Managing Cancer Costs Without Health Insurance: Options for Coverage
Breast cancer treatment can be expensive, even with health insurance. If you don’t have some form of health insurance, treatment can be very difficult to afford. So for most people, the question isn’t how to cover costs without insurance — it’s how to find coverage.
There are a number of options for getting health insurance. Some plans may be more affordable than you think, and if your income is low, you may be eligible for plans that are free. Your options will depend on factors such as your age, where you live, your household income, and the time of year you’re trying to enroll.
One common challenge is finding coverage that takes effect quickly. Certain health insurance plans are only open for enrollment for a few specific months each year, unless you qualify for a special enrollment period. There are some plans that you can enroll in year-round if you meet their eligibility requirements.
Do I need to have insurance to get treatment for cancer in the U.S.?
Hospitals and cancer centers in the U.S. usually will provide treatment for cancer even if you don’t have insurance. Typically, a social worker or financial navigator at the facility will work with you to help you get signed up for insurance coverage as quickly as possible after your diagnosis (or help you apply for the hospital’s financial assistance or charity care program, if you’re eligible). However, if you aren’t able to get coverage with their help or on your own, you may be responsible for paying for your cancer treatment costs out of pocket (which can add up to being in the tens of thousands of dollars or more).
Can I be denied coverage because I have a cancer diagnosis?
Medicaid, Medicare, and Medicare Advantage plans, employer-sponsored plans, and plans available through the Health Insurance Marketplace at Healthcare.gov cannot refuse to cover you because you have a pre-existing condition — in this case, a cancer diagnosis. They also cannot charge you more or limit your benefits.
However, some other health plans can deny you coverage if you have a pre-existing condition or refuse to cover treatment for the condition for a certain period of time after enrolling (typically 12 or 18 months).
Also, in most states, Medigap plans (private plans that are used in addition to Medicare and that help cover what Medicare does not) can charge more for premiums or refuse to provide coverage if you have a pre-existing condition and are trying to enroll in them six months or more after enrolling in Medicare Part B. There are certain situations, however, in which insurance companies do need to allow you to enroll in a Medigap plan outside of the typical Medigap open enrollment period. (Check with your state insurance department to see if "Medigap protections" or "guaranteed issue rights" apply in your situation).
How quickly can I get insurance after my diagnosis?
There are some health plans that you can enroll in at any time, including Medicaid plans and Health Insurance Marketplace plans for those with household incomes below 150% of the federal poverty level.
For other types of plans, you may need to wait for an open enrollment period. The timing will depend on the insurance plan but is usually from October or November through December, with coverage taking effect in January.
You might qualify for a special enrollment period, however, if you have a “qualifying life event,” such as moving, leaving a job, having a significant drop in income, or getting divorced. In that case, you’d typically have a window of 60 days after the qualifying event to enroll, and the coverage would begin the month after you sign up.
How can I tell if a health insurance plan will meet my needs?
Check that doctors you want to see and facilities where you want to receive care are considered in-network. Also check that the prescription medicines you currently take are covered. Overall, you’ll want to make sure that the plan won’t leave you with huge out-of-pocket costs and medical bills.
You can get free help finding out about and comparing your health insurance options from a financial navigator or oncology social worker at your hospital or cancer center. There are also nonprofit organizations, like Triage Cancer and the Patient Advocate Foundation, that offer free financial navigation.
Which coverage is right for me: Medicaid, Medicare, or a Marketplace plan?
There are Medicaid, Medicare, and Marketplace health insurance options available to people in the U.S. who are uninsured. Medicaid is for people with low incomes or certain disabilities; Medicare is for people age 65 or over or who are receiving Social Security Disability Insurance (SSDI) benefits; and Marketplace (also sometimes referred to as Obamacare) plans are private insurance plans that are often purchased by people who don't have or are not opting for private insurance through their jobs.
Medicaid provides free or low-cost health insurance coverage to eligible people with low incomes or disabilities. It is funded jointly by states and the federal government. Each state has its own Medicaid program and eligibility guidelines. Whether you qualify depends on factors such as your household income, assets, age, family size, and whether you have certain disabilities. Contact your state’s Medicaid agency for more information or to apply. You can also do a quick screening to see if you’re eligible for Medicaid based on your income alone.
