How to Get Help Paying for Cancer Treatment

When Barack Obama ran for president in 2008, his campaign aired a TV commercial that started like this…

My mother died of cancer at 53. In those last painful months, she was more worried about paying her medical bills than getting well. I hear stories like hers everyday. For 20 years, Washington has talked about health care reform and reformed nothing. I’ve got a plan to cut costs and cover everyone.

Obama succeeded in passing his healthcare reform, and as we wrote about a few weeks ago, some big changes have already happened. Many of them will benefit Americans who get cancer, from banning limits on coverage to offering free preventive cancer screenings. Sadly, though, they may not be enough, since the high cost of co-pays and out-of-pocket expenses can really add up.

A new poll of cancer doctors by medical information supplier M3 USA offers this sobering fact: “67 percent of responding doctors reported patients rationing medications or forgoing treatment due to financial and insurance coverage concerns.”

The poll quotes Wisconsin-based oncologist Dr. Shahid Shekhani, who says his patients are canceling appointments and even treatment to save money. “I just had a young grandmother, in her 60s, halt lung cancer treatment that would have extended her survival in order to preserve her family’s finances and her ability to leave an inheritance to her children,” he says.

One big reason is obvious, says M3 USA’s CEO Aki Tomaru: “the continuing grinding effect of the worldwide economic downturn.”

If you or a loved one has been recently diagnosed with cancer, you should obviously start with your insurance provider, but there may be help from places other than your insurance company…

Medicaid

Most people know Medicaid offers healthcare for the poor. And many know the level of that care isn’t exactly what you’d call “state of the art.” But depending on where you live – Medicaid is funded by both federal and state governments – you might be able to qualify for some pretty sophisticated treatment.

“If your state covers ‘off-label’ use of cancer drugs and/or clinical trials, you are covered as a Medicaid cancer patient,” claims Caring4Cancer, a clearinghouse of cancer-related information Off-label treatment means using drugs for purposes other than they were designed for. It’s common, legal, and sometimes very effective.

Caring4Cancer even makes this claim, which isn’t as hard to believe these days as it might’ve been in years past: “Generally, the Medicaid program is less problematic in terms of coverage than many other insurance plans.”

Go to the Medicaid website to find out what your state has to offer, and if your income level qualifies you for this assistance.

Social Security

Most cancers, no matter how draining and debilitating the treatment, don’t qualify you for disability benefits under Social Security. You might think it would, but this is the major rule, according to Social Security’s own website: “You have a medical condition that has prevented you from working or is expected to prevent you from working for at least 12 months.”

Even many of the most severe cancer treatments don’t keep you from working for an entire year. But under specific circumstances, you’re eligible. The Disability Expert sums it up best…

For most types of cancer to be eligible for Social Security disability benefits, the cancer either has to be unresectable (that means it cannot be removed by surgery) or it has to recur after surgery (that means it comes back after surgery) or it has to have distant metastasis (that means it spreads to another site in the body).

Check with Social Security for more details.

Private groups

Many nonprofits offer help with everything from prescription drugs (Partnership for Prescription Assistance) to co-pays (The Patient Advocate Foundation’s Co-Pay Relief Program). The American Cancer Society even has a Road to Recovery program that offers free rides to treatment. Each have their own specific qualifications, so check them out carefully.

For further financial assistance, it turns out that you need to apply based on the cancer you have. Strange but true. So, for instance, the website CancerCare lists a grant application “to help with transportation costs such as gasoline, parking and tolls, and taxi, bus or train fare to and from their medical care” – but only if you have multiple myeloma.

How can you find out what assistance is available for which cancer? The American Association for Cancer Research offers an extensive list. Finally, the problem of paying for cancer treatment has grown so pervasive that 14 cancer-fighting organizations joined forces to launch the Cancer Financial Assistance Coalition. Check it out.