Managing the hidden costs of breast cancer

The financial impact of breast cancer doesn’t end with your medical bills. As you spend more time away from work and in doctor’s offices, paying for daily living expenses in addition to medical bills can be challenging. Many people find their monthly and daily living expenses – for food, mortgage, rent, and utilities – must compete with their healthcare costs.

Thinking about these hidden costs of breast cancer ahead of time will help you avoid some of the fear and frustration that financial instability can cause. Figuring out your monthly income, how much you spend, and what you spend it on, can help you decide if and where you can cut back. If you suspect you’ll come up short, you can take steps to get help.

Help is out there, though it may take some work to find it. Many businesses are willing to work with you on payment plans and nonprofits, churches, and even pharmaceutical companies may have financial assistance programs for people like you. Ask questions and do research.

Professionals who can help

• Your social worker can help you navigate your health insurance policy and recommend local organizations and resources available to you.
• Your health insurance case manager can tell you what information your doctors should submit to get your medicines and treatments covered.
• An accountant or financial advisor can show you how to manage your money most effectively.

Paying your bills on time

Paying your bills on time may be difficult, but creditors may be more helpful than you expect.

Ask creditors if you can work out a payment plan. For help negotiating with creditors or making a debt management plan, contact an accredited, nonprofit credit counseling service like the National Foundation for Credit Counseling.

Contact your mortgage lender to work out new payment arrangements like a second mortgage, a reverse mortgage, or a home equity loan. Make sure that you consult with a financial advisor, so that you fully understand these options before making any decisions.

Ask if you can get a disability waiver for some debts, such as your mortgage or car loan.

Always make a payment, even if it is small, to show your creditors that you’re trying to pay. “Good faith” payments can be the basis of working out a better agreement.

Call utility companies and let them know about your hardship. In some cases, they may lower your monthly fees or offer other assistance.

Find out if your health insurance covers any indirect costs of treatment, like at-home care, special foods, nutritional supplements, or special equipment and attire (like lymphedema sleeves and wigs).

Find out if you can use your home or life insurance to get cash to support your medical needs.

Avoiding eviction

If you are are behind on your rent, or think you might get behind, there are resources to help you prevent eviction.

Start with your social worker who will be familiar with local resources. The process of eviction and your rights will vary state by state as well.  Here are some tips that will help you no matter where you live:

• Talk to your landlord. Communication is important. Find out if they are willing to work with you, but don’t promise anything you can’t do. For example, don’t promise a payment you can’t make.
• Check your local 211 United Way Hotline. Dial 2-1-1 on your phone and they can recommend local resources for which you might qualify.
• Call your local housing counseling agency. They will be able to advise you on any rental assistance funds that may be available in your state. To find an agency near you, consult the directory managed by the US Department of Housing and Urban Development.
• Look into getting help with other bills to free up money for your rent.  Check your state’s Low Income Home Energy Assistance Program (LIHEAP) program for help with utilities, talk to local churches, and your local food bank. If you have a car payment, talk to your bank to see if skipping a payment is an option. Some banks will let you miss one payment per year and only pay the interest.
• Check for your local Legal Aid Society or Legal Services program. They can represent you for free if you have to go to court for your eviction.

Finally, the Consumer Financial Protection Bureau has a list of frequently asked questions to help guide you. You can filter by state to get more specific information on available resources.

Paying for prescriptions

Prescription medicines often make up a large portion of medical expenses. If you have limited income or a health plan that has a high deductible or very high co-pays, covering treatment such as chemotherapy pills and anti-nausea medicine can become even more challenging. Many resources can help you pay for prescription medicines.

• Ask your doctor about generic medicines or samples. Generic medicines are usually less expensive than brand name medicines. Samples allow you to try a medicine before you buy the full prescription. Once a prescription is purchased, it can’t be returned.
• Shop around. Some pharmacies charge less than others for the same prescription. Take the time to compare and find the best price. Consider mail-ordering several months of a prescription if the co-pay is lower.
• Ask about over-the-counter medicines. Talk with your doctor about OTC medicines that will have the same effect as your prescription, and find out if they cost less.
• Go to a local pharmacy. If your insurance allows you to use local pharmacies, you may save on co-pays.
• Fill half your prescription at a time. If you don’t have insurance or your health plan doesn’t cover prescriptions, filling only half your prescription at a time may help you save on the up-front, out-of-pocket cost.
• Use medicines on your insurer’s preferred drug list. Some health plans have a preferred drug list for prescription medicines. You may have to pay full price for a medicine that is not covered. Check to be sure your prescription is on the list. If it’s not, ask your doctor if you can switch to medicines that are covered.
• Contact your insurance case manager or the Patient Advocate Foundation. Both are sources that will help you figure out what information your doctor needs to submit to the insurance company to get your medicines covered.
• Find out if you qualify for a Patient Assistance Program. PAPs provide discounted or free medicines to those who qualify. Some can also help you file an appeal with your insurance company to cover certain medicines. PAPs are available through state governments, charitable groups, and some pharmaceutical companies. Your social worker, nurse, or doctor should be able to find out if you qualify.

Support from nonmedical sources

Local organizations and community groups often have grants that can help people with breast cancer deal with transportation issues by offering services or helping to pay for transportation costs. Others may be able to assist with meals, lodging, and special equipment like wigs and breast prostheses. We offers such assistance through our Living Beyond Breast Cancer Fund. Other organizations that offer such programs include:

• United Way
• American Cancer Society
• CancerCare

Local nonprofit, civic, or church groups may sponsor families who are facing long-term illnesses or other traumatic events by providing food and helping with daily expenses.

Family and friends feel empowered when they are able to help; having their help can decrease your anxiety and worry. Asking for help financially should not be a source of shame or discomfort. If you are not comfortable asking yourself, have a trusted point-person let others know that gift cards for food, gas, or groceries would be helpful as you go through treatment.

Financial planning services

Ask a social worker or nurse at your hospital or cancer center to refer you to a nonprofit, government agency, or other group that may be able to help you.

Get advice from an accountant, financial advisor, or other professional. Accountants can help you save money on income taxes by deducting medical expenses. A financial advisor can help you protect your assets from creditors by setting up a trust. They can teach you how to take control of your assets and plan for the future.

Look for free or low-cost financial planning talks sponsored by organizations such as AARP or by investment management companies.