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Coping With the Cost of Breast Cancer

The last thing you want to think about when you are fighting breast cancer is unpaid medical bills or rising credit card balances. Find out how to work with your health insurance carrier and what costs to prepare for.

By Madeline R. Vann, MPH

Medically Reviewed by Lindsey Marcellin, MD, MPH

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A breast cancer diagnosis is hard enough without considering the direct and indirect costs associated with breast cancer treatment. Beating your cancer is your first priority, but financial worries are often not far behind.

Breast cancer’s economic burden for the United States exceeds 9 billion a year in lost productivity and medical costs. Unfortunately, for some, the cost of breast cancer treatment may even mean going into bankruptcy.

“Breast cancer patients (who have employer-sponsored health insurance) spend ,553 out of pocket. This figure is high because annual claims expenses are roughly ,000 for breast cancer,” says Jon Gabel, senior fellow in the health care research department at the National Opinion Research Center office in Bethesda, Md. “Medicare patients would pay more out of pocket than private pay patients. Group insurance on average for all persons covers about 80 percent of the cost. Medicare covers about 65 percent of the cost without Medicare Part D prescription drugs.”

The exact cost of your breast cancer treatment could vary widely from that figure, perhaps topping 0,000 or more in a worst-case scenario. The details of your health coverage, the type of breast cancer you have, the stage at which it is found, and whether it is recurrent or has metastasized all affect your financial bottom line. One positive for many women is that federal law requires health insurance to cover reconstructive surgery for both breasts. However, a recent survey by the American Cancer Society (ACS) reveals that costs are forcing women to make unpleasant choices.

“We found that many cancer patients are cutting prescriptions, not going to their doctor, or not getting preventive services just because of the huge cost,” says Mona Shah, MPH, a senior policy analyst with the American Cancer Society Cancer Action Network. “It’s pretty atrocious that some families are dealing with cancerandbankruptcy.”

The survey also revealed that among cancer patients:

  • Two out of five people with cancer have difficulty paying health care costs.
  • One out of four people with cancer has used up all their personal savings.
  • One in four has been contacted by a collection agency.
  • One in three adults with cancer has had problems with their health insurance plan, such as not being able to see a recommended specialist.
  • One in three adults under age 65 has had problems affording the medications they need. Another 23 percent report cutting pills in half or skipping doses.
  • Close to one in 10 (8 percent) have declared bankruptcy.

Coping With the Cost of Breast Cancer Treatment

Because breast cancer treatment coverage and costs differs with each health plan and each patient’s cancer, you must be proactive with your planning. Here are the steps you should take:

  • Get the facts.The survey conducted by the ACS found that about half of cancer patients do not know the details of their health insurance plan, such as whether there is a limit on what the plan will pay out each year. Contact your insurance provider and ask the following questions:
    • What breast cancer treatments and medications are covered by my insurance? What portion of the treatment my doctor recommends is covered?
    • What are my co-pays and deductibles going to be?
    • Do I need a referral for specialists and certain treatments or tests?
    • Are additional therapies, such as cosmetic surgery or fitting for prosthetic breasts, covered under my plan?
    • Are there limits on how much I will have to pay out-of-pocket or how much the insurance company will pay out each year?
  • Work with your team.It can be embarrassing to bring up the issue of cost, but everyone involved in breast cancer treatment is sensitive to the financial burdens people are facing. Work with your doctors or a hospital social worker to find a plan that will maximize your care and minimize your cost.
  • Research other options.For example, certain low-income women may qualify for care through the National Breast and Cervical Cancer Early Detection Program, administered in all 50 states through the . Ask your medical team and local ACS office if there are other programs in your area that might help with cost.
  • Contact a financial planner.An expert in financial planning may be able to point you toward strategies you aren’t aware of. For example, breast cancer treatment costs may qualify for an early (and penalty-free) withdrawal from your retirement plan or life insurance policy, or you may be able to deduct costs from your taxes. Keep good records of every expense related to your treatment, no matter how small. A financial planner may also be able to help you find ways to cover your costs at a lower interest rate than using credit cards.

Shah points out that the health reform package recently signed by President Obama may change the landscape of breast cancer treatment costs for the better. For example:

  • Health insurance plans can no longer refuse coverage because of pre-existing conditions, such as previous breast cancer.
  • Health insurance plans can no longer refuse to cover you after you have reached a pre-determined lifetime dollar limit for treatment.
  • Preventive screenings are to be universally covered, which means cancer can be found earlier when it is easier to treat.

Coping With Indirect Costs

When you start on your breast cancer treatment journey, there may be a number of indirect costs that could surprise you and should be taken into account:

  • Time off from work.Many people can work while going through breast cancer treatment, taking only a few days or weeks off here and there. Others may feel too sick to work and need more sick leave than they have already saved up, or more than their employer allows. This can mean reduced income for many households. Check with your employer to find out if you can work a reduced schedule or work from home. Also find out whether you qualify for the Family Medical Leave Act; it protects your job for up to three months of leave, which may be unpaid. You may also need to apply for disability benefits if your leave is prolonged.
  • Cost of housekeeping or child care.When you’re focused on beating your cancer, you may need help caring for your children, older relatives, or your home. The American Cancer Society has local branches that often provide assistance or can point you toward agencies that can help.
  • Travel costs.Parking, gas, and overnight stays can add up. Check with your clinic or hospital to find out about parking validation, gas cards, free shuttles, and reduced-cost overnight stays for your companion. Your local ACS chapter may also be able to tell you about local resources.
  • Cosmetic costs.Scarves, wigs, and the cost of cosmetics or skin lotions to keep you looking your best during this difficult time may or may not be covered by your insurance. Check with local and national non-profits for help with these costs.

Video: How much does it cost to treat breast cancer ? |Health Issues & Answers

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Date: 17.12.2018, 22:05 / Views: 82592