Navigating finances

With a diagnosis of metastatic breast cancer, there are enough changes to navigate without the stress of financial uncertainty. If managing your diagnosis has affected your ability to work steady hours and have a regular income, paying for daily living expenses in addition to medical bills can be a new challenge. Many people find that their monthly and daily living expenses — for food, mortgage, rent, and utilities — compete with their healthcare costs.

On this page, you can read about potential costs and ways you can manage them, including

• types of expenses you may encounter
• how employment status changes can impact finances
• how legal assistance can protect you and your financial security
• financial resources and how accountants can help

Controlling costs not covered by health insurance

You probably already know that there are things health insurance plans don’t always cover, or that they may cover only a part of certain costs.

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. Here are some potential ways to make sure your costs are as low as they can be:

• Call your insurance provider to make sure that you are getting medical care and prescriptions from providers within your insurance company’s network. Staying in-network can keep costs down.
• If you don’t have health insurance or you are not happy with your coverage, visit Triage Cancer’s health insurance guide. The guide offers information about insurance plans, including how to decide what type of plan is the best fit for your coverage needs. You can also find contact information for the health insurance marketplace and other resources in your state.
• Many healthcare providers, as well as other creditors, are willing to work with you if you are having trouble paying bills. Working out a payment plan is a good way to meet your financial obligation while on a budget. If you are having trouble paying your bills, it can be helpful to communicate with your creditors to see what your options might be. Typically, creditors don’t sue for unpaid bills, but they can send your bills to a collections agency, and that can have a negative impact on your credit.
• Visit NeedyMeds.org to find out if you qualify for any prescription assistance programs.

Changes in your employment status and impact on your finances

After a metastatic breast cancer diagnosis, one of your first instincts may be wanting to make sure your job and income are secure. Or maybe you were looking for work at the time of diagnosis. Whatever your employment situation is, knowing your rights and protections can help you plan.

• Protections when disclosing your diagnosis at work: If you decide to share information about your medical condition at work, the Americans with Disabilities Act or a state fair employment law may protect you from workplace discrimination if you are eligible. This means that covered employers cannot treat you differently or make work-related decisions (hiring, firing, benefits, promotions, or bonuses) based on your medical condition.
  • As an example, if you work for a company that lays off the entire IT department, but also lays you off, and you work in the communications department, that could be seen as discriminatory. But if the company lays off the entire IT department and your communications department, that is not likely to be seen as discriminatory.
  • Generally, however, if your employer is going through layoffs, then you are not entitled to special protections that prevent you from being laid off because you have cancer. But your state, your employer, or your union contract (if you have one) might have specific rules on this topic.
  • Since this can be a nuanced issue, visit Triage Cancer’s Quick Guide on Disclosure for more information.
• Protections when disclosing your diagnosis in a job interview: Some people feel very strongly about disclosing their medical condition in an interview. And while the law is protective, if an interviewer does act in a discriminatory way by not hiring you because of your medical condition, it is very difficult for you to know that was why they didn’t hire you.
• Protections when taking time off work: If you are taking time off from work and are receiving disability benefits, your job is not generally protected. But if your employer has a policy that says they will hold your job for you for 6 months while on leave, then your job may be protected from layoffs during that time period. The details depend on the employer’s policy. Another example would be while you are taking leave as part of the Family Medical Leave Act. If you are taking FMLA leave your job is protected, but if your company decides to lay off your whole department, you may still be laid off under the FMLA. Learn more about FMLA protections and limitations.
• Protections for health insurance: COBRA is a federal law that allows eligible beneficiaries to keep their existing employer-sponsored health insurance coverage after experiencing a qualifying event. COBRA only applies to private employers with 20 or more employees or state or federal governments. If you work for a smaller employer, you may qualify for coverage under a state COBRA plan. Learn more about state laws on health insurance, employment, and more at Triage Cancer.

To learn more about your rights at work, visit Work life balance with metastatic breast cancer.

Legal help to protect you and your finances

Metastatic breast cancer isn't only a medical issue. It can also come with a variety of legal issues. Understanding laws related to treatments, insurance, employment, and other issues can help you get the best care while protecting your family, your finances, and your career.

