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Out-of-Pocket Costs for Myeloma?
What are the average out-of-pocket costs for a myeloma diagnosis? The article below list average out-of-pocket costs for common cancers but not for MM.
I write posts that I hope will inform newly diagnosed MM patients. Studies like the one below are great, but may or may not apply to a diagnosis of a rare blood cancer like MM.
I’ve linked the video below because it gives valuable, specific information about OOP and insurance companies.
Out-of-Pocket Costs and How to Talk to Your Insurance About Them
I am a long-term MM survivor. When I was first diagnosed, I simply ignored my EOB’s (explanation of benefits) for about six months. This was a big mistake. Do NOT do this!
Have you been diagnosed with MM? Were you blindsided by OOP costs that you didn’t expect? Please email me at David.PeopleBeatingCancer@gmail.com with your experiences.
thank you,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Cancer Care Costs High Among Privately Insured Patients
TOPLINE:
A recent analysis found that privately insured US patients with newly diagnosed cancer, especially those with more advanced disease, had “substantial out-of-pocket costs.” Monthly out-of-pocket costs among these patients increased by a mean of almost $600, on average, but increased to nearly $720 per month for those with stage IV disease.
METHODOLOGY:
- Out-of-pocket costs for cancer care in the US are rising, but most research has focused on Medicare beneficiaries. It’s important to understand privately insured patients’ financial burdens, especially with cancer rates growing among younger Americans.
- Researchers conducted a retrospective study of 19,656 patients with cancer, using a dataset that links claims from a large private insurer to the Surveillance, Epidemiology, and End Results cancer registry.
- Overall, 74.1% had breast cancer, 14.5% had colorectal cancer, and 11.4% had lung cancer. Analyses also included 26,502 individuals without cancer who were assigned pseudo-diagnosis dates.
- Monthly out-of-pocket costs (copays, co-insurance, and deductibles) were calculated from claims and inflation adjusted to 2024 US dollars.
TAKEAWAY:
- After a cancer diagnosis, monthly out-of-pocket costs rose by $592, on average.
- Those added costs increased with disease stage, from $462 per month for stage 0 cancer to $720 per month for stage IV cancer.
- Out-of-pocket costs spiked in the month of diagnosis and remained elevated for 6 months compared with those in individuals without cancer — totaling an average of $4145 in cumulative additional costs (over 7 months).
IN PRACTICE:
“In this cohort study, patients with private insurance were found to have high OOPCs [out-of-pocket costs] after an incident diagnosis of cancer, and those with the most advanced cancer had the highest OOPCs,” the authors wrote. “The variability in OOPCs based on cancer stage underscores the need for policies, such as paid sick leave, that address both insurance continuity and financial assistance, especially for patients with more advanced cancer.”
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