Tag: Health Insurance

Breast Cancer: Surviving the High Cost of Treatment

(Title image: Photo by Alexander Mils on Unsplash)

Since we are now in the Pink Season, otherwise known as Breast Cancer Awareness Month, in the midst of encouraging mammograms and regular clinical exams, it’s also useful to consider a very important barrier to obtaining cancer treatment and services in the United States: cost.

This is particularly distressing because breast cancer research has been very well-funded and treatments are quite effective for most forms of the disease, with great strides also having been made in understanding some of the most aggressive variants.

But according to a 2021 memo from the the American Cancer Society’s Cancer Action Network, 61% of (all) cancer patients describe paying for their treatment to be “somewhat or very difficult”.

It is striking that financial difficulty affects the majority of cancer patients. Obviously, the lower the family income, the greater the hardship, with 80% of patients having to “make financial sacrifices to cover their health care expenses, including 44% who’ve dipped into their savings, 36% who’ve gone into credit card debt to pay medical bills and nearly a quarter who say they did not schedule or cancelled an appointment or procedure because of cost.”

None of this will come as a surprise to you if you’ve ever had to pay for healthcare in the United States. Suffice it to say, we have a problem with affordability here.

Aside from the stressors of the disease and treatment side effects, many people have the added anxiety of not being able to afford the cost of cancer care.
(Photo by Woliul Hasan on Unsplash)

I was one of the very lucky ones in this regard, as my husband and I both work for non-profit research institutes with generous benefits. At the time of my diagnosis, we were enrolled in an employer sponsored PPO (Preferred Provider Organization) insurance plan with a per-person, out-of-pocket yearly maximum of $2000. When we initially signed up for the coverage, I thought the increased cost of the PPO was unnecessary as we were all quite healthy. However, after my diagnosis, I was struck by how blessed we were to even have this degree of health coverage as an option.

Clearly, my family is in the minority in our good fortune. We were able to avoid the financial fears and burdensome debt, even bankruptcy, that affect so many other cancer patients. Cancer care is devastatingly expensive, particularly for those with little to no insurance coverage, or insurance coverage with extremely high deductables.

What options do you have if you find yourself delaying care due to finances?

*Start with your cancer center’s social workers. They have experience in helping patients and survivors who are dealing with financial hardship and can point you in the right direction.
* Visit the Cancer Financial Assistance Coalition (CFAC) website, which has a database that you can search according to your cancer type and financial needs to find a list of charitable organizations that can offer support for your situation.
*For medicines that are not covered by insurance, pharmaceutical companies may offer deep discounts on their drugs. Reach out to them directly. They would rather sell you a heavily discounted medication than not make a sale at all.

Even when it seems that your luck has run out, there are still options available to ease your financial burden. Unfortunately, the healthcare system might not change anytime soon, but please know that supportive charities can to lend a hand as you make your way through the cancer maze.

Invisible Effects: Cancer Ain’t Cheap

In the midst of trying to avoid dying from cancer, and being fortunate enough to have health insurance, I wasn’t thinking about the cost of treatment. I couldn’t get past the thought of having cancer, the incoming test results and what my treatment options were.

But even with excellent insurance, there were a lot of expenses. Every doctor’s visit dinged us, as did every infusion. Surgeries (biopsy, lumpectomy, port placement) came with co-pays, some in the hundreds. A trip to the emergency room for an infected fingernail (thank you, chemo) was a few hundred.

Did I need this treatment? Yes! Do I regret spending this money? No! I received excellent care from my oncology team in addition to some amazing freebies that were offered by the cancer center, not the least of which was truly exceptional counseling. As someone with degrees in psychology, I feel that therapeutic psychological support during cancer treatment is an absolute necessity, and I was blessed to have an amazing Clinical Counselor. Additionally, the Nurse Navigator assigned to me had also been a breast cancer patient and was able to offer insight and support that I wouldn’t have been able to get from just anyone.

But once I got through the initial shock of my diagnosis, I had to start asking, “Is this covered by my insurance?” While some treatment was non-negotiable (surgery, chemo, radiation) there were things that I didn’t get (lymphedema compression sleeve) because a costs–benefits analysis suggested I could get by without them, and other things (genetic testing, 3-D mammogram) that I sprang for because they were well worth the peace of mind.

The financial impact of cancer may be one of the “downsides” of survivorship.

What saved us as a family was that there was an out-of-pocket maximum that limited how much financial damage we incurred. I consider myself unbelievably lucky because of that, particularly with two kids only a handful of years away from applying to college. Our savings did take a hit as the expenses piled up, but it was much, much smaller than it could have been.

I dodged that pricey bullet, but there are so many others who do not. The financial impact of cancer is not discussed enough. When I started researching the actual cost of all my treatment — not the fairytale insured version that I was so fortunate to pay — I was absolutely dumbfounded. The price tag topped $100k for my chemo alone! Going through treatment without insurance would have devastated us. Survivors go bankrupt over this.

Medical bills aside, there are costs to be incurred simply from lost work due to treatment and survivors may find themselves unable to work once treatment is over. Chemo brain has caused a great deal of stress for me as I face transitioning from part-time to full-time employment (a necessity due to the ridiculously high cost of living here). I am slowly learning to adjust to my lapses in concentration so that chemo brain does not pose a liability to the quality of my work. Mindfulness and meditation play a huge role in addressing these issues, as does moving towards a career that makes more use of my strengths and experiences, rather than simply looking for advancement in my current position.

I didn’t anticipate any of this when I found out I had cancer. I was so anxious about the diagnosis that the quality of my insurance didn’t even register. We thought we were ready to do “whatever it takes”. I mean, can you put a price on a life? And yet, can you plunge your family into debt with a clear conscience? These are painfully difficult questions with no good answers. It is unbelievably fortuitous that my husband had switched us to a more expensive insurance several years earlier, and heartbreaking to know that many others never had that option.