Things to Know About the Cost of Your Cancer Treatment

Cancer care and treatment can cost a lot. It can be hard to plan for it when you’re not sure what to expect . You may wonder what your insurance will pay for and what you will be expected to pay out of pocket. 

Here are some tips on finding out what costs you might expect and ideas on how to plan for, ask about, and discuss treatment costs with your health care team.

Medical expenses of cancer treatment

Try to learn as much as you can about your cancer treatment before it starts. Remember that each person's experience and treatment is different. Asking questions will help you learn what you might expect.  It can also help you plan for and deal with the costs related to your care.

 Medical expenses for people with cancer can include: :

• Visits with your cancer care team
• Lab tests
• Procedures (for diagnosis or treatment, which can include room charges, equipment, different doctors, and more)
• Imaging tests (like x-rays, CT scans, and MRIs, which may mean separate bills for radiologist fees, equipment, and any medicines used for the test)
• Radiation treatments (external radiation, internal radiation, or both)
• Medicine costs (medicines that treat your cancer or manage side effects of your treatment)
• Clinic visits for treatment
• Hospital stays (which can include many types of costs such as medicines, tests, and procedures as well as nursing care, doctor visits, and consults with specialists)
• Rehabilitation, such as physical therapy
• Surgery (surgeon, anesthesiologist, pathologist, operating room fees, equipment, medicines, and more)
• Home care (can include equipment, medicines, visits from specially trained nurses, home care aides, and more)
• Specialist referrals (other specialty doctors, physical therapy, and others)
• Transportation costs (might include the cost of travel to receive treatment by car, airplane, train, cab, or bus. In some hospitals or clinics, you may have to pay for parking).
• Some people with cancer might need a place to stay if they live far from where treatment is given. The American Cancer Society might be able to help if you need lodging closer to treatment.

What to ask about the costs of your cancer treatment

Talk with your health care team. They’ll usually know who can help you find answers to your questions, including questions about the costs of your treatment. You might also want to ask if there is someone in the office, clinic or hospital who can help answer your questions about costs and insurance.

 

 

Here are some questions you can ask about costs

• How long will I need to be treated? Will what I owe out-of-pocket start over again next year?
• How much do you think the total cost of the suggested treatment will be? Are there any treatment options that might cost less? Are the other options likely to work as well?     
• For each of my treatment options,  how much will I have to pay myself?
• Does my health insurance company need to pre-approve or pre-certify any part of the treatment before I start?
• Is there any way I can get help paying for my treatment if I need it? Who can I talk to about financial assistance or help setting up a payment plan?
• If I am taking oral chemotherapy (by mouth), how much can I expect for prescriptions to cost? Are there any patient assistance programs that can help me pay for the cost of my prescriptions?
• What other medicines might I need along with my cancer treatment? Will I need other prescriptions to help manage side effects? How do I find out how much those prescriptions will cost me?
• How likely am I to have to stay in the hospital for any of my treatment or side effects? Will my insurance company need to pre-approve or pre-certify any services that I get during my hospital stay? How much might my stay cost? Will I need services such as physical therapy or home health care after I leave the hospital?

What to ask about health insurance coverage of your treatment

Out-of-pocket costs are those you have to pay, such as your deductible, co-payments and co-insurance. Most insurance plans have a max that you will pay for the year.  This is called a “max out of pocket”.  Your max out-of-pocket may be high which can make it hard for you to pay for other things you need. You’ll want to be sure that your health insurance plan pays a large part of your medical expenses. This means you’ll need to:

• Know the terms of your insurance plan
• Find out if your plan has preferred or network doctors, hospitals, or clinics
• Keep careful records of your health care costs

If any of your treatments might be done by out-of-network doctors or providers, find out about those costs from your insurance company. Even when you know the terms of your policy, getting payments can mean re-submitting claims, appealing denials, and much more.

 

Need more information?

Patient Access Network Foundation (PANF)
Toll-free number: 1-866-316-7263
Website:   www.panfoundation.org

Helps under-insured patients with certain cancer diagnoses cover out-of-pocket costs related to cancer care.

Patient Advocate Foundation (PAF)
Toll-free number: 1- 800-532-5274
Website:   www.patientadvocate.org

Works with the patient and their insurer to resolve insurance problems; also provides direct financial support to insured patients who are financially and medically qualified for prescriptions or treatments by helping with out-of-pocket costs.

In addition, organizations that provide support for people with specific kinds of cancer may be able to help. 

*Inclusion on this list does not imply endorsement by the American Cancer Society.