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Coping With Cost

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A breast cancer diagnosis can be devastating enough. But after wondering how the cancer will be treated, many patients find themselves asking a second, just as distressing question: How will I pay for it?

It’s especially true for younger women, many of whom are unused to navigating the world of healthcare.

According to a recent study, the costs of breast cancer treatment for younger women can be much higher than similar treatments for older patients. That’s because breast cancer in younger women is often diagnosed at a much more advanced stage.

Women aged 21 to 44 pay on average $97,486 more in the first year of treatment after a breast cancer diagnosis compared to women the same age without cancer. In comparison, women aged 45 to 64 with breast cancer pay $75,737 more in the first year.

Treatment can include multiple lab tests, clinic visits, radiation treatments, surgery, drugs and radiation treatment. In addition to these costs, patients in treatment often need to take long absences from work, which could result in the loss of a job and with it the loss of insurance.

There also can be other costs, such as transportation or hotel if patients have to travel for treatment

“I think one of the first things is to take a deep breath and begin to gather information,” says Susan Brown, senior director of education and patient support at the Susan G. Komen Foundation. Brown knows patients can sometimes be unsure about what to do next. She encourages people to take time to speak at length with their doctor to understand the nature of the cancer and how to treat it.

This should include getting a copy of their pathology report and seeking out a second opinion.

“Their doctor should talk to them about the stage of their breast cancer, and the test that will be required to gather the information to make those treatment recommendations,” she says. Patients can educate themselves on different treatment methods so they know what to expect.

It’s also important for patients to discuss specific treatment options with their treatment team. Find out from your doctor how much each treatment will cost, how much time off from work will be required and which costs health insurance will cover.

“Realize that it’s OK to ask for help,” Brown says. “There are resources for financial information and assistance.” 

“People of all socio-economic statuses will have some sort of financial impact from the cost of treatment, Brown says. “There’s no stigma with asking for more information.”

Often a doctor’s office can provide that guidance. Some practices have a dedicated financial counselor on staff or a social worker who can also answer questions. These staff members also can gather information about the patient’s insurance and give some information about what the out of pocket cost might be.

Brown suggests patients ask to be put on a payment plan to spread out their out-of-pocket costs. The Komen foundation also maintains a phone helpline at 1-877-465-6636 for live answers to questions. The American Cancer Society website also maintains an extensive set of pages on paying for cancer treatment (https://www.cancer.org/treatment).

Patients also can educate themselves on the terms of their health insurance plan. They can start by getting a copy of their health insurance policy from human resources.

“The written policy itself is really important,” Brown says. “It’s a legal document, and that patient should really read that policy so that they understand what the insurance company is obligated to covered.”

People should ask their HR department questions, and they also can go directly to their insurance company.

Insurers want to hear from patients. “Healthcare providers have a sensitivity to this issue that they haven’t had in the past,” Brown says. Insurers know patients in financial difficulty won’t be able to follow their treatment, which can lead to bad outcomes. To help with this, many insurers have “navigators” within the walls of the company to help patients understand the process and what happens next.

When talking with an insurance company, take time to learn about your individual policy and follow the procedures the insurance company requires. “If there’s a sequence where things should occur, follow that sequence,” Brown says.

She also advises asking lots of questions, especially whenever anything is unclear. (See the sidebar for some suggested questions.) Keep a written record of whom you talked to and when, and keep that log in a designated place along with letters, claim forms and other insurance documents.

Above all else, she says, ask questions, don’t be embarrassed and find all the resources available.