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Covering the Costs of Your Breast Cancer Care

The costs of breast cancer treatment and follow-up care can be a financial strain for some people and their families, even when they have health insurance.

The costs of breast cancer treatment and follow-up care can be a financial strain for some people and their families, even when they have health insurance.

Besides the out-of-pocket costs of your treatments, you may be facing extra expenses for transportation to and from a treatment center, child care while you’re having treatment, or special foods to make sure you’re meeting your nutritional needs. If you’ve had to take time off from work and your income is lower, these living expenses can be challenging to cover.

If you don’t have health insurance or are unemployed, paying for treatment may feel overwhelming. Don’t panic, and don’t skip any treatments or doctor visits. There are resources available to help you.

Your medical team may be able to give you a list of organizations that offer financial assistance for breast cancer medicines and care, as well as a list of local organizations that offer financial assistance for your practical needs, such as transportation, child care, and food. In addition, many pharmaceutical companies offer patient assistance programs to help people cover the costs of prescription medicines.

Here we discuss various U.S.-based resources and U.S. regulations. Other countries may have different laws regulating health insurance coverage and hospital operations. If you live outside the United States, ask your doctor about resources in your country.

 

Understanding the costs associated with breast cancer

Soon after your diagnosis, it’s important to take some time to calculate the out-of-pocket costs for your breast cancer care and treatment. If you don’t have any health insurance, the first step is to secure some kind of coverage. Ask your doctor if there is a patient financial counselor, social worker, and/or nurse navigator (also called a patient navigator) at your hospital who can try to help you find a plan that works for you. This person also should be able to tell you whether your hospital offers any payment plans to help manage costs or assistance programs to help defray costs that aren’t covered by health insurance. Health insurance brokers know the ins and outs of different plans and can also offer advice quickly. For more information, see options for people without health insurance.

Even with health insurance, you can expect to face some out-of-pocket costs. Take some time to understand what your plan covers and what it expects you to pay out of pocket. For example, you should make sure that the hospital or medical practices where you receive breast cancer treatment are in your health insurance network. Otherwise, you might be surprised by large bills later on. “We give patients the diagnosis codes, the procedure codes, and encourage them strongly to call their insurance company to see if they need any pre-certifications and pre-authorizations and for information about co-pays and deductibles,” says Annette Hargadon, CRNP, breast surgery specialist at the Lankenau Medical Center, Main Line Health, Wynnewood, Pa.

Health insurance policies aren’t easy to read, but it’s a good idea to know what you’re getting into and see if you might need help covering out-of-pocket costs. Generally, cheaper health insurance plans with lower premiums — that’s the monthly amount you pay or your employer pays for coverage — tend to have higher out-of-pocket costs. Learn more about managing your health insurance.

Come up with a system for keeping your medical information organized. This includes your medical records, such as test results and treatment plans; any communications you get from your health insurance plan; and any bills or financial statements you receive from your doctor or hospital. Good recordkeeping can be a major help if you run into any issues with health insurance coverage. Learn more about managing your medical records.

Indirect costs of breast cancer

Along with out-of-pocket costs for treatment, you may need to plan for any of the following additional expenses:

  • Lost wages: Your income may decrease if you and/or your partner — if you have one — need to take time off from work.

  • Transportation: If you drive to and from the hospital for treatments, you should plan to pay for gas and possibly parking. If you take public transportation, you should plan to cover the roundtrip fare for a subway, bus, taxi, or driving service, such as Uber or Lyft. And if you are traveling to a cancer center outside your immediate area, you also may need to pay for lodging.

  • Child care: If you care for children or grandchildren, you may need to pay for child care while you’re receiving and/or recovering from breast cancer treatment.

  • Household help: You may need to hire someone to help you with cleaning, cooking, laundry, and other household chores until you’re finished with your breast cancer treatment.

It’s a good idea to keep these items in mind as you plan your budget for the coming months.

 

Lowering costs: Start with your care team

If you’re concerned about paying for your treatment, talk to your care team. Hospitals and cancer centers often have patient financial counselors, social workers, and nurse navigators on staff who have experience helping people manage their cancer costs. There are many people who are “functionally insured” — meaning that although they have health insurance, they also have major difficulty affording the out-of-pocket costs associated with serious illness. If you find yourself in this situation, you’re not alone.

Here are some ways you may be able to reduce treatment expenses or make each payment fit into your budget.

  • Ask if you can set up a payment plan. You may be able to pay a smaller amount each month toward your bill, rather than pay the full amount due at the end of each visit. Although private medical practices often can’t offer this type of payment option, many hospitals do.

  • Ask if your hospital or treatment center has funding to offset medical costs that aren’t covered by health insurance, discounts for uninsured or underinsured people, or programs that help with living expenses. You may have to provide proof of your financial situation — such as income statements and/or tax returns — to be eligible for these funds.

