Out of Pocket Expenses during Cancer Care

Last Modified: May 7, 2012


I'm worried about my out of pocket expenses for my cancer care. Where can I go to for help?


Christina Bach, Oncology Social Worker at Penn Medicine responds:

Financial issues and the cost of cancer care are fast becoming one of the greatest sources of distress for cancer patients and caregivers.

You should start with REALLY knowing your insurance plan. I encourage patients to actually request a copy of their insurance policy from their company. They MUST supply you with this. Important things you want to know about your plan is

  1. What is my deductible &emdash;or the amount I need to pay out of pocket BEFORE the insurance company starts paying for my health care needs?
  2. What are my co pays for medical appointments (with both your primary care provider and specialists) as well as for procedures like CT scans, surgery or radiation. You will also want to know what your co pay for chemotherapy is.
  3. You will want to know what your out of pocket maximum or "stop gap" is. This is the maximum amount paid by you ANNUALLY before your insurance plan pays at 100%.
  4. You will want to know what calendar your plan runs on; is it calendar year, fiscal year or some other pre-determined plan year. This will help you determine where you are in your current benefit cycle.
  5. You will want to know all about your PRESCRIPTION plan as well...again deductibles, co pays, out of pocket maximums AND is there a yearly CAP on prescription drugs.

After you are armed with this information, you can start to assess what your expenses may be as well as what you can afford and where you may need to access help.

There are a great number of co pay assistance foundations out there that can assist with bridging the financial gaps. For information about co pay assistance see my blog, Christina's Resource Round-up.

Also, the Cancer Support Community has just launched the latest edition of their fantastic resource, Frankly Speaking About Cancer: Coping with the Cost of Care. This is a free resource available via download or to be ordered.

The Association of Clinical Oncology also publishes "Managing the Cost of Cancer Care" as well as has a podcast and video available about this topic on their website:http://www.cancer.net/patient/All+About+Cancer/Managing+the+Cost+of+Cancer+Care

There are also many organizations that provide financial assistance for transportation, household items/repairs, lodging and other financial supports. Talk with your local oncology social worker about what organizations might be available in your area.

This question and answer was part of the OncoLink Brown Bag Chat Series. View the entire transcript from the Focus on GI Cancers webchat.