By Kiara Ford
A breast cancer diagnosis is devastating for many reasons. The questions of how this will disrupt your life, what will treatment be like, and how will this affect your family are common and understandable responses. And for many, these emotional questions are followed by one major financial one: how will I be able to afford cancer costs?
Continue reading to learn more about insurance coverage for cancer, Medicaid and Medicare options, what medical expenses to expect, other treatments that may not be covered by insurance, and additional financial considerations for those with breast cancer.
What Insurance Covers Cancer Care?
In the United States, healthcare and cancer treatment are not guaranteed. Private health insurance will typically cover some, but not all cancer costs. In addition, depending on the private insurance someone has, their plan may only pay for them to see certain doctors or undergo certain treatments. Out-of-network doctors, specialists, and specific treatment options may not be covered.
People without private insurance often rely on Medicaid, a government program that provides coverage to low income people, older people, people with disabilities, and those with dependent children. Medicaid is funded on both a state and federal level, so the exact parameters of eligibility and coverage vary state by state. This is not to be mistaken with Medicare, which is a federal health insurance program for people 65 and older and some younger people with disabilities. Even with these options, it is unlikely for them to cover all cancer costs. Even for those who are fortunate enough to have primary costs covered by insurance, they will still have to pay for their own co-pays and coinsurance, deductibles, premiums, and other out-of-pocket expenses.
What Medical Expenses Can I Expect During and After Cancer Treatment?
The exact cost of direct medical expenses varies depending on treatment plans. Treatments such as surgery, chemotherapy, radiation, hormone therapy, and immunotherapy all come with their own individualized prices, and you will typically have to pay for some combination of these options. This partially explains why studies have shown the cost of cancer treatment to be lower the earlier it is diagnosed, as they may not require as many treatments. One study found that for stage I and II breast cancer the price range was $61,621-$97,066, whereas for stage IV the average cost was between $89,463-$182,655.
These numbers continue to grow with follow-up care. Cancer care does not necessarily end after active treatment is finished. You may be monitored throughout your lifetime in order to manage recurrence. This means there are added costs of check-ups with oncologists, mammograms (with the exception of those who have had a double mastectomy), medications to reduce risk of recurrence, and various other tests and exams.
What Other Treatments Should I Consider?
In addition to all of these necessary costs, there are many treatments which may not be considered essential for your active treatment, but can still greatly help you. Physical therapy and acupuncture can be beneficial for the discomfort caused by surgery, chemotherapy, and radiation, but are not always covered by insurance. There is also the mental challenge of experiencing cancer, which may be aided by the work of a therapist, psychiatrist, or counselor, but once again, are not always covered by insurance and often come with a hefty co-pay.
Other Financial Considerations
Medical costs are only one piece of the puzzle. There is also the toll cancer can take on your lifestyle, and the costs that come with it. Many people with cancer are unable to work while undergoing treatment. Some employers have health leave policies, and some people may qualify for social security disability income, but even with these assistance programs, many people will experience a loss of income. With the inability to work may also come the inability to perform essential daily tasks, including looking after children. Parents with breast cancer may have to navigate the added cost of childcare. Finally, there is the issue of transportation. During treatment, you will likely need to spend a great deal of time commuting back and forth to appointments. Whether you’re spending money on public transportation fares or gas, this travel comes at a price that can quickly add up and create more complications to an already difficult situation.
The Bottom Line
The cost of cancer can have life-altering impacts. Research has found that patients with cancer are 2.5 times more likely to declare bankruptcy than other adults with health care debt, and 30% of cancer survivors report experiencing financial hardship. A cancer diagnosis alone is already a massive amount of stress. The compounding factor of financial toxicity is quickly creating a crisis that is devastating patients, families, and communities.
On the Podcast: Breast Cancer Conversations
Breast Cancer and the Law: Resources for Patients and Caregivers
About the Author:
Kiara Ford is a recent graduate of Emerson College, where she majored in communication studies and minored in health and society. She is currently a community health worker trainee with the non-profit organization Asian Women for Health. She is passionate about patient advocacy and health equity, and hopes to raise awareness and increase understanding of patients’ rights through her work.
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