- After Diagnosis: A Guidefor Patients and Families
- What is cancer?
- Who gets cancer?
- Did I cause my cancer?
- Can cancer be inherited?
- Why me?
- Am I going to die?
- How do I cope?
- How do I talk to people about my diagnosis?
- Making treatment decisions
- How is treatment planned?
- What should I ask my doctor?
- Will I have pain?
- Will I be able to work during treatment?
- Will I be able to exercise during treatment?
- How will cancer affect my sex life?
- How will I pay for all this?
- What other resources do I have?
- To learn more
How will I pay for all this?
How much will it cost?
The cost of treatment depends on the type of treatment, how long it lasts, how often it’s given, and whether you are treated at home, in a clinic, in the doctor’s office, or in the hospital. Most health plans, including Medicare Part B, cover at least part of the cost of many treatments. In many states, Medicaid may help pay for certain treatments. Before you start treatment, find out whether your insurance company or Medicare will pay for your care. Also, find out what part of the cost, if any, you will have to pay.
If you are in a low income bracket or are not working, check to see if you can get state or local benefits, such as Medicaid. If you are employed and are thinking about leaving your job, find out about conversion options through your current insurance plan. Conversion options may allow you to switch from your employer’s insurance plan to an individual plan with similar coverage. Many group plans allow for conversion to individual plans, but the cost may be much higher. You usually must apply for individual plans like this within 30 to 60 days of leaving your job.
Most managed care plans should pay for you to be in a clinical trial if your doctor recommends it and if the clinical trial is approved by a trustworthy agency. These plans also often have case managers or other people with whom your doctor can speak about the need for drugs not usually covered. Health maintenance organizations (HMOs) often pay for preventive care and routine doctor visits, but access to state-of-the-art cancer care can sometimes be hard to get through these organizations.
Learning about your health insurance will help you be ready for the cost of treatment and for talking with all the people who handle your health insurance plan. Patients who understand their insurance and know how to communicate with the insurance company are more likely to get the coverage they need. You may have to go outside the plan for the cancer care that is best for you. Knowing what your health insurance will cover ahead of time can give you some peace of mind as you make treatment decisions.
There are actions people who have a dispute with their health plan can take. Always keep records of your care and all interactions with health insurance staff and your health care team. Your doctor can usually help you. In cases of denied care, your doctor may have to give more information about your case to the health plan.
If you do not have health insurance, there are several options to look into when trying to get coverage. For instance, an independent insurance broker may be able to help you find a benefits package you can afford. You might also be able to apply for group insurance through professional organizations (such as those for retired persons, teachers, social workers, or real estate agents). Talk to a social worker or call the American Cancer Society at 1-800-227-2345 to find out more about insurance options.
Last Medical Review: 03/08/2012
Last Revised: 01/25/2013