Who can help me with cancer costs?

Four kinds of people, and most cancer centers have at least two of them on staff. A financial navigator. A hospital social worker. A financial counselor in the billing office. And an insurance case manager assigned to you.

You do not have to choose one. They do different jobs, and the fastest route is usually to ask your nurse who is available where you are treated.

Who does what

A financial navigator teaches you which insurance plans and cost-saving methods you qualify for. The National Cancer Institute lists this meeting among the approaches being studied to reduce financial toxicity. That term means money problems caused by the cost of care.

A hospital social worker knows the programs that exist beyond insurance. They can point you to groups that help pay for treatment. This is also the person to ask about travel costs, since some groups provide rides or help with fares.

A financial counselor in the hospital billing office can set up a payment plan or a reduced rate. They can also link you to patient assistance. Ask before a bill goes unpaid, not after.

An insurance case manager is one you have to request. Call your plan and ask to be assigned one, so you speak to the same person each time instead of restarting the story with a stranger.

When you need a hired hand

Patient advocates and medical billing advocates work on bills and insurance for a fee. NCI notes that even with the fee, they may save you money over time.

That is worth considering if your bills are large, come from several hospitals, or have already been denied once. It is probably not worth it for a single disputed copay.

Programs, by name

• The Cancer Financial Assistance Coalition runs a database of organizations that give financial help to people with cancer.
• CancerCare offers some direct financial assistance and a searchable database called A Helping Hand.
• The State Health Insurance Assistance Program, or SHIP, gives free counseling and referrals for your state. It serves people on Medicare and their caregivers.
• Medicare questions go to 1-800-MEDICARE or Medicare.gov, including drug coverage and the claims and appeals process.
• NCI's Cancer Information Service, at 1-800-4-CANCER, can name organizations that may help with treatment or travel costs.

For drug costs, start by asking about generics. Then look at the Medicine Assistance Tool and RxAssist. Rx Outreach is a nonprofit mail-order pharmacy, reachable at 1-888-796-1234. GoodRx compares prices and gives coupons at over 70,000 pharmacies. Its price can beat your own insurance copay.

If you have no insurance at all

Ask hospitals and clinics about charity care and sliding-scale programs, where the fee is set by your income. Some hospitals are required to see uninsured patients. Your local department of public health or social services can tell you which ones. So can the business office of the hospital you want to use.

Why asking early is not just a platitude

Money pressure changes medical behavior in ways that hurt. NCI reports that some patients skip doses to stretch a prescription. Others take less than prescribed. Some never fill it at all. The higher the copay, the less likely people are to take the medicine as directed.

The damage reaches further. People with financial toxicity report more pain and more symptoms. They report worse physical and mental health. They worry more about the cancer coming back. In one study, some patients rated the money strain as worse than the physical, emotional, social, or family strain.

Some cancer survivors report spending more than 20% of their annual income on medical care. That is not a personal failing. It is a known feature of cancer treatment in the United States, and it is exactly what these four people exist to blunt.

Sources

https://www.cancer.gov/about-cancer/managing-care/track-care-costs/financial-toxicity-pdq

https://www.cancer.gov/about-cancer/managing-care/track-care-costs