Sadly, over 250 thousand American women and almost 2,500 men will be diagnosed with invasive breast cancer this year alone, as reported by The American Cancer Society. The time and energy required for just the medical treatments is extremely challenging by itself. Add in the emotional challenges and it’s easily among the most daunting trials any person and their family will ever go through. But that’s not all. The mountains of financial challenges compound this issue to a scary situation. Unfortunately, even with assistance from high-quality health insurance, the cost of deductibles, copays, out-of-network charges and a variety of other fees do not take long to amount to an insurmountable volume throughout the course of cancer treatments. What’s worse is that many cancer patients need to take time off to complete their treatments, requiring so much time off that they sometimes need to take unpaid leave, which means they’re forced to pay out of pocket due to less paychecks coming in.
The following are actual experiences, and successes, of real people faced with the financial burdens of breast cancer.
Melissa Thompson of Stamford, Connecticut:
Thompson was diagnosed with stage-3 breast cancer in 2015 at the age of 32. This tragic news came amidst the joy of having just given birth to her first child five weeks before. With this news, she was forced into having to decide whether she would freeze her eggs to ensure she could have more children if she decided to in the future.
Thompson was fortunate enough to have her health insurance provider pre-authorize her fertility treatment, at which time she started over two weeks of hormone injections. However, her insurance provider then decided to reverse its authorization the day before her egg retrieval process was to begin. At that time, the fertility clinic she was using then threatened to submit her information to a collections agency since her only option for payment was to use her credit card for the $12,085 bill. Thompson related that cancer patients of similar ages are often tasked with this virtually impossible decision, “Do you want to survive or do you want a family?” And it’s not just the cost of the actual process required to extract and freeze the eggs. Thompson is also responsible for paying thousands to store her eggs every year.
Thompson is still trying to manage her credit card bill in addition to interest accruing on her student loans since she was unable to maintain her independent contract work during her recovery period. She ended up being directly responsible for $64,000 last year. Doing everything she could within her power, Thompson even made a valiant effort to work from her hospital bed. However, Thompson reported she often couldn't move her fingers, preventing her from maintaining gainful contract employment. “[In your twenties and thirties] you should be at the prime of starting your career,” Thompson said. “I was taken out of that.” The interest on her student loans continued to accrue despite finding a way to defer her federal student loans. She is now responsible for over $170,000. To try to reduce her costs, Thompson even admitted, “I got to a point where I skipped scans or didn't fill my prescriptions. I stretched out the time in between [chemo] infusions."
Knowing she unfortunately wasn’t the only one faced with such heavy challenges, Thompson became a cancer patient advocate. Upset with the knowledge that women with infertility due to medical intervention are often denied deserving help from their health insurance provider, Thompson has made an excellent effort to modify state insurance laws. “On June 20, 2017, Connecticut became the first state to require insurance coverage for fertility preservation,” Thompson said. In fact, Melissa's Law for Fertility Preservation also passed in Rhode Island in July. Thompson continues to make a heroic effort to have the policy passed in other states as well.
Maryann Small of Nanuet, New York:
Small had a routine mammogram that discovered invasive lobular carcinoma (stage 1 breast cancer) in October 2013 at the age of 52. She required hospital stays multiple times due to needing a surgically implanted chemo port. She also received three lumpectomies during her time in the hospital. “The problem with cancer is that you're seeing quite often three different specialists at the same time,” Small said. Compounding that problem is the fact that multiple visits are required for each specialist every month, even if the treatment process is moving along smoothly void of unforeseen difficulties. For example, a single patient will often need to regularly interact with a variety of specialists that include surgeons, an oncologist, and radiologist multiple times each month.
As costs continued to mount, made even worse by steadily increasing health care costs, Small quickly realized that, like countless other patients, she needed help covering her significant medical bills. Small noted that no matter how good your health insurance is, “everybody has a copay.” “With mammographies, most insurance companies cover them when they're diagnostic, but once you're diagnosed, they're subject to a copay,” she added. “You also have to have an ultrasound pretty much every time.”
