Living with Cancer? Get Help with Financial & Legal Issues
Immediately upon a cancer diagnosis, the medical questions and decisions start. Where should you go for treatment? Which treatment options should you pursue? How will your diagnosis and treatment affect your quality of life now and in the future?
Along with the medical questions and decisions come financial, legal, and practical concerns. How will living with cancer affect your family’s income? Can you keep your job? Work part time? Will your insurance cover your bills? What happens if it doesn’t?
Joanna Fawzy Doran
“Financial hardship is very real for families living with cancer,” said Joanna Fawzy Doran, Esq., CEO, Triage Cancer®. “Lengthy and costly treatments, caregiving expenses, loss of family income, transportation costs and more combine to create a financial situation that can be toxic to the patient’s health and to their economic future. The decisions made along the way can make a big difference.”
Triage Cancer exists to ensure those diagnosed with cancer and their caregivers have access to the resources needed to make the best decisions for them. The non-profit advocates for the health care, financial, insurance, employment, and consumer rights of those diagnosed with cancer and their caregivers and provides free education on cancer-related legal and practical issues through events, materials, and resources.
Financial Hardship Throughout the Cancer Journey
As the cost of cancer care and its impact on family finances grow, more providers are screening patients for financial hardship at the point of diagnosis. Doran suggested that while screening at diagnosis is an important first step, the initial screening should be followed by additional screenings throughout treatment – and beyond.
“Screening at diagnosis helps identify those who come into their cancer journey with pre-existing financial hardship that will likely increase as they move through the continuum of treatment if not mitigated,” she said. “For many people, however, it’s not until they start treatment, begin receiving medical bills, need to cut back on work hours, or stop working entirely that their true financial picture emerges.”
If a patient does not have many prior insurance claims at the point of diagnosis, for example, they will face significant out-of-pocket expenses for early treatment costs until their deductible has been met. As treatments go on, they may incur additional expenses until they meet their out-of-pocket maximum. Even after remission, cancer patients encounter out-of-pocket costs for diagnostic screenings, medications, and other follow-ups.
“Insurance plans renew annually,” Doran explained. “That means the deductible and out-of-pocket clocks reset each year, often to the tune of thousands of dollars. The ongoing expenses and piled up medical bills can be devastating for patients whose cancer metastasizes or requires years of treatment. It can be very difficult to ever dig out.”
According to Doran, loss of family income is the second biggest contributor to financial hardship. Whether the patient cuts back on work hours or leaves the workforce, or the patient’s caregiver is forced to, reduced income makes it difficult to not only pay for medical expenses, but also expenses of daily living like rent, mortgage payments, car payments, and groceries.
“Eligibility restrictions make many ineligible for unpaid family and medical leave,” she said. “For those who do qualify, they often don’t take the benefit because they can’t afford to.”
Navigating Finances
Triage Cancer offers a range of materials and resources to teach people living with cancer and their families how to avoid the financial burden of a cancer diagnosis, manage medical bills and debt, pay for prescriptions, find financial help, and more. For the newly diagnosed, Doran suggested starting with Triage Cancer’s Cancer Rights Guides, including their Practical Guide to Cancer Rights, which is designed to help families navigate and understand:
- Their rights at work
- Disability insurance
- Health insurance basics
- Health insurance options
- Accessing medical records
- Insurance appeals
- Managing medical bills
- Planning ahead
“While many of our resources are designed to help people through a moment of immediate financial crisis, our bigger goal is to address the underlying causes of hardship,” Doran said. “If we don’t address why the family needs assistance, they will likely be in the same situation next month, and the month after that.”
Through online resources and one-on-one help, Triage Cancer helps those living with cancer understand their insurance plans and how to use insurance effectively to minimize out-of-pocket costs. They help people evaluate insurance options, calculate deductibles and out-of-pocket costs, and plan for enrollment windows to ensure they have the best opportunity to avoid insurance-related financial hardship.
One-on-one help is available through Triage Cancer’s Legal & Financial Navigation Program. This service connects patients, caregivers, advocates, community health workers, and health care professionals with Triage Cancer staff attorneys who provide free guidance about health insurance, disability insurance, employment information, finances, other types of insurance, and estate planning.
“If someone has a question about disability insurance for example, we’ll review their options together,” Doran said. “Or, if they need to take time off work or leave the workforce entirely, we’ll help them figure out how to maintain health insurance coverage. It’s all about helping them weigh their options and understand next steps.”
Doran noted that the program takes a holistic approach to assistance by going beyond the initial and immediate questions. Participants can revisit the service as their situation changes. Additional practical tips to navigate systems can be found in Triage Cancer’s free educational webinar series, which provides foundational information on a range of topics that contribute to financial hardship and gives people the opportunity to get questions answered by experts.
“There are many trigger points throughout a cancer journey that increase the likelihood of financial hardship,” Doran concluded. “With access to care contracting and social safety nets eroding, it’s more critical than ever for those living with cancer to have a place they can learn about their rights, weigh their options, and get access to the support they need when diagnosed with a serious medical condition like cancer.”
Editor’s Note: Are you or someone you care for living with cancer and having a hard time paying for medications or insurance premiums? The HealthWell Foundation offers assistance through several oncology funds. Visit https://www.healthwellfoundation.org/disease-funds/ for more information and eligibility criteria.