  • Ask for referrals to local government agencies and nonprofit organizations that offer financial assistance for medical care and living expenses. Oncology social workers often are aware of local and national organizations that offer financial assistance to people with breast cancer.

  • Be strategic about scheduling treatments and visits. A social worker or patient navigator may be able to help you “bundle” your visits to the hospital or cancer center to save money on co-pays, or schedule treatments or tests all at the same time to help you reduce your costs. For example, most health insurance plans have deductibles that reset to zero at the end of the calendar year. If you haven’t met your deductible for the calendar year and the year is nearly over, you may want to consider scheduling any expensive tests you need in the new year. Also, some plans may pay more for treatments and tests you get at the hospital versus at an outpatient center.

  • Ask your doctor if you’re eligible for any clinical trials. In some cases, you don’t have to pay for the medicine and care you receive as part of a clinical trial. If you find a clinical trial that you don’t have to travel to, it may be worth looking into whether you are eligible.

  • Ask your doctor about generic medicines. Generic medicines are usually less expensive than brand-name medicines. There are some generic options for certain types of chemotherapy, hormonal therapies such as tamoxifen and aromatase inhibitors, and bone-strengthening medications such as bisphosphonates. Ask about generic versions of medicines used to treat side effects such as pain and nausea. Depending on your situation, you may be able to take the generic rather than the brand-name medicines.

  • Ask your doctor for samples of medicines prescribed to you. Samples can help you avoid paying for a full prescription that you might not be able to take if you have side effects and have to switch to a different prescription. Keep in mind that samples might not be available for all medicines.

 

Managing your health insurance

Understanding your health insurance plan can help you feel more in control as you begin breast cancer treatment. Learn more.

 

Options for people without health insurance

Even if you don’t have health insurance, you may be eligible for health care plans that give you partial or full coverage or programs that can help you cover treatment costs. Learn more.

 

Tips for lowering medicine costs

Medicine assistance programs can help you get your prescription medicines at a reduced cost or, in some cases, free. Learn more.

 

Help paying for medical tests

As part of your treatment plan, your doctor may recommend certain tests, such as a genomic assay (or test) or genetic testing.

Genomic tests help doctors determine whether it’s beneficial to prescribe more treatments after surgery. Genetic tests can tell you if you have a mutation — or an abnormal change — in a gene that is linked to a higher risk of breast cancer. Genetic mutations run in families.

Although many health insurance plans cover genomic and genetic tests, there may be out-of-pocket costs as well. There are resources that may help you cover costs if you don’t have health insurance or can’t afford out-of-pocket expenses.

Learn more about the genomic tests, including information on health insurance coverage and financial assistance:

Learn more about genetic testing, including information on costs and health insurance coverage.

 

Help paying for living expenses

After being diagnosed with breast cancer, people may find their incomes stretched to the limit because of out-of-pocket expenses — especially if they are earning less because they’ve had to take time off from work. For this reason, some people may need help paying for living expenses, such as food, transportation, child care, mortgage or rent, and utility bills, while they’re receiving breast cancer treatment.

If you’re worried about paying your bills, get help early. Speak with the social worker at your hospital or cancer center. Social workers are likely to know about local and national assistance programs that can help with not only medical treatment costs but also everyday living expenses.

Here are some tips that also may be useful — ask someone you trust to help you if you’re feeling overwhelmed:

  • Develop a budget that lists your monthly income and all your monthly expenses. Listing all your expenses can help you prioritize your bills and see if you can cut back anywhere. You also can see if you’re going to be short of funds so you can get help if you need it.

  • Talk to your creditors and let them know you’re having trouble paying your bills because of medical expenses. Ask them if you can work out a payment plan. Most creditors are willing to work with customers, especially if they have a good payment history. Don’t wait until your account has been turned over to a collection agency.

  • Always try to make a payment. Even if you can only pay a small amount every month, some creditors may acknowledge that you’re making an effort to pay what you owe.

  • Contact your local United Way or American Cancer Society office. These organizations may be able to offer financial assistance or direct you to other groups in your area.

  • Ask your local church, synagogue, mosque, or other religious organization or fraternal order whether they have a financial assistance program. You may also be able to connect with volunteers who can help with transportation or grocery shopping.

  • Speak with a credit counselor if you’re having trouble keeping up with bills, you may want to contact a credit counselor. A credit counselor can suggest strategies you can use to pay down debt and rebuild your credit. To find a reputable counselor, talk to someone at your bank or local consumer protection agency. Many universities and local housing authorities offer nonprofit credit counseling programs. The National Foundation for Credit Counseling (NFCC) provides educational resources and can help you find an accredited counseling agency in your area. You also can use NFCC’s MyMoneyCheckUp tool to get a snapshot of how your finances are doing and show you areas you can improve.

 

Tax deductions for treatment

In the United States, you may be able to deduct a percentage of your treatment costs from your federal taxes if you meet certain requirements. To deduct medical expenses, you have to list every deduction you are taking. This is called “itemizing” your deductions.

