Financial Aid Programs for Breast Cancer Patients

Kathy Lee says the last 18 months have been life-changing. An aggressive stage II invasive duct cancer in her right breast led to a double mastectomy. Dealing with the physical and emotional trauma from breast cancer was second only to the financial burden.

“Cancer is a big business,” says the 55-year-old. “One shot following chemo is $4,500. If I hadn’t met the maximum on my insurance I would have had to pay 20% of that,” says Lee, who pays for her own private health insurance out of pocket. Her husband is retired and she is self-employed, but currently not running her travel agency due to her health. She did have to fork over $6,000 out of pocket for the deductible before the 100% coverage kicked in. With medication, co-pays for around 10 doctor visits a month, and costs associated with being on the road much of the time for treatment, her out-of-pocket expenses for medical costs are around $500-plus a month. “We’re tapping our savings,” she says.

Lee is thankful for organizations such as the Sisters Network Inc. When she had to have surgery in Houston, the organization’s Breast Cancer Assistance Program paid for her husband’s eight-day hotel accommodations so that he could be nearby. “That was a significant help to us,” says Lee, who is optimistic. “I am cancer-free. Now, it’s about the healing. I look out the window and see that if God is taking care of the birds, he will do the same for me. ”

Breast cancer can be devastating not only to your body and spirit, but also to your finances. “Last year, more than 60% of the breast cancer patients case managers served came to us with debt crisis, pharmaceutical or medical co-payment issues,” says Nancy Davenport-Ennis, CEO for Patient Advocate Foundation, a nonprofit that works to improve healthcare access.

Breast cancer treatment varies, but standard treatment for stage II breast cancer would include breast-conserving surgery, chemotherapy, Herceptin therapy, radiation therapy, and hormone therapy. From start to finish, these treatments would take place over 87 weeks at a price tag of about $111,000, according to the American Cancer Society Cancer Action Network.

In addition to direct medical costs, patients frequently experience increases in their regular expenses, for example, higher amounts of fuel for transportation to and from treatment, points out Erin Moaratty, chief of Mission Delivery at PAF.

“Just yesterday a woman was telling me her house was in foreclosure because of the medical expenses from her breast cancer,” says Lynn Erdman, an oncology clinical nurse specialist who is the vice president for community health at Susan G. Komen for the Cure. “Some of our callers to the Komen Helpline (1-800-IM-AWARE) have no insurance and are not eligible for Medicaid and others have high insurance deductibles of $5,000 to $10,000, making it very difficult for them to access care,” Erdman adds.

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Ask healthcare providers for assistance.
Discuss with your doctor what your ability to pay for the prescribed treatment is. Ask if you can qualify for a financial assistance plan or hardship. Inquire about a lump sum discount, and request and/or set up a payment plan based on your financial ability.

Consider charity care.
“Most hospitals, especially nonprofit hospitals, have money allocated to help patients with their outstanding bills. The hospital can reduce the patient bill by a percentage-based discount, or choose to cover the bill in its entirety, leaving the patient with a zero balance,” says Moaratty. “Contact the hospital’s billing department to learn about the hospital’s options.

A big piece of cost savings is understanding and reviewing your insurance plan.

Does your plan require pre-authorization of medication? Are there programs available to assist with out-of-pocket expenses associated with medications? Additionally, Moaratty says patients can look into a Pre-Existing Condition Insurance Plan if they’re uninsured.

Explore all options.
If you don’t qualify for comprehensive programs, explore ways to save on other expenses. “Look for programs that will help defray the out-of-pocket costs such as transportation costs to and from treatment or that offer reduced costs for prescriptions. Get covered where you can–any savings will at least give you a little more to put food on the table and pay living expenses,” says Erdman. Also, determine if you are eligible for federal, state, or local programs. One program worth checking out, says Erdman, is the Hill Burton program–about 200 healthcare facilities nationwide are obligated to provide free or reduced-cost care. To find one in your area go to www.hrsa.gov/gethealthcare/affordable/hillburton/.