Financial Burden of Cancer: How insurance policies adversely affect patient health

Financial Burden of Cancer: Insurers shift costs to patients

Insurance companies are contributing to the financial burden of cancer with unfair policies that harm patients’ health.

Last week, we explained how insurance companies can legally charge cancer patients more if their treatment comes in a pill form. Patients are working to end this policy with the movement for oral drug parity. But, it’s far from the only issue where insurers’ are putting the bottom line ahead of patient care and treatment.

Surabhi Dangi-Garimella, PhD explains in a recent piece published in the American Journal of Managed Care that the financial burden of cancer treatment can directly affect patients’ health.

“Healthcare coverage policies can create roadblocks for patients to access much needed care, especially in oncology; this has been shown in both the Medicare and commercially insured populations,” Dr. Dangi-Garimella writes. “Financial burden is a potential nonclinical adverse event in cancer patients. As patients, especially those in the lower income ranges and the middle class, struggle to meet their medical bills, the likelihood of them skipping doses or doctor’s visits is quite high.”

Dr. Dangi-Garimella points to a 2012 study that found “Medicare, on average, reimbursed less than 40% of charges for chemotherapy while private insurance shared a little over 55% of the enrollee’s costs.” In other words, cancer patients are left paying the high costs in order to access the right, life-saving treatment.

Insurance policies discourage patients from accessing colon cancer tests

As a result of insurance companies shifting the cost to patients, many patients choose to avoid getting the proper medical care.

Kaiser Health News reports that colon cancer patients are forgoing proper tests and screening due, in part, to the way that insurance companies charge patients.

When asked why patients aren’t getting the proper tests, one cancer patient advocate didn’t mince words. “The number one factor is always cost,” Caroline Powers, director of federal relations at the American Cancer Society Cancer Action Network, told Kaiser Health News.

Powers says that the problem lies in rules for secondary screening tests. Although insurance companies are required to pay for cancer screenings that are recommended by the U.S. Preventive Services Task Force, they can charge patients for a follow-up colonoscopy that confirms the results. Medicare and some insurance companies label this diagnostic and therefore make the patient pay for any deductible and coinsurance charges.

“From a public health perspective, it goes against everything we’re trying to do,” Powers says.

Addressing the high financial burden of cancer facing young adult cancer survivors

Samantha Watson and Michelle Landwehr argue that the financial burden of cancer is especially hard for young adult cancer survivors.

“Young adult (YA) cancer survivors are hit the hardest in the wallet by their treatment,” Watson and Landwehr write at the American Journal of Managed Care. “The average net worth of YAs who have received grants from The Samfund is a staggering –$35,000, while their counterparts in the general population is $68,000.”

They add, “This starts a pattern from which it can seem impossible to escape: a YA has to leave his job to undergo treatment, receives bills for his treatment that are difficult to pay without an income, stays out of work after treatment (while continuing to receive bills) because of the treatment’s effects, and then avoids necessary follow-up care because he cannot afford additional bills.”

Thankfully, the Samfund is offering support to young adult cancer survivors as they deal with the financial burden of cancer. The non-profit offers direct financial assistance as well as free online support and education. They’ve also teamed up with Triage Cancer to developing a new program: “Finances 101: A Toolkit for Young Adults with Cancer

The goal of the program is to “equip the YA community with the tools necessary to make educated decisions about their finances, healthcare, and other related challenges during key moments in their cancer journey (diagnosis, during treatment, or after treatment), so that recovering financially from cancer does not become a lifelong struggle.”

Join the Conversation: #CancerisntFree

Don’t just sit back. Join the conversation. The Samfund is using the hashtag #CancerisntFree to help keep track of all the latest news related to the financial burden of cancer.

Breast cancer survivors left with lifelong financial burden #financialtoxicity #cancerisntfree #cancersurvivor

— The Samfund (@TheSamfund) August 25, 2016

Patients, Fearing Pricey Follow-Ups, May Shy Away From Colon Cancer Tests #cancerisntfree

— The Samfund (@TheSamfund) August 30, 2016


Proud to partner with the first org to talk about #financialtoxicity, bc #cancerisntfree

— Michele Bennett (@MBennett715) July 21, 2016


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