Paying for Pain Treatment

When you're in pain, the last thing you want to think about is the cost of getting the relief you deserve.

Yet some women avoid seeking help because they believe their insurer won't cover pain treatment, and they can't pay for it themselves.

This section will help you understand how to get pain treatment affordably.

Insurance concerns

Before deciding that you can't afford the pain relief you need, arm yourself with complete information:

• Call your medical insurance company and find out what treatments your insurer will cover.
• Learn whether you have to pay co-payments up front, and how much those are. Because co-pays for chemotherapy are often high, some doctors hesitate to use such treatments to manage long-term pain.
• Be sure you know whether the balance of the charge (beyond the co-pay) will be billed to the insurer, or whether you have to pay in full and then request reimbursement.
• If you're considering going to a pain center, determine how fully your insurance plan will cover charges from that facility and those doctors. Using a pain center that is included in your insurer's network will save you hefty out-of-pocket costs.
• The cost of specific palliative therapies (treatments that reduce pain but don't cure the disease)—radiation, chemotherapy, and anesthesia procedures—is generally covered by most health care plans.
• Some insurance companies now pay for acupuncture because advocates have presented compelling research results. Other effective treatments that insurance doesn't yet pay for may also become available in this way.

If you don't have private health insurance:

• Medicaid pays for oral pain medications as well as those administered by pump or intravenously (by vein).
• Pharmaceutical companies have special programs to give free drugs to patients in financial need who don't have Medicaid coverage. Ask your doctor about these programs or visit www.needymeds.com for more information.
• Ask your doctor for drug samples to try before paying for a prescription. Since samples of opioids are almost never available, ask your pharmacist to fill only part of an opioid prescription at first. For example, first pay for only 10 pills of the total prescribed. If the pills work, and you can tolerate the side effects, then go back and buy the rest.
• Medicare pays only for medications administered by pump or intravenously. It doesn't pay for oral medications.
• If you've elected the Hospice Benefit under Medicare, you should still be able to have palliative radiation, chemotherapy, and anesthesia procedures if you don't get adequate relief from pain medication.

Getting the medications you need

You're not weak, or a complainer, because you need pain medication. Getting the relief you deserve will improve your mental and physical strength as well as speed your recovery.

Here are some things to remember about getting pain medication:

• Many pharmacies do not carry opioids (pronounced OH-pee-oydz; also called narcotics) but can order them for you.
• Pills are generally the cheapest form of medication.
• If pain symptoms return, don't automatically use medication that you may have left over from earlier treatment. Doing this may not be safe or effective. Always speak with your doctor before taking any medication for pain.
• Don't be embarrassed to tell your doctor or nurse if you're having trouble paying for your medications. You can usually get effective medications to fit your budget.
• To save money, you can use a bulk-order mail pharmacy or shop through AARP. But remember, you save money on a bulk order only if you are sure you will use the medications.
• Some American Cancer Society chapters will help pay for pain or anti-nausea medications.