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Lowering Costs: Start With Your Care Team

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If you're concerned about paying for your care, talk to your care team. Hospitals and cancer centers often have patient financial counselors, social workers, and patient navigators on staff who are experienced at helping patients manage their cancer costs. There are many patients who are “functionally insured” — meaning they have health insurance — but then have major difficulty affording the out-of-pocket costs associated with serious illness. If you find yourself in this situation, you’re not alone. There may be ways 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, rather than paying the full amount due at the end of each visit. Private medical practices often can’t offer this, but many hospitals do.
  • Ask if your hospital or treatment center has funding to offset medical costs that aren't covered by 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 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 the 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 copays, or schedule treatments or tests all at the same time to help you reduce your costs. For example, if the end of the calendar year is approaching and you need an expensive test, get it before the new year begins and you again have to meet the deductible on your health insurance plan. Also, some plans might pay more for treatments and tests given inside the hospital versus 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. However, if you have to travel to access the trial, this may not be all that helpful.
  • Ask your doctor about generic medicines. Generic medicines are usually less expensive than brand name medications. 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 generics for medications 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 any medicines you're prescribed. Keep in mind that samples might not be available for all medicines. But if you try the sample and have side effects that are difficult to manage, you won't have to pay the cost of a full prescription if you switch.

Expert Quote

“The financial piece can seem overwhelming at first. It’s kind of like a messy room — who wants to dive in and clean a messy room? But if somebody starts cleaning for you, you’re like, ‘OK, I can finish.’ Sometimes it’s just getting someone to help and remove some of those barriers up front.” — Annette Hargadon, MSN, RNC-OB, CBCN, Nurse Navigator/Breast Care Coordinator, Riddle Hospital/Main Line Health, Media, PA

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