Managing Cancer Costs in Tough Economic Times
Article date: February 27, 2009
Even in the best of times, paying for cancer care is difficult. In an economic recession, the financial burden of a cancer diagnosis and treatment can be crippling.
What happens if your family is dependent on your paycheck and you can't work because of your cancer treatment? Or what if you've been out of the office getting treatment, only to come back and find your job doesn't exist anymore? What if you've lost your job – how will you pay for your healthcare?
There are many possible sources of help for families who need extra financial support in tough times.
If you reduce your working hours, quit your job, or lose your job, you have the right to choose to temporarily keep your group health insurance benefits through the Consolidated Omnibus Budget Reconciliation Act, or COBRA, which became law in 1986. However, under that law, you have to pay the full cost of the insurance premiums yourself. Premiums often cost more than $1000 a month, which can be a problem if you don't have a job.
Special help with COBRA premiums: As of March of 2009, you may get extra help if you lost your job involuntarily between September 1, 2008 and December 31, 2009. You may qualify for short-term help paying for COBRA through the American Recovery and Reinvestment Act of 2009 (ARRA).
If you lose your job any time after ARRA goes into effect (March 2009), your employer should let you know that you can choose COBRA and that you may qualify for help paying for it.
If you have already lost your job (anytime after September 1, 2008) and you declined COBRA at that time, you should get a second chance in March 2009. Your former employer must notify you that you are eligible and that you may be able to keep your insurance while paying only 35% of your COBRA premiums for a limited time. The federal government pays your employer the other 65%. If you meet the requirements for this help, you can start COBRA coverage while paying only 35% of the premium for up to 9 months.
If you meet the requirements for the federal help but you have been paying the full COBRA amount since your job loss, you should be able to get 65% of your money back. Your employer may credit that amount toward future COBRA payments, or refund it to you outright. Talk to your employer for details.
Limits on help with COBRA premiums: Those who resigned or quit their jobs, even for medical reasons, do not qualify. You don't qualify for this aid if you will make $125,000 or more in the tax year that you want help, nor can you get it if your jointly-filed taxable amount will be $250,000 or more in that year. (The income limits used are the modified adjusted gross income.) Also, the help can last for up to 9 months, or less if you can get new health insurance coverage. You must notify your employer if you become eligible for new employer-sponsored health coverage or Medicare.
If you get to the point that you cannot work, find out if your employer has a long-term disability insurance policy before you leave the job. This type of policy typically replaces 60% to 70% of your income. Evaluate your policy by finding out the definition of "disabled," the monthly benefit amount, the benefit period, the waiting period, and its taxability status. Some companies also have a short-term disability option that covers you during part or all of the waiting period of the long-term disability policy.
Social Security Disability Income (SSDI)
If you have been working for many years, you probably have contributed to Social Security, and you may qualify for disability benefits.
Under the standard application process for Social Security Disability Insurance, it typically takes several months for someone to begin receiving benefits. A recent initiative called the Compassionate Allowances program aims to help people with certain types of cancer and other diseases get their federal disability claims processed faster. The program covers 50 conditions, including 25 cancers, that are so serious that they obviously meet the standards required for the Social Security Administration to make a finding that the person is disabled. The program is still very new, however, so there's no data yet on how well it works, and it doesn't help people with certain types of cancer.
Your income has nothing to do with whether or not you qualify for SSDI. To find out how to apply, contact the Social Security Administration. Also keep in mind that after receiving SSDI for 24 months you become eligible for Medicare benefits.
Supplemental Security Income (SSI) benefits
If you have not worked much or if your income was very low before you became unable to work, you may be eligible for Supplemental Security Income (SSI). The benefit provides cash for basic needs, like food, clothing, and shelter. To qualify for SSI, your income and assets must fall below a certain level; you must be disabled, over 65, and/or blind. The amount you could get from SSI varies from state to state. To find out if you're eligible for SSI or another Social Security benefit, use the Benefit Screening Tool.
Temporary Assistance for Needy Families (TANF)
TANF replaced the former Aid to Families With Dependent Children (AFDC) program, administered by the Office of Family Assistance under the U.S. Department of Health and Human Services. It gives states help in providing job opportunities to the people in their welfare programs. For information about programs in your state, visit the Office of Family Assistance Web site.
State Health Insurance Risk Pools
State health insurance risk pools are designed to help people who can afford to buy health insurance, but are denied health insurance overage by private companies because of a pre-existing medical condition. Contact your state department of insurance to find out if such programs are available in your state, or if there is another way to get coverage. You can find your state's insurance department in the blue pages of your local phone book, or visit the National Association of Insurance Commissioners Web site.
Many treatment centers have short-term housing centers or discount programs with nearby motels and hotels. Ask your clinic's social worker or oncology nurse for suggestions.
The American Cancer Society's Hope Lodge program offers cancer patients and a family member a free, temporary place to stay while getting the cancer care they can't get at home. Currently, there are 28 Hope Lodge locations in the United States. In 2007, more than 30,000 patients, caregivers, and family members stayed at an American Cancer Society Hope Lodge, saving nearly $19 million in hotel expenses. To find a Hope Lodge or learn more about a specific facility, call the us toll free anytime, day or night, at 1-800-ACS-2345.
The extra expenses of treatment or major loss of family income may make it hard for you to meet your mortgage or rent payments on time. To keep a good credit rating, it is important to talk with your creditors or landlords about your situation and try to make special arrangements.
If you are forced to move out of your home, talk with your county department of social services to find out if you qualify for government-supported housing programs.
The American Cancer Society's program, Road to Recovery, connects volunteer drivers with patients and families who need rides to hospitals and clinics for cancer treatment. To learn more about the program, visit the program's web site or call us toll free anytime, day or night, at 1-800-ACS-2345.
Community and church groups may be sources of help with travel or its costs, too. Also, talk to your social worker about getting help with hospital or clinic parking fees.
There are several government programs that can help with food costs.
School-based programs, such as:
- the National School Lunch Program
- the School Breakfast Program
- the Special Milk Program
- Team Nutrition
Other programs, including:
- The Supplemental Nutrition Assistance Program (formerly the Food Stamp Program)
- Women, Infants and Children (WIC), which includes the Farmers' Market Nutrition Program
- the Summer Food Service Program
- Child and Adult Food Care Program
- Food Distribution, such as the Commodity Supplemental Food Program
These programs are run by the U.S. Department of Agriculture. You can learn more about them on the USDA Web site.
You may also get assistance from special funds in your medical center or community.
Reviewed by: Members of the ACS Medical Content Staff
ACS News Center stories are provided as a source of cancer-related news and are not intended to be used as press releases.
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