Learn about the resources and programs available so you don’t have to go without the treatment you need.
Walter Tsang, MD courtesy of American College of Lifestyle Medicine Published on March 22, 2024
They will spend, on average, $42,000 during their first year of treatment, according to a study in Cancer Epidemiology, Biomarkers, and Prevention.
If you get a cancer diagnosis and you have good health insurance coverage, it might cover all or most of your treatment costs. But what if you don’t have enough coverage — or any health insurance at all?
Nearly 26 million Americans under age 65 were uninsured in 2022.Many others have high deductibles and copays that make their healthcare unaffordable.
Given these statistics, it’s not surprising that more than half of cancer patients live under the heavy weight of medical debt, which they can carry for many years.
Having no health insurance or subpar insurance is not only a financial burden. It could compromise your health outcome. “We know that in many parts of the country, people are recommended treatments they can’t afford,” says Sara Whelan, a licensed master social work and oncology social worker at CancerCare. “The reality is that some patients are unable to get the [recommended] treatment, and it is detrimental to their health.”
Being uninsured doesn’t mean you have to forgo the cancer treatment you need. Resources are available through your cancer hospital, nonprofit organizations, local agencies, and drug manufacturers to help you pay for care. Taking advantage of these programs can ensure you get access to lifesaving therapies without putting yourself into debt.
If you’ve been diagnosed with cancer and you’re uninsured, it’s not too late to find a plan that will cover your cancer treatment. Go to HealthCare.gov and see what options are available to you. You might qualify for Medicaid, the state-administered program that offers low-cost or free health insurance plans, if your income is low enough or you have a disability.
At age 65 and over (or possibly younger if you have a disability), you can enroll in Medicare.
Another option is to purchase a plan through your state’s Marketplace. Under the Affordable Care Act (ACA), any plan you buy on the Marketplace can’t deny you coverage or charge you more for a preexisting condition, which includes cancