The cost of breast cancer can quickly skyrocket for the individual insured. (Photo Credit: Public Domain/National Institutes of Health/Wikipedia)
The cost of having breast cancer is devastating on many levels. Even those with insurance can quickly run into the annual cap, leaving them uninsured afterward. While various health care reforms have helped, it pays to be prepared. Know what your health insurance covers and adjust accordingly.
Breast cancer: A fight for your financial life
Cancer care cost the American public $104.1 billion in 2006, and the largest segment of that money went to breast cancer care – $13.9 billion. That price requires a great deal of commitment to making personal finances work, as former Procter & Gamble executive Jenny Saldana found after her diagnosis. Going on short-term disability changed everything.
“I was able to make my road to recovery my full-time job, but I earned 40 percent less, with 100 percent of the same bills,” she told Fox Business.
The ballad of the uninsurable
Five years after breast cancer ended her marriage, executive coach Ellen Baker found that the costs of treatment and reconstructive surgery, plus the lack of a second income, were almost insurmountable. She faced foreclosure but managed to fight it off with government assistance. However, the real problem today is her insurance.
“I’m uninsurable now, and I have until July of next year to use COBRA from my husband’s company,” said Baker. “COBRA cost me $1,000 a month, so along with my out-of-pocket expenses, health care costs me about $23,000 a year.”
Considering that Baker still needs two surgeries to complete the breast reconstruction process – and doctors want as much as $20,000 up front, months before her insurance can reimburse – there are still financial mountains to climb.
Know your health insurance policy
It is vitally important for the insured to know what’s covered in their health insurance policy and what is not. Battling with insurance companies over payment for radiation treatments, prescription creams, MRIs and anesthesia isn’t uncommon. That’s why getting estimates for out-of-pocket expenses as early as possible is important for preparedness.
“Experimental treatments are not covered,” explains Dr. Daniel Fass, a radiation oncologist and Cornell Medical School professor. “Ten years ago there was some use of bone marrow transplants for breast cancer. Insurance carriers considered this experimental and did not cover it. This treatment was eventually deemed ineffective and is no longer used. Also, patients participating in a clinical trial are not covered by insurance. Patients need to determine their coverage before proceeding with treatment.”
Many experts advise patients go with HMOs to lower co-pays and premiums, as out-of-pocket expenses with PPOs are only tax-deductible if they exceed 7.5 percent of a patient’s adjustable gross income. That’s a difficult threshold for most people to meet, even with chemotherapy and various other exams and treatments.
Don’t let breast cancer ruin you financially
Insurance companies will generally only agree to pay for procedures deemed medically necessary. If in doubt, obtain as much documentation as possible to prove it to your insurer. Strap yourself in for a long, hard battle.
When it comes to making payments, insist upon a payment plan. Financial experts agree that medical debt is one of the leading causes of bankruptcy, so don’t settle for payments that bear a heavy interest load.
Early breast cancer detection: An economic perspective
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