Typically, you can write off qualifying medical expenses that exceed a certain percentage of your adjusted gross income. Tax policies can change from year to year, which means that the percentage can increase. Your adjusted gross income is your taxable income minus any adjustments to income such as deductions, contributions to a traditional IRA, and student loan interest.

Examples of deductible medical expenses include:

  • preventive care

  • treatments and surgeries

  • dental and vision care

  • visits to psychologists and psychiatrists

  • prescription medications

  • appliances such as glasses, contacts, false teeth, and hearing aids

  • travel costs related to medical care, such as mileage, bus fare, and parking fees

You cannot include any medical expenses for which you were reimbursed by your employer or health insurance plan.

Itemizing deductions can be complicated, and there are many rules based on your income and filing status. To ensure you’re including everything you can and nothing you can’t, consider talking to a tax preparation expert or certified public accountant. The American Institute of Certified Public Accountants has a tax planning section that may provide helpful information.

 

Tips for choosing a financial planner

Handling your finances while also handling a cancer diagnosis can be challenging. Some people find it helpful to work with a professional financial planner. A financial planner can look at your household income and assets, routine expenses, and new cancer-related expenses and help you figure out how to budget realistically for the next several months and beyond. A financial planner also can give good advice about creating a budget that takes treatment costs into account and offer recommendations on how to best ensure you have enough money to cover all your expenses. For example, cashing in a retirement account or life insurance policy to free up cash may seem like a good idea but may not necessarily be the best move for your long-term financial situation.

A professional financial planner has access to financial records and other sensitive information, so it’s important to do your research when choosing one. If finding a financial planner is more than you can take on right now, ask a family member or close friend you trust to help.

If cost is a concern, ask your care team or social worker if they can recommend someone who provides pro bono (free) or reduced-fee services for people diagnosed with cancer. For example, the Dana-Farber Cancer Institute in Boston partners with the Financial Planning Association of Massachusetts to connect people with volunteer financial planners. Your state or local financial planning association might be able to connect you with pro bono services. The Foundation for Financial Planning also may be able to help. The foundation has launched the Pro Bono for Cancer Campaign to raise funds to support free financial planning services for people diagnosed with cancer.

If cost isn’t a major concern, you can search for a Certified Financial Planner™ in your area through the Financial Planning Association. There are other organizations with searchable databases as well, such as the National Association of Personal Financial Advisors and the Society of Financial Service Professionals. When considering certified financial professionals, make sure they have experience helping people deal with the unique financial challenges that serious illness brings.

As you search for financial planners in your area, get recommendations from people you trust. Good sources include the social worker or other patient support staff at your hospital; colleagues, friends, or relatives; or other people who’ve been diagnosed with cancer. If you already have a lawyer or an accountant, ask them if they can recommend anyone. Approach this search the same way you might approach finding a plumber, car mechanic, or real estate agent: Use your social networks and pay attention to any names that come up repeatedly.

Once you have a few candidates, you are ready to research each person. You can ask a family member or friend you trust to help you with this process if you’d like. Check each candidate’s education, professional credentials, licenses, experience, and affiliations to professional groups or associations. Ask the candidates to tell you about the clients they’ve served and whether they have worked with people diagnosed with chronic illnesses, such as cancer. You may be able to find this information on the financial professionals’ websites. You also could call their offices and request an information packet.

After your review each candidate’s information, you are ready to schedule an introductory meeting so you can ask questions and make sure you find the right fit. You can schedule these meetings around your treatments, when you’re feeling up to it, or ask someone you trust to help you. During these meetings, it’s a good idea to ask the financial planners about the following:

  • How they charge fees — is it a flat fee, by the hour, or as a percentage of the assets they manage for you? Do they receive commissions from selling you certain financial products?

  • Whether they have experience working with clients who have been diagnosed with cancer or other serious illnesses. How is advising such clients different from advising clients who are not ill?

  • How familiar they are with financial areas that are likely to be of concern to you, such as medical coverage, life insurance, disability benefits, and unemployment benefits.

  • What information they need from you, and how often you should meet to discuss how your finances are doing.

  • The kind of advice you can expect to receive — can the financial planner give you advice in person, in writing, over the phone, or over a virtual online meeting?

  • References from other clients, especially people diagnosed with cancer or other chronic illnesses.

Before getting started, you may wish to read How to Find a Financial Professional Sensitive to Cancer Issues: Financial Guidance for Cancer Survivors and Their Families (PDF), a booklet produced by the American Cancer Society and the National Endowment for Financial Education. It includes key questions to ask and issues to think about as you search for a financial planner who meets your needs.

— Last updated on January 21, 2022, 9:23 PM

Reviewed by 2 medical advisers
 
Toby Stolberg, MSW, LSW, OSW-C
Riddle Hospital Cancer Center, Main Line Health, Media, PA
Annette M. Hargadon, CRNP
Lankenau Medical Center, Main Line Health, Wynnewood, PA
Learn more about our advisory board
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