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Where Do I Begin?

Many individuals and families facing cancer have shared that financial worries are a significant source of stress, and they don’t know where to turn. You are not alone. Talking about money can be difficult. But, having open conversations about money and the cost of cancer care can help you become better informed about your options for help.

There are options available and we hope this information will help you deal with the significant financial matters related to cancer and the potential life changes that cancer can bring.

How Do I Get Health Insurance

If you do not have health insurance, below are some options that might be available to you.

State Health Insurance Marketplaces:

Can be found at www.HealthCare.gov. Marketplaces provide one location for people to learn about private and some public health insurance plans available to them, where they live. Individuals who choose plans in the Marketplace may be eligible for financial assistance.

Medicare:

A federal health insurance program, which provides coverage to individuals who are entitled to Social Security retirement benefits and are 65 years of age or older, individuals who are under the age of 65, but have been receiving Social Security Disability Insurance (SSDI) for no less than 24 months, individuals entitled to Railroad Retirement benefits or Railroad Retirement disability benefits, individuals with end-stage renal disease (ESRD) and individuals with Amyotrophic Lateral Sclerosis (ALS). For more information visit www.medicare.gov. You may be eligible to receive both Medicare and Medicaid benefits if you are over 65 or disabled and have very limited income. Medicaid might cover what Medicare does not.

Medicaid:

A federal health insurance program with eligibility criteria and benefits that vary from state to state. Thirty-one states provide coverage for low income adults, while in other states individuals have to meet other requirements, such as having a disability, having a dependent child or being over age 65. For more information visit www.medicaid.gov. You may be eligible to receive both Medicare and Medicaid benefits if you are over 65 or disabled and have very limited income. Medicaid might cover what Medicare does not.

COBRA:

If you have health insurance coverage through your employer or a spouse’s employer, COBRA may allow you to maintain that coverage if you experience a qualifying event, such as leaving your job. For more information visit www.dol.gov/ebsa/COBRA.html.

Veterans:

You may be eligible to receive health care through the Veterans Administration. For more information visit www.va.gov/health.

Health Insurance Resources

Communicating With Your Insurance Company

If you have health insurance, it’s important to learn about the specifics of your policy, including:

  • What’s covered
  • Deductibles (what you must pay out-of-pocket before your insurance company will begin to cover claims)
  • Co-payments or co-pays (a dollar amount set by your insurance provider required to be paid by a patient each time care or a drug is received)
  • Other out-of-pocket costs
  • How to best use your insurance benefits

A good place to start is with your health insurance card. Your insurance card will have numbers you can call to learn more about your policy.

Many health insurance companies offer insurance case managers to assist insured individuals diagnosed with cancer. These trained individuals (often registered nurses or licensed social workers) will follow your case closely, helping to coordinate care and insurance benefits. Contact your insurance company to ask if they will assign you a case manager.

Learning more about what your policy does and does not cover will help you better work with your insurer to make sure you receive all the benefits and coverage to which you are entitled. You will also be better prepared to deal with any questions or disputes you may encounter.

Appealing Insurance Denials

How Can I Manage Costs?

Understanding what costs to expect is an important first step in gaining a sense of control.

It is difficult to form a plan for managing costs until you understand what to expect.

Potential expenses that you may want to ask your health care team about are:

  • Physician/Provider
  • Treatment-Related
  • Prescriptions
  • Clinical Trials
  • Home Health Care and Home Hospice Care
  • Rehabilitation Care
  • Private Duty, Long Term and Custodial Care
  • Psychotherapy & Counseling
  • Family and Living
  • Transportation
  • Legal

Help with Drug Costs

Community Resources

Your city, county or state government may have helpful resources. To find out more about programs such as Section 8 Housing, Supplemental Nutrition Assistance Program (SNAP) and Senior Housing, contact your local department of Social Services. Faith-based organizations and some hospitals may also provide help. The website www.survivorshipatoz.org is a great source for additional information.

You may also call CSC’s toll free Cancer Support Helpline® (1-888-793-9355). Our call counselors are available Monday-Friday from 9am-9pm ET to answers your questions and link you to valuable information.

Other Possible Resources

Employment and Cancer

For some, treatment requires frequent or lengthy hospital visits or stays. Your health care team may be able to offer advice on the likelihood of your treatment affecting your ability to work, so it is important to talk with them about what you do in your job, as well as your priorities. A cancer diagnosis does not mean that there will be a need to work less or leave your job, although some people do. There is not one “right” answer.

Some things to consider might be:

  • Do I enjoy my work and/or find it a welcome distraction?
  • Can I complete my work functions while on treatment?
  • How would taking time away from work affect my income? If I take time away from work, will the Family and Medical Leave Act apply?
  • How much sick leave do I have?
  • Do I live in a state with state-sponsored short term disability insurance?
  • Will I qualify for long term Social Security Disability Insurance (SSDI)? If so, do I have savings to carry me through the 5 month waiting period?
  • Do I have a disability insurance benefit through my employer? If so, how much will it pay? Do I have private disability insurance? If so, how much will it pay?
  • If I decide to stop work temporarily or permanently, how will this affect me and others?
  • If I decide to stop work, what will I need to do to keep my health insurance?

Talking With Your Employer