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Sick with Debt

Sick with Debt
July 8, 2019 coraandkrist

Scott Petinga Featured In

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Sick with Debt

After costly treatments and surgeries that aid in treating cancer, there is often one worry plaguing the mind of the average survivor—how to pay for it all.

Asia Carter survived breast cancer, but her troubles are far from over—she recently filed bankruptcy.

When Carter was first diagnosed with stage III breast cancer in 2016, she was working as a contractor and didn’t have health insurance. It wasn’t until 2017 that she got insurance, and it was expensive: $653 a month. Out-of-pocket expenses added up quickly with MRIs, EKGs, a double mastectomy, surgery to remove lymph nodes, and two reconstructive surgeries. “I spent at least $10,000,” says Carter, a single mother from Frisco, Texas.

“It’s been an uphill battle that I’m still climbing,” she says. Unfortunately, stories like Carter’s are all too common.

“Few people are aware of the financial toll the disease can take. It’s a one-two punch,” says Scott Petinga, a cancer survivor and founder of the Center for Advocacy for Cancer of the Testes International. “Having to go through treatment will cause a loss of work and inertly a loss of income—and at the same time, medical and pharmaceutical costs, not covered by insurance, are due.”

When high deductibles, co-pays, and a loss of income collide, the financial dominoes fall, leaving tens of thousands of Americans resorting to medical bankruptcy.

A study conducted by researchers at the Fred Hutchinson Cancer Research Center found the financial toxicity resulting from the high cost of cancer care is almost as deadly as cancer itself. According to the National Cancer Institute, anywhere from one-third to over three-quarters of cancer survivors exhaust their savings to finance medical expenses, which can cost tens of thousands per month.

“Cancer costs the U.S. economy more than $216 billion annually in direct treatment costs and lost productivity, a number that will increase dramatically as incidence rates climb,” says Susan Brown, the senior director of education and patient support, at Susan G. Komen.

When high deductibles, co-pays, and a loss of income collide, the financial dominoes fall, leaving tens of thousands of Americans resorting to medical bankruptcy. “A Harvard study estimated that 62.1 percent of all bankruptcies were because of medical bills, and this was before the Affordable Care Act was in full force,” says Molly MacDonald, a breast cancer survivor and founder and executive director of The Pink Fund, a breast cancer charity and nonprofit, financial assistance fund that provides cost-of-living expenses to breast cancer patients.

She adds that it’s important to note that most medical bankruptcies result from hospitalizations in addition to outpatient treatment and costly prescription drugs. “A patient may have a very high deductible with their health insurance, which may require them to start a GoFundMe or similar program, deplete their savings, ask relatives for financial help, sell an asset, dip into retirement savings, and max out credit cards […] and that is just to begin treatment,” says MacDonald.

Mitigating Cancer’s Toxicity

So how do you come back financially after cancer? Find a financial advisor. Start by asking friends and family for recommendations of people they’ve worked with, or turn to the National Association of Personal Financial Advisors which provides a directory of advisors in your area. A financial advisor can help you reconstruct your financial life, be it negotiating with creditors, finding ways to generate extra income, or managing debt. The best strategy is to be proactive sooner rather than later.

Understand your Coverage

Some cancer patients face even higher out-of-pocket costs if they obtain medical care outside of their plan. “Be sure your providers participate in your insurance plan, so that you are not subject to balance billing. Ask if chemotherapy or surgical procedures can be performed at freestanding facilities rather than hospital-based facilities,” recommends Dr. Jeffrey Levin-Scherz from the Harvard T.H. Chan School of Public Health. Many types of chemotherapy can be administered in ambulatory facilities—and this can lead to both lower costs and better patient experience. There are only a few chemotherapy regimens that need a high level of monitoring which require hospital care.

Ask for Help

Don’t be afraid to speak up. There are many financial resources available for people with breast cancer. Hospital discharge planners, patient-service offices, nurse navigators, and patient navigators may also have information on resources and advice about financial matters. Most hospitals and treatment centers have financial counselors. They can help you understand the details of your insurance paperwork and give an estimate of the cost of treatment.

Financial counselors can also help work out a payment plan. Some places may be willing to reduce or waive some costs. And candidly express your concerns about costs to your doctor. “You and your health care professional can probably develop a cheaper plan that still adequately addresses your condition,” says Petinga.

Cancer may be a formidable opponent, but what might take you by surprise is the impact it can have on money matters.

Tap All Resources

Seek out pharmaceutical company coupons and patient-assistance programs if you are eligible. Look to nonprofits—the Susan G. Komen Treatment Assistance Program helps bridge the gap for underserved individuals by providing limited financial assistance, education, and support services to low-income, underinsured, or uninsured women and men across the country undergoing treatment for breast cancer.

No matter a person’s income, they may qualify for financial aid from federal, state, or local programs. Many organizations such as the New Day Foundation for Families, the Cancer Financial Assistance Coalition, and The Pink Fund offer financial assistance and help with travel, lodging, and medical items, including prescription drugs.

Many employers offer services to help their employees navigate clinical care—and also navigate the bills that follow complex cancer therapy. Talk to your human resources department. And although it may not be pleasant, talk to your creditors. Some mortgage companies, for example, are now expanding their payment-deferment programs to include those facing costly health challenges.

Protect Yourself

Build a medical emergency fund to better weather future health costs. While it’s hard to estimate what your medical bills might be, you can estimate how much you would need on a monthly basis if you were unable to work. Aim to have at least three to six months worth of expenses saved and easily accessible.

Explore Insurance Options

John Hill, president of Gateway Retirement, works with people to develop a financial plan that includes preparation for the unexpected. He’s big on guaranteed universal life insurance, because it can be tapped for critical and chronic illnesses. Similarly, there’s Fifth Season Financial’s FLAG (Funds for Living and Giving). FLAG is designed to bridge the gap between traditional financial assistance programs, mitigating the direct medical and treatment costs and the much broader financial needs of patients with advance-stage illnesses. The individual can access a significant portion of the face value of their life insurance policy (as opposed to the cash-surrender value) at a time when they need funds the most. Fifth Season pays the premium on the policy. Throughout the process, the policy is kept in place, and ultimately the advance is repaid using the proceeds of the policy. Remaining funds are given to the family. There are zero stipulations, conditions, or financial obligations to Fifth Season. The individual can choose to spend the funds in whatever way best suits their context and lifestyle, like paying rent or mortgage or medication and treatment costs.

Cancer may be a formidable opponent, but what might take you by surprise is the impact it can have on money matters. Keep your guard up to protect your financial future. When you win your battle with cancer, the last thing you need is a fight to fix your finances.