• How to find a lawyer who specializes in cancer-related issues: The Cancer Legal Resource Center
  • provides information and resources on cancer-related legal issues
  • provides referrals to local legal aid organizations and lawyer referral services
  • connects patients with attorneys in their area who have agreed to give free consultations to clients referred by the CLRC
• What you can do if you think your doctor handled your care inappropriately: If your doctor did not follow the appropriate standard of care for your situation or made a mistake, he or she might have committed negligence or malpractice. If you feel this has happened to you, contact a local medical malpractice attorney about this as soon as possible. Medical malpractice suits are generally subject to strict time limits, called statutes of limitations. In some states, the statute of limitations is as short as 1 year from the date you were harmed.
• What to do if you experience serious side effects and were not warned: Most prescription and over-the-counter drugs have possible serious side effects. But if you had severe side effects and your doctor, pharmacist, and any written labels, packaging, or inserts did not warn you about them, you might be able to file a claim on the basis that the product failed to provide adequate warnings or instructions. Sometimes, patients who have all had the same injury band together to sue a pharmaceutical company in a class action lawsuit. Winning this type of claim requires demonstrating that a drug has dangerous side effects, that you experienced some sort of injury, and that the injury was caused by the drug's side effects. Consult an attorney who specializes in pharmaceutical product liability for more information.
• How to get legal help for workplace issues: If you believe your diagnosis is related to exposure to a cancer-causing substance at work or you experienced discrimination because of your diagnosis, here are some options:
  • If you think you were exposed to a cancer-causing substance on the job, receiving workers’ compensation depends on your ability to prove that exposure happened at work and whether there is a link between those cancer-causing substances and the type of cancer you developed. A clear connection between your job and your illness is required. Workers’ compensation laws generally provide employers with immunity from private lawsuits by employees, except in limited circumstances. Consult a workers’ compensation attorney, your state’s workers’ compensation program, or both for more information. Additionally, the Occupational Safety and Health Administration is the federal agency responsible for investigating complaints about workplace safety. If you think you might have been exposed to cancer-causing substances at work, you might want to file a complaint with OSHA. Also, the National Institute of Occupational Safety and Health (NIOSH) is a good resource for more information on occupational cancer.
  • If you believe you’ve experienced discrimination at work because of your diagnosis, here are some things to know:
    • If you need to make changes to your work environment to make your job more manageable and your employer refuses, you may have the right to request reasonable accommodations from your employer under the Americans with Disabilities Act, as long as you work for an employer with at least 15 or more employees. The ADA provides protection from discrimination in the workplace and gives workers with disabilities (including cancer and the effects of cancer treatment) the right to request help or changes to the work environment, as long as the requests are not too costly or difficult for the employer. If you work for a smaller company, check your state fair employment law (or contact the Cancer Legal Resource Center) to see whether your state offers protections for people who work for employers with fewer than 15 employees. It’s important to request changes before your work performance suffers, because if your employer is not aware that you need help, they are still allowed to take negative employment actions against you.
    • It’s important to know that it is not uncommon for people undergoing cancer treatment to be forced to leave their positions if they are not eligible for job-protected medical leave or if their treatment requires more time off than their employer can give them. If you think that your employer might be discriminating against you or not following the law or their own policies, you might want to consider talking to an employment attorney.

Other unexpected costs related to metastatic breast cancer

Considering potential unanticipated costs ahead of time will help you plan ahead. 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, there are steps you can take:

Think about some of the unexpected expenses you might have, such as treatment-related travel expenses, childcare or eldercare, products to address the comfort and cosmetic side effects of treatment, mental health care, and daily living expenses including help with meal preparation, cleaning your home, and lawn care. Create a budget that includes these expenses in addition to your regular living expenses.

If you have to take time off work for treatment, ask your employer about disability insurance options to help replace lost wages.

Sometimes phone, cable, and other utility companies offer discounts or allow delayed payments in certain situations. It’s worth calling to explore your options.
Ask the social worker or nurse navigator at your cancer center about local assistance programs.

Local organizations and community groups sometimes offer grants to help people living with breast cancer with the costs of transportation, meals, lodging, and special items such as wigs and breast prostheses. Organizations include:

• United Way
• American Cancer Society
• CancerCare

Seek advice from an accountant or financial advisor. Accountants can help you save money on income taxes by deducting medical expenses. A financial advisor can show you how to take control of your assets and plan for the future.