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The Cost of Cancer Treatment and How to Pay For It

November  28,  2017 in

Millions of Americans are affected by cancer every year. According to the National Cancer Institute, there were over 14 million total cancer cases in 2014, and over 1.6 million new cases so far reported in 2017.

While those numbers continue to rise, so do the various costs of cancer treatment. Between cancer patients and their families, insurance companies, research organizations, and taxpayer-funded programs like Medicare and Medicaid, billions of dollars are spent every year on cancer-related healthcare. In 2014, the Agency for Healthcare Research and Quality (AHRQ) estimated that direct medical costs for cancer in the U.S. alone reached $87.8 billion.

Naturally a cancer diagnosis prompts a family to ask the question: What is the true cost of cancer treatment?

While the answer may vary depending on cancer type, insurance policy, and a variety of other factors at play, it’s important to get clear on the financial aspect of treatment and plan meticulously for what could be an expensive road ahead.

The Price of Treatment Without Insurance

Patients without any health insurance will typically be responsible for all treatment costs. After doctor and laboratory visits, radiation and chemotherapy treatment, surgery, and medication, the dollar amount can quickly spiral up to six figures in a single year  alone.

What to Do If You or a Loved One with Cancer Has No Health Insurance

First, note that you’re not alone. A 2017 Q1 Gallup-Healthways poll found that more than 1 in 10 Americans don’t have health insurance. Cancer treatment for uninsured patients may be harder to access, but it’s not impossible.

Work to Get Health Insurance ASAP

Insurance typically means less out-of-pocket expenses for you and your family, so you’ll want to be diligent and proactive in working to get your own health insurance as soon as possible. Use as many resources around you to obtain a workable plan that makes sense for your circumstances.

However, if obtaining health insurance is not currently an option, there are other measures you can take to get treatment.

Find Facilities that Treat Uninsured Patients

In every region there are local and state-run government hospitals and medical centers that treat anyone who needs care, whether or not they have health insurance. Do a quick search to find what public health services are offered in your area.

In 1946, Congress passed the Hospital Survey and Construction Act, or the Hill-Burton Act, which provided health facilities in the U.S. grants and loans for building construction. In exchange, these health facilities agreed to make their services readily available to anyone residing in the area, including those unable to afford such services.

See if any hospitals or medical centers in your area are operating under the Hill-Burton Act, and find out what steps or measures you’ll need to take to get treatment.

Contact a Healthcare Social Worker in your Area

A healthcare social worker’s job is to help people navigate the complex world of healthcare. They’re most likely to have the most knowledge about public services relevant to a person’s health issues. Ask them about various programs that assist cancer patients without health insurance.

Call the National Cancer Institute (NCI)

Utilize the NCI to help point you to supported clinical trials, authoritative information concerning your cancer and the latest research developments. For more information, go to www.cancer.gov or call (800)-422-6237.

The Price of Cancer Treatment with Health Insurance

The treatment cost outlook for insured patients may be brighter than for uninsured patients, but overall it can still be daunting. When understanding what the cost of treatment is with insurance, it’s important first to understand the fundamental health insurance terms:

Premium: the monthly amount to be paid by the insured person for an insurance policy.

Deductible: the annual amount the insured person must pay out-of-pocket before the insurance company starts to cover costs.

Copayment: a fixed amount the insured person pays (on top of the specified premium and deductible) for an outpatient visit or drug prescription.

Coinsurance: a form of health insurance where the insured person pays a fixed percentage of the total medical expense after the deductible has been reached.

In a nutshell, cancer treatment expenses for an insured patient is equal to the premium + deductible + copayments and/or coinsurance.

Consider some of the services you or your loved one will be paying for with health insurance:

  • Provider visits
  • Hospital and clinic visits
  • Medicine and prescription drugs
  • Lab tests (blood, urine, and more)
  • Imaging tests (X-rays, CT scans, MRIs)
  • Radiation treatments
  • Chemotherapy
  • Procedures/surgeries
  • Home care
  • Hospital/facility stays

The Costs Health Insurance Won’t Cover

While health insurance will typically cover a portion of each medical procedure, related costs—such as transportation to and from the hospital, hotel stays during treatment at a far-away facility, and childcare during treatment — are almost never reimbursed. Other costs that a family may encounter during a loved one’s fight with cancer include accessibility modifications to the home and hired assistance with cleaning, cooking, or yard work.

Surprise/Unexpected Medical Costs Along the Way

Cancer patients may also encounter surprise costs. For example, a doctor who performs a surgical procedure might be in-network, but the anesthesiologist may be out-of-network, resulting in extra out-of-pocket costs. Patients who undergo radiation will find that co-pays or co-insurances build quickly with each repeated visit to the clinic. And patients who undergo pharmacological therapy may find that intravenous drugs are covered under a plan’s medical benefit, while drugs taken as pills are covered under a plan’s pharmaceutical benefit.

As cancer treatment continues, patients may also need treatments such as supportive or palliative care, rehabilitative therapy, mental health services, nutrition counseling, or other types of care. These are expenses that health insurance policies may not cover, but could be a necessity – leaving no choice but to pay out-of-pocket.

Help from the FLAG Program

The bottom line is that paying for late-stage cancer treatment can be an overwhelming financial burden. That’s why Fifth Season Financial has created the Funds for Living and Giving (FLAG) Program  — a way to leverage a life insurance policy into funds that a family can use for the cost of cancer treatment today, while still leaving funds for beneficiaries to have in the future.

If you or a loved one need assistance paying for cancer treatment while maintaining a comfortable quality of life, contact Fifth Season today to learn more about the FLAG Program.

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Relieve financial stress with the FLAG Program, a viatical alternative that uses your life insurance for a cash advance

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