Cancer Financial Toxicity: Costs, Medical Debt, Insurance, Financial Assistance, and Survivorship

Cancer Financial Toxicity: Causes, Symptoms, Costs & How to Protect Yourself. Learn what cancer financial toxicity is, why it affects millions of patients, and practical strategies to reduce medical debt, insurance costs, lost income, and treatment-related financial stress.

1. What is Financial Toxicity?

Cancer financial toxicity is the financial hardship caused by cancer treatment. It includes medical bills, insurance deductibles, lost income, travel expenses, and emotional stress that may interfere with treatment and quality of life.

2. Symptoms of Financial Toxicity

delaying treatment
skipping medications
borrowing money
using retirement savings
anxiety
depression
bankruptcy

3. Who Is Most At Risk?

younger patients
high deductible insurance
metastatic disease
oral chemotherapy
self-employed patients
caregivers leaving work

4, How Financial Toxicity Affects Survival

treatment adherence
stress
delayed care

5. Hidden Costs

travel
lodging
parking
lost wages
childcare
supplements
rehabilitation
caregiver expenses

6. How to Reduce Financial Toxicity

financial navigator
appeal denials
manufacturer assistance
nonprofit grants
payment plans
disability benefits
crowdfunding
tax deductions

7. Understanding Cancer Costs

How Much Does Cancer Treatment Really Cost?
Cancer Costs After Insurance
Hidden Costs of Cancer
Travel Costs
Lost Income

8. Paying for Cancer

Grants
Co-pay assistance
Foundation support
Pharmaceutical assistance
Crowdfunding
Hospital charity care

9. Insurance

Appealing denials
Prior authorization
Medicare
Medicare Advantage
Supplemental insurance
COBRA
Marketplace insurance

10. Employment

FMLA
Disability
Returning to work
Employer accommodations

11. Medical Debt

Cancer and Medical Debt

Negotiating bills
Payment plans
Bankruptcy
Credit scores

12. Financial Navigation

Cancer Financial Navigators

Hospital social workers
Case managers
Oncology navigators

13. Questions Patients Should Ask

Questions for Your Medical Team

Ask these questions before starting treatment: [1, 2]

“Can we review all costs for my treatment plan, including copays and deductibles?”

“Is an equally effective but less expensive medication or treatment schedule available?”

“Are these treatments considered ‘in-network’ for my specific health plan?”

“Will I need prior authorization from my insurance for any of these tests?” [1, 2]

Questions for Your Insurance Company

Call the member services number on the back of your insurance card: [1]

“What is my maximum out-of-pocket limit for the year?”

“Do you cover biomarker testing and targeted therapies?”

“How do I appeal if a treatment or drug is denied?” [1]

Questions to Find Extra Financial Help

If bills get too high, ask these questions to find help: [1, 2]

“Do you have a social worker who can connect me to travel assistance or co-pay relief?”

“How do I apply for medication assistance programs from drug manufacturers?”

“What local charities or non-profits offer grants for cancer patients?”

“Can my employer protect my job under the Family and Medical Leave Act (FMLA)?” [1, 2]

14. Research Center

When I was first diagnosed with multiple myeloma in early 1994, I focused entirely on surviving cancer after my diagnosis. Looking back, I wish I had understood that managing the financial side of cancer is also part of managing the disease. Financial stress can influence treatment decisions, quality of life, and even long-term outcomes.”

I was fighting an incurable cancer, and I was angry, depressed, you name it. I simply ignored what my insurance company was telling me- positive or negative.

Big mistake…

I am both a multiple myeloma survivor and cancer coach. Research and experience have taught me:

Conventional cancer care is expensive and works only some of the time…
Non-Conventional Cancer care can be inexpensive-
Ignoring the financial toxicity of cancer care is a mistake

The need for developing a plan to pay for your cancer is the same as developing a therapy plan for your cancer in general.

Learn about both conventional therapies and evidence-based, non-conventional therapies. Combining the best of both may afford the highest quality of life with the most cost-effective therapies.

Scroll down the page, ask me a question or post a comment. I will reply to you ASAP.

