insurance

Insuring against the high costs of cancer

Signing insurance forms
Highlights
  • Some cancer drugs can cost up to $100,000 for a year's treatment.
  • While insurance can help, copays on hefty medical bills can add up.
  • There are different supplemental policies to help with high cancer costs.

If you are diagnosed with cancer, you have two battles ahead of you: to get well and to stay solvent.

Fortunately, you can prepare for the latter, so it doesn't impede the healing process.

"Understanding the costs you can expect before you even begin treatment can help you manage the impact more effectively," says Rosalie Canosa, program division director for CancerCare, a New York-based national nonprofit that provides counseling and financial assistance to cancer patients.

CancerCare receives about 500 calls a day from Americans overwhelmed by cancer's financial burden. Some are among the 50 million who don't have health insurance in this country; others are shocked and scared to find that while their health insurance picks up most of the tab for cancer treatment, their copay or co-insurance portion can still prove astronomical.

"The cost of cancer is increasing at a rate of about 15 percent per year, (which is) nearly three times the rate of increase of overall health costs," says Canosa. "It's mind-boggling."

Some of that is due to the jaw-dropping cost of new cancer drugs and treatments, says Dr. Otis Brawley, chief medical officer and executive vice president of the American Cancer Society.

"We have a number of drugs in oncology that have been FDA-approved in the last decade or so that tend to cost around $100,000 for a year's treatment," he says. A few examples: $85,000 per year for the colon cancer drug Avastin; $92,000 for the prostate cancer drug Provenge; and $8,000 to $9,000 a month for the melanoma drug Yervoy.

Expensive new procedures such as proton beam therapy and da Vinci robotic surgery can just as easily bust a copayer.

"I get letters every week from people looking for some way to pay off a bill," Dr. Brawley says. "I get the guy who thinks he has great insurance and then his 12-year-old kid gets leukemia, and he finds out that the 20 percent copay on a $300,000 health bill is more money than he makes in a year. That's a real story."

Canosa says health insurance will typically cover medical expenses, doctor visits, hospital visits, drugs and other medications.

What it won't cover includes your deductible; the copay (a preset dollar amount you must pay each time you have a medical service); co-insurance (you pay a certain percentage of your health care costs); and of course your health insurance premium itself -- you don't want that to lapse just when you need it most.

On top of your ongoing daily living expenses (rent/mortgage, food, utilities and taxes), you may face these additional bills during your cancer treatment:

  • Transportation.
  • Auto fuel and parking expenses.
  • Home care.
  • Child care.
  • Food supplements.
  • Lodging expenses for out-of-town care.
  • Over-the-counter medications not covered by insurance.

Those bills can loom especially large if you're forced to miss workdays or go on workers' compensation, which can cut your income by 40 percent.

How can you stave off an avalanche of cancer-related bills? There are several insurance products to consider in addition to -- but never in place of -- a solid basic health insurance plan. They include the following.

Cancer insurance

Cancer insurance may sound reassuring, but cancer policies often come with more questions than answers.

For starters, they only pay if you get cancer; if you've already been diagnosed, you're out of luck. Then there are the odds: statistically, only 3 in 10 Americans will ever get cancer, according to the National Association of Insurance Commissioners. Nor will a cancer insurance policy help with the nonmedical bills.

Finally, they may contain coverage limits and restrictions, such as inpatient procedures only, that may not pay for the treatment you need.

"I've had lymphoma patients who have been cured for 15 years, and the only time they've ever been in a hospital is when they were born; we do it all as an outpatient," says Dr. Brawley.

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