What’s worse is that her family had just changed to health insurance that required a higher deductible. This meant Small was responsible for paying $1,100 for a 90-day refill of aromatase inhibitor, which is used to stop production of estrogen. And that was for a generic drug, not even a name brand. “They gave me some samples first, and then when I got my prescription filled, I almost fell over,” Small reported. To make room in their budget for these new costs, she and her family heavily leaned on their credit cards in addition to limiting their expenditures on absolutely bare minimum essentials.
Despite her giant challenges, Small heroically continues to work for United Way, which is a nonprofit organization focused on health, education, and financial stability, in Rockland County, New York. This includes working during her cancer treatment. Not only that, but Small demonstrates super-human strength in also continuing to act as primary caregiver for her mother, who suffers from dementia. “[My boss] let me work from home sometimes when I felt too sick to go in,” Small said. “I did continue to work as much as I possibly could just for my own sanity,” she added.
Small learned of a United Way partnership with the prescription drug savings program FamilyWize through a colleague. This partnership enabled a life-saving reduction of her prescription costs from the initial $1,100 down to a much more manageable $400 every time she needed to refill her 90-day prescription. The good news is the free FamilyWize program does not have any eligibility requirements. Those in need can easily research FamilyWize prescription prices at their local pharmacies. Then, all they need to do is provide their free discount card or app to get the discount. Consumers can also inquire with their drug company as to whether they provide discount programs for their prescriptions.
What’s proven to be another big boost is Small’s local Meals on Wheels program, which she learned about via her local cancer support group. Small is thankful for the nutritionally balanced meals that go a long way in helping her through this challenging time. “I found out [after completing chemo], but that's something that I pass on to other people in groups now,” Small said.
Hannah Martine of San Diego, California:
Martine felt a lump while showering in August 2015 at the age of 29. Initially, she was hoping it was only a pulled chest muscle. Thanks to breast cancer awareness literature, she knew she should have it checked by a doctor regardless. Sadly, the doctor confirmed the lump was actually stage 4 breast cancer. “As a single professional in San Diego with my insurance tied to my work, I had no choice but to continue working during treatment,” Martine said. “I used all my [paid time off] during chemo, as well as many unpaid hours,” she reported.
Short-term disability leave was required for Martine in order to have her mastectomy done. However, the recovery period went beyond what she had originally anticipated due to a staph infection, which necessitated two additional surgeries to successfully remediate the infection. Since Martine couldn’t afford taking off any more time without pay, she had no choice but to work for six weeks of her radiation treatment. She continues to receive medical bills from 2015 and still receives treatment for her stage 4 cancer. She does not know the finite amount of what she’ll be directly responsible for, approximating that she owes more than $10,000.
As Thompson did, Martine too used her own money to pay to have her eggs frozen before she began chemo and other treatments since she was aware of the distinct possibility of infertility due to such treatments. “I don't have children, but it was something that I do want for my future,” Martine said. Her insurance did pay for one wig, while Martine also used her own money to purchase others, in addition to skin treatment creams to help with the side effects from radiation. Her six rounds of chemotherapy as well as follow-up appointments also produced expensive copays.
Martine was finally able to find some relief through a cancer care coordinator at her hospital who helped her find programs that assist cancer patients like Martine. She also qualified for a free meal delivery service and was also eligible to receive financial assistance from Hope for Young Adults With Cancer, which is a nonprofit organization with a mission to help patients between the ages of 18 and 40. Martine was also able to get help from Jewish Family Services.
Martine strongly suggests that all cancer patients leverage any and all support resources possible. “It's so hard [to think about money] when you're newly diagnosed, and hard during chemo treatments when your energy is depleted,” Martine said. “If you have a good friend or family member, that can really help you …have them help you fill out those applications and that paperwork.”
Remember, you’re not alone. You can do this.