Thank you,

David Emerson

Cancer Survivor
Cancer Coach
Director PeopleBeatingCancer

Possible Conventional Therapies-

To learn more about cancer financial toxicity:

Financial toxicity and myeloma:

Patients Paid $21 Billion for Their Cancer Care in 2019

“The financial burden on patients receiving cancer care in the United States came to $21.1 billion in 2019, according to an analysis published October 26 in the Journal of the National Cancer Institute.

Patients’ out-of-pocket medical and pharmaceutical costs represented an estimated $16.2 billion of the $21.1 total (77%) and time costs represented the remaining $4.9 billion (23%).

The analysis — the second part of the US National Cancer Institute’s annual report to the nation on cancer — provides a more comprehensive look at the economic impact of cancer on patients than many previous reports. The researchers not only explored patients’ out-of-pocket costs but also broke down the data by time costs associated with cancer care — including round-trip travel and hours waiting for and receiving treatment — as well as by cancer site, stage of diagnosis, and age.

For instance, when it comes to the cost of care, age at diagnosis matters. In the first year after being diagnosed, the average out-of-pocket treatment and time costs for people 65 and older was approximately $2700 — about $2440 for medical services and drugs and $279 for time. But for patients younger than 65, those costs were more than twice as high — almost $5900 ($5556 for treatment and $304 for time).

Study compares cancer drug cost, benefit

“A new study from Queen’s University professor Christopher Booth has revealed the pricing of cancer drugs appears to have no relationship to their effectiveness…

Through the review it was revealed that the most expensive drugs were not the most beneficial…”

Cancer’s Financial Burden Tied to Poorer Survival, Study Finds

“The staggering cost of cancer care forces many patients to file for bankruptcy, and that financial stress may play a role in cutting their lives short, new research suggests.

In fact, patients suffering from colon, prostate or thyroid cancers who went broke had almost 80 percent higher odds of dying during the study period compared with similar patients who remained financially sound, the researchers said…”

‘I Am Drowning.’ The Voices of People With Medical Debt.

“Our article on Americans’ struggles with medical debt generated thousands of reader comments. More than 1,200 readers wrote us to answer our question: “How have medical bills changed your life?”

New Adverse Event in Cancer Treatment: ‘Financial Toxicity’

“”Out-of-pocket expenses related to treatment are akin to physical toxicity, in that costs can diminish quality of life and impede delivery of the highest quality care..Cancer treatments are more expensivethan in the past, and they are being overused; importantly, rising costs are being passed on to the patient, the essayists write.

Indebtedness is common and can be severe. In a recent study of colorectal cancer patients, researchers found that about 25% were in debt because of treatment, and that the average debt was $26,860 (J Clin Oncol. 2011;29:954-956)…

What to Do? The first step in discussing cancer costs is actually knowing the cost of treatment…But other research suggests a “conundrum”: patients want to talk about cost, but they don’t want their physicians making treatment decisions based on cost.

Prices Soaring for Specialty Drugs, Researchers Find

“…In 2013, Ms. Pearson said, 23 percent of employer-sponsored health plans placed specialty drugs in their own group, or tier, in which consumers are asked to pay a percentage of the drug cost, rather than a set co-payment. In 2006, just 5 percent of employer plans had a specialty tier. The trend is likely to continue: In the new plans offered to individuals through the health insurance marketplaces, Ms. Pearson said, specialty tiers are “ubiquitous.”

NCCN Reimbursement Resource App now available for patients and caregivers

“”By making the NCCN Reimbursement Resource App available free of charge, NCCN seeks to assist
patients, caregivers, and providers in identifying resources that may ease that burden by providing easy access to payment assistance and reimbursement programs, respectively.”

Possible Solutions:

How to Appeal a Health Insurance Denial– yes, insurance companies can and do refuse to pay for meds, scans, etc. prescribed by your oncologist.
What if my insurance does not cover my cancer medications? What do I do when this happens???
23 Web Sites to Help You Figure Out Health Care Prices
Working the System: One Cancer Patient’s Story
For cancer patients, new tool predicts financial pain

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