We’re grateful for guest blogger Kelly Alvord from the Patient Advocate Foundation. In this blog she’s helped explain struggles patients may face with the cost of cancer care and suggestions on how to organize, lower costs and get help with the financial burdens that come with a cancer diagnosis. PAF is a national leader and established resource that helps seriously ill patients get help when it comes to figuring out insurance and healthcare access. We’re grateful for our partnership and the excellent resources from PAF. We also appreciate the leadership of Dr. Alan Balch, CEO of PAF who also sits on the Fight Colorectal Cancer board of directors. If you’ve recently been diagnosed with colorectal cancer, your first concern is your health. Your second concern? Your wallet. Receiving a cancer diagnosis is never easy and certainly never inexpensive. However, there are steps you can take and resources you can access to minimize some of the financial challenges.

Step 1. Get Organized

After you’ve been diagnosed with colorectal cancer, one of your top priorities will be to get organized. Store any paperwork, including things like resources or receipts, in one location so you can easily access them in the future. Resist naming your folders too generally because you will likely accumulate information quickly and it might be hard to sort through paperwork later. Instead of naming the folder “insurance,” try naming it “explanation of benefits” or “invoices.” It also helps to arrange your paperwork by date within those folders, and keep a separate log for your phone interactions surrounding your healthcare. Lastly, creating an accurate household budget for yourself with your income sources and expenses will also help you maintain financial security and illuminate areas of financial vulnerability. In this same organized place you’ll want to keep phone numbers, online resources and important point of contacts for easy reference.

Step 2. Get Insurance

It’s always important to have health insurance, but it becomes invaluable if you’ve been diagnosed with colorectal cancer.

For the Uninsured

If you are currently uninsured, seeking out and enrolling in health insurance will be critical to accessing care and lowering costs. Check out the health insurance marketplace in your state and review your options for a special enrollment period or the next open enrollment period. Insurance does not become effective on the day you enroll, so the sooner you start the process the sooner your insurance benefits will begin. If you recently were enrolled in a group or employer-based insurance plan, inquire about whether COBRA is an option for you, as this allows you to extend previous coverage without connection to an employer. During the period that you are uninsured, if you need to access care, inquire about charity care programs through your medical providers for reduced cost options. You CAN get insurance even if you’ve been diagnosed There is good news! If you have symptoms or have been diagnosed while uninsured or selecting new insurance, the passing of the Affordable Care Act prohibits insurance companies from turning you away because of a pre-existing condition.  It does not matter what your current health is -- you are eligible to enroll in comprehensive health insurance during an open enrollment period. Additionally, if you are nervous about affording insurance, there are protections in place such as tax credit premium subsidies and lowered cost-sharing levels that will help offset the costs for those with incomes less than 400% of the poverty limit. Connect with your state’s insurance marketplace to check your eligibility for financial support towards insurance and find out the dates for the next open enrollment period.

For the Insured

As an insured member of a health insurance plan, becoming familiar with your plan language, out-of-pocket responsibility and coverage details will help you make better financial decisions about your health. If you are unsure of your coverage options or if you are not sure whether your doctors are in your covered network, contact your insurer directly to inquire. Before you begin treatment or if your treatment plan changes, ask the billing office or your insurance company if the service or treatment is covered under your plan and what copayments or co-insurance amounts are due. Your doctor is likely not familiar with your exact coverage, so they sometimes unknowingly refer you to someone outside of your network or prescribe treatment requiring prior authorization. Maintain the lines of communication with your insurance company to avoid unexpected high costs; ultimately, maintaining an accurate understanding of your financial costs is your responsibility. Prescription Coverage Although the Affordable Care Act requires all plans to have prescription coverage, the higher cost medications are usually found on the specialty tier listing in your plan. If you have been prescribed a treatment that is on the specialty tier, ask your doctor if there is an alternate drug that might work better for your budget that will still be effective in treating your condition. If there is not another option for you, refer to your budget sheet to see how you may be able to factor in this cost and seek out medication assistance programs in the community or prescription assistance programs through the drug manufacturer. For covered medications, understanding your plan’s defined maximum out-of-pocket amount for pharmacy benefits can help you understand what you will be responsible for in a given plan year.

Step 3. Offset Your Medical Costs

There are many ways to be proactive and offset your medical costs. Ask your doctor’s billing office if you are eligible for any coupons or samples for your medications. For medical bills, ask if your provider’s billing department will work with you to set up a payment plan to address your balance. Additionally, the cancer team often has a social worker or financial counselor who may connect you with local and national resources that may serve as alternate funding. You might not know it, but insurance companies also have case managers who can be a bridge between your cancer team and the insurance company, and are offered to you as part of your plan benefits. If you explore any of these options, try to work with one point of contact to maintain consistency. And don’t forget to lean on your friends and family for help, assistance or advice.

Step 4. Nonprofit Assistance

Nonprofits and community organizations can offer a wide range of support and financial services that can help reduce the strain of your illness and provide critical assistance.

Mobile App for Uninsured and Underinsured

A great place to start is the National Uninsured and Underinsured Resource Directory mobile phone search tool called My Resource Search available for free on Apple and Android phones. This tool provides matches to assistance programs that help patients in your situation.

Patient Advocate Foundation

And lastly the Patient Advocate Foundation is dedicated to helping patients with chronic and life-threatening diagnoses overcome healthcare access barriers. Patients and caregivers can call 1 (800) 532-5274 to initiate a case specific to the challenging situation you are experiencing. A colorectal cancer diagnosis can be intimidating and expensive but by staying organized, self-advocating and keeping a line of communication open, you’ll feel more in control of your health, well-being and finances.

About Patient Advocate Foundation (PAF)

Established in 1996, PAF serves uninsured and insured patients all across the country at no charge to help overcome and resolve insurance-related and financial obstacles that impact care.   Patient Advocate Foundation has numerous patient-focused programs that aid seriously ill patients to navigate healthcare access issues during their medical journey, including free personalized case management, co-payment assistance for medications and the option to apply for specific financial grants through the financial aid fund division. In addition, PAF offers education and guidance to all consumers nationwide through its 30+ publications and expert materials.   For more information about Patient Advocate Foundation and their mission to improve health access to all patients, visit patientadvocate.org or call 1 (800) 532-5274.

JOIN FIGHT COLORECTAL CANCER

If you’ve been impacted by colorectal cancer, we need you! Join us and use your experience, your story and your voice to create real change. Get started by signing up. Next, see all the ways you can do something about this disease and take steps to get connected with our community. Come fight with us.  

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