Planning Your Finances

While many insurance companies offer comprehensive coverage for the treatment of cancer, there are still substantial out of pocket expenses to consider. When planning finances, one must consider both the additional costs that will be incurred and any potential decrease in income. For women that are self-employed or work part-time without sick leave or Family Medical Leave Act (FMLA) benefits, this change may have a significant impact.

The American Cancer Society recommends planning for the worst case scenario, which means that the cost of the treatment is estimated to be the maximum level of what was been quoted.1 This is helpful when the budgeted amount for treatment turns out to be less than expected, leaving extra support for things around the home to be covered. However, even with the best planning unexpected expenses may occur. Since the majority of people have no experience estimating the cost of some procedures, it is important to use as many resources as possible when conducting research. Helpful sources for this kind of information include hospital social workers, insurance agents, prior breast cancer patients and patient advocate groups that assist with financial planning for patients.

Income Calculations

It is important to calculate income accurately to understand where your money is coming from. Income can include your wages minus all deductions, income from stocks, bonds or other investments. Be sure to include the income of a spouse or partner as well.

It is important to keep in mind that most breast cancer patients will take at least 6 months off work after having major surgery. Typically patients will require additional time away from work, with the majority of breast cancer patients returning to full-time employment in 12 to 18 months.2  If you do not have disability insurance, paid time off or other sources of income during this time, calculate your income as the lowest possible amount.

Expense Calculations

There are several kinds of expenses to consider that are directly associated with your treatment, such as helpers to assist with daily living activities, and others that are indirectly related, such as the cost of traveling to visits. Out-of-pocket expenses will vary based on insurance coverage for the types of treatment you receive. Asking in advance for an estimate of these costs can be discouraging, but it is an important first step in your financial planning. This information is available from your insurance provider and/or through your hospital social worker.

Typical expenses to consider include:

  • Mortgage/rent payment
  • Utility bills (phone, internet, television, power, gas, water, waste)
  • Child care costs
  • Travel costs (for medical treatment)
  • Lodging and food while receiving treatment (for self and family)
  • In home support during recovery (cleaning services, lawn care, home health care, etc.)
  • Pet care and boarding (if applicable)
  • Insurance premiums
  • Copays and coinsurance requirements
  • Out-of-pocket medical expenses not covered by insurance
  • Prescription medications
  • Medical services not covered by insurance (clinical trials, procedures, etc.)

One must also consider the possibility if becoming ill during treatment, especially chemotherapy, that will add to expenses. This includes emergency room visits for treatment of conditions such as fever, infection, electrolyte disorders, nausea/vomiting, dehydration or complications of thrombocytopenia.3

Expenses are subtracted from income to determine if the budget covers all necessary costs. If there is an issue with determining how to pay for everything, speaking with a financial planner can help determine if money from savings or investments can be used to cover medical bills.

Living Will and Estate Planning

Having a valid living will prior to any medical procedure or essentially at any time, is the only way to ensure that your wishes are upheld in reference to your medical care, your body, your estate and anything else you decide to include. Should you be unable to make decisions for yourself, you can select a durable power of attorney, which is a person that will make all medical decisions for you while you cannot make them. An attorney can provide state specific information on developing a living will and establishing a durable power of attorney, if you do not have one already.

Getting Financial Assistance

Most breast cancer patients will qualify for financial assistance programs offered by local, state or national programs and organizations. Take time to research what programs that may apply to you, and it can help relieve some stress during your breast cancer treatment. The American Cancer Society and some charity groups such as Catholic Social Services, The Salvation Army and the United Way can be provide funds for specific needs and ease the burden of covering the cost of treatment. In addition, sometimes pharmaceutical companies or research organizations can supply medicines at a greatly reduced cost for those who qualify, or can supply them free of charge if you are participating in a clinical trial.

As a last resort, you may be able to borrow money from family members, use credit cards or take out a home equity loan in order to pay the bills while you are unable to work. Be aware that charges to a credit card will accrue interest and in the long run you will pay more than what you were going to originally pay. And do borrow money from family members that you do not plan to repay, as it can cause undue strife between family members, adding further stress during your recovery period.

References

1 American Cancer Society. (2004). A Breast Cancer Journey: Your Personal Guidebook, 2nd Edition. Atlanta: American Cancer Society.

2 Bradley, C. J., Neumark, D., et al. (2007). Employment and Cancer: Findings from a Longitudinal Study of Breast and Prostate Cancer Survivors. Cancer Investigation, 47-54.

3 Hassett, M., O’Malley, J., Pakes, J., et al. (2006). Frequency and Cost of Chemotherapy-Related Serious Adverse Effects in a Population Sample of Women With Breast Cancer. Journal of the National Cancer Institute , 1108-1117.

This article was originally published on July 27,2012 and last revision and update of it was 9/2/2015.