Understanding the Costs Involved
Before diving into strategies, it’s important to understand the types of expenses breast cancer patients may face. Diagnostics and screening for procedures like mammograms, ultrasounds, biopsies, and MRIs can quickly add up. There are also costs associated with types of surgery, like lumpectomies, mastectomies, or reconstructive surgery. Beyond that, chemotherapy sessions, radiation therapy, and medications are often prolonged and costly. Medications can also add to the cost. From hormone therapies to pain management, medications may be required long-term. Physical therapy, lymphedema management, and regular check-ups contribute to ongoing expenses as well.
Each stage of treatment can bring new costs, so it’s essential to understand what’s covered by your insurance and what you may need to budget for out-of-pocket.
Leverage Health Insurance Coverage
Navigating your health insurance coverage is the first step to managing breast cancer treatment costs. Here are some tips to ensure you maximize your benefits:
Review Your Insurance Plan
Understand the specifics of your coverage. What percentage of treatments, medications, and hospital stays are covered? What are your deductibles, co-pays, and out-of-pocket maximums?
Out-of-Network vs. In-Network Providers
Using in-network providers will typically cost less. If your preferred oncologist or surgeon is out-of-network, negotiate for in-network rates or discuss alternative options.
Pre-authorization
Some treatments may require pre-authorization from your insurance company. Failing to secure approval ahead of time may result in denied claims, which means higher out-of-pocket costs.
Appeal Denied Claims
If your insurance company denies a claim, appeal it. Many patients successfully overturn claim denials, especially for necessary treatments.
Ask About Patient Assistance Programs
Some insurance companies offer patient assistance programs for those undergoing extensive treatments like chemotherapy or surgery.
Financial Assistance Programs and Resources
When insurance coverage isn’t enough, financial assistance programs can be a lifeline.
Many nonprofits offer grants or direct financial support to breast cancer patients. For instance, the Susan G. Komen Foundation, Breast Cancer Assistance Fund, and The Pink Fund provide various forms of financial help, including medical bills, transportation, and living expenses.
Medicaid and Medicare may offer coverage for certain individuals. If you don’t qualify for Medicaid based on income, some states have expanded coverage under the Breast and Cervical Cancer Prevention and Treatment Act, providing Medicaid benefits to women diagnosed with breast cancer.
Many pharmaceutical companies offer patient assistance programs for expensive cancer drugs. Contact the manufacturer of your prescribed medication to inquire about discounts or free medication programs.
Cancer Care’s Co-Payment Assistance Foundation is an organization that helps with co-pays for cancer patients, helping cover the cost of medications and treatments.
Budgeting and Financial Planning
Once you understand the costs, it’s important to create a realistic budget to help you stay financially on track. Maintain a detailed log of your medical bills, including the dates of service, descriptions, and amounts paid. Use a spreadsheet or app to stay organized.
If you’re facing a large medical bill that you can’t pay immediately, many hospitals and providers offer no-interest payment plans. Call your provider’s billing department to negotiate a reasonable monthly payment.
If you have a high-deductible health insurance plan, contribute to an HSA. Funds in these accounts are tax-free and can be used to pay for qualified medical expenses, which can help you save money over time.
Using credit cards with high interest rates to pay medical bills can worsen your financial situation. Seek lower-interest loan options or patient-specific credit cards, such as CareCredit, which offers special financing options for medical expenses.
Seek Professional Financial Advice
If managing the costs becomes overwhelming, consider consulting a financial planner who specializes in medical or cancer-related expenses.
A specialized financial advisor can help you create a comprehensive plan, considering your current expenses, insurance coverage, and potential future treatments.
Financial planners or medical billing advocates can negotiate on your behalf with hospitals and providers to reduce the total cost of treatments or services.
If your ability to work is compromised during treatment, a financial advisor can help you navigate the process of applying for disability benefits from your employer or government programs such as Social Security Disability Insurance (SSDI).
Maximize Workplace Benefits
Your employer may offer benefits that can assist with medical costs:
Short-Term and Long-Term Disability Insurance
These policies can replace a portion of your income if you’re unable to work during treatment or recovery. Check with your employer to understand your coverage.
FMLA (Family and Medical Leave Act)
Under FMLA, eligible employees can take unpaid, job-protected leave for serious medical conditions such as breast cancer. This can provide job security while you focus on treatment.
Flexible Spending Accounts (FSAs)
Like an HSA, FSAs allow you to set aside pre-tax dollars for medical expenses. Though less flexible than HSAs, they can still be helpful for budgeting.
Take Advantage of Tax Deductions
Medical expenses can be tax-deductible, especially if they exceed a certain percentage of your adjusted gross income (AGI). Keep careful records of all out-of-pocket medical costs, including doctor visits, hospital stays, treatments, medications, transportation, and lodging related to your care. When tax season arrives, consult a tax professional to ensure you’re maximizing your deductions.
Plan for the Future
Cancer treatment often comes with long-term health implications. After active treatment ends, you may still need follow-up care, ongoing medication, and screenings, all of which can be expensive. Therefore, it’s essential to think about how to manage future medical costs. Look into supplemental insurance policies that cover cancer-related expenses. These plans can help pay for costs that regular health insurance doesn’t cover, such as transportation or lost income.
Consider setting aside funds or purchasing long-term care insurance if your cancer increases the likelihood of needing assistance later in life.
Conclusion
Breast cancer treatment can be financially daunting, but by leveraging the right resources, planning, and seeking help, you can manage the costs more effectively. From maximizing insurance coverage to utilizing nonprofit organizations and fundraising, there are ways to ease the financial strain so you can focus on what matters most—your health and recovery.
Important Disclosures
The opinions voiced in this material are for general information only and are not intended to provide specific advice or recommendations for any individual. Investing includes risks, including fluctuating prices and loss of principal. No strategy ensures success or protects against loss.
This commentary reflects the personal opinions, viewpoints, and analyses of the Moneco Advisors employees providing such comments and should not be regarded as a description of advisory services by Moneco Advisors or performance returns of any Moneco Advisors client. The views reflected in the commentary are subject to change at any time without notice.
There is no guarantee that a diversified portfolio will enhance overall returns or outperform a non-diversified portfolio. Diversification does not protect against market risk.