One of the ways you may be able to enroll in Medicaid is through your state’s Breast and Cervical Cancer Treatment Program (BCCTP). Every state has a BCCTP that provides Medicaid coverage to eligible low-income, uninsured people under the age of 65 who have been diagnosed with breast cancer or a precancerous condition of the breast. Eligibility rules vary by state. In some states, you must have been screened for and diagnosed with breast cancer at a health center affiliated with your state’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to qualify.
Since each state has its own BCCTP program, search for “Breast and Cervical Cancer Treatment Program” in your state or contact your state’s Medicaid agency to learn more.
Medicare is the federal health insurance program that provides coverage to people age 65 and older and to people of any age who have been getting Social Security Disability Insurance (SSDI) benefits for at least two years. It also provides coverage to people of any age who have amyotrophic lateral sclerosis (ALS) or end-stage renal disease.
There are some changes to Medicare Part D prescription drug coverage for 2025 that will help lower costs for many beneficiaries: People who have this coverage through traditional Medicare or Medicare Advantage plans won’t pay more than $2,000 a year on out-of-pocket costs for their Part D covered medications. This is the first time there has ever been an upper limit on those costs. (The cap will increase, however, in future years).
In addition, there are several ongoing programs, like the Extra Help/Part D Low-Income Subsidy program and the Medicare Savings programs, provide financial assistance with Medicare premiums, deductibles, coinsurance, or copayments. To qualify, your income and assets must be below certain limits and you must meet other requirements.
To find out if you’re eligible for Medicare, get help comparing Medicare coverage options, and learn if you qualify for programs that would reduce your costs, contact your state’s SHIP (State Health Insurance Assistance Program) or The Medicare Rights Center. You can also learn more by visiting Medicare.gov or calling 1-800-633-4227.
A variety of health insurance plans are available for purchase through the Health Insurance Marketplace at HealthCare.gov. Depending on the state you live in, you’ll be directed to the federally run Marketplace or your state-run Marketplace. Keep in mind that you can only enroll in Marketplace plans during an open enrollment period (typically November through January, with the insurance becoming effective in January if you sign up by December 15) unless you qualify for a special enrollment period or your household income is below 150% of the federal poverty level.
Many people with a low or moderate income who buy health insurance through the Health Insurance Marketplace qualify for financial assistance through the premium tax credit and cost-sharing reductions. Eligibility for assistance is based on income and household size. You can see if you qualify by using this tool or filling out an application for Marketplace coverage.
To learn more, call 1-800-318-2596 or search here for local assisters that can help you choose and apply for Marketplace coverage.
Other insurance options that may be available to you – but are not necessarily lower cost – are plans through your employer or union (or a spouse’s employer or union), COBRA continuation coverage through a former employer, military plans, or plans you buy directly from a health insurance company or through an insurance broker.
Read more tips for when you're looking for health insurance.
What are other ways to lower my treatment costs?
Ask a financial navigator at your hospital or cancer center about programs and resources that could decrease your expenses. In addition, you could:
Contact the financial assistance department at the hospital or cancer center where you’re receiving treatment to see if you can receive free or discounted medical services or set up an interest-free payment plan.
See if you can switch to getting your cancer care at a different hospital that provides free or lower-cost services to people who are low-income, uninsured, or face other social or economic hardships. These facilities are often referred to as safety-net, essential, or public hospitals.
Look into whether you can reduce the cost of your medications by applying for help from a pharmaceutical company’s patient assistance program or a non-profit organization’s prescription assistance program. Learn more about ways of lowering medicine costs.
Check whether there are charities that can assist with your medical and non-medical expenses during and after treatment.
Find out if you’re eligible for a clinical trial. Clinical trials typically cover the cost of whatever medication, test, procedure, or intervention the trial is studying.
Read more about managing financial burdens from breast cancer.
— Last updated on July 21, 2025 at 3:08 PM