gift cards, and financial aid for physician and hospital co-pays.
Healthcare Hospitality Network - Another option for adults or children with cancer is the Healthcare Hospitality Network. This group of nearly 200 non-profit organizations throughout the US provides free or low-cost family-centered lodging to families getting medical treatment far from home. You can check online at www.hhnetwork.org to see if there’s a location that works for you.
The Assistance Fund CancerCare, Inc. - Offers limited financial assistance for cancer-related costs and co-pays, and our professional oncology social workers can help you find additional resources.
GoodDays - Helping overcome the burden of treatment costs, connecting you to a community that cares. They make life-saving and life-extending treatments affordable, acting as your advocate, helping you navigate the system and guiding you to additional support through foundations and other organizations dedicated to those with specific, life-altering conditions.
Healthwell Foundation - Helping the underinsured afford critical medical treatments .
PAN Foundation - offering financial assistance to help people with serious illnesses afford their out-of-pocket treatment costs.
The Assistance Fund - offering financial assistance for those who are dealing with breast cancer and some other diseases.
Not Currently Insured?
If you do not have health insurance, discuss this with the social worker or financial counselor at your medical facility. They can guide you through the process of filing for government assistance or seek out charity care coverage or may know of available sliding scale coverage options.
Medicaid is a government program for low-income people and families. You can find more information at www.cms.gov. You can get health insurance through Medicare if you are 65 or older and are eligible for Social Security benefits, disabled (at any age) and have been collecting Social Security benefits for two years. You can find more information at www.medicare.gov. In addition, some states offer their own public health insurance plans that low-income workers can buy at a reduced rate. For a state-by-state guide www.familiesusa.org/resources/resources-for-consumers.
Your Local Department of Social Services (LDSS) may be able to assist you in obtaining your health insurance coverage and/or provide you with information about other programs and benefits you may qualify. Find the contact information for your LDSS by following the link below. Find Your Local Department of Social Services.
Free and Low-Cost Screenings during Recovery or After Treatment:
Having regular health screenings while you’re in recovery and post-treatment is crucial for monitoring treatment effectiveness as well as detecting cancer recurrence. If you don’t have insurance or can’t afford office co-pays here are some resources that could help:
- American Cancer Society – 800-227-2345
- Cancer Services Program of Fulton, Montgomery and Schenectady Counties – 518-841-3726
- Cancer Services Program of the Greater Capital Region - 518-525-8684
- The Center for Disease Control and Preventions National Breast and Cervical Cancer Early Detection program
- National Cancer Institute –800-422-6237
- The Patient Advocate Foundation – 800-532-5274 – This organization recently launched a ground-breaking new online directory intended to help underinsured people locate important resources and seek alternative coverage options for better reimbursement. A 7 section guide addresses insurance options for the underinsured, financial issues, access concerns, existing protections and more.
Know Your Rights:
Legal information on job discrimination related to cancer issues, entitlement programs and health insurance coverage can be provided by contacting:
- Free legal aid programs for low and moderate income individuals
- Legal Aid Society of Northeastern New York
- The National Cancer Legal Services Network
The Elderly Pharmaceutical Insurance Coverage (EPIC) program is a New York State program for seniors administered by the Department of Health. It helps income-eligible seniors aged 65 and older to supplement their out-of-pocket Medicare Part D drug plan costs.
Every major pharmaceutical company has a Patient Assistance Program (PAP). They provide free, discounted medicine or assistance with prescription co-payments to people who are unable to afford them. Each program has its own qualifying criteria. Coupons, rebates & more can be offered by various drug companies too. These offers require a doctor's prescription. Talk with your oncology social worker and/or nurse to see if they can connect you with programs to assist with medical prescription payments.
Additional Medication Assistance:
- AstraZenenca - 800-292-6363
- The Assistance Fund - 855-845-3663
- Genentech - 877-436-3683
- Good Day Chronic Disease Fund - 877-968-7233
- NeedyMeds - 800-503-6897
- Partnership for Prescription Assistance – 888-477-2669
Locally, if you need transportation to your medical appointment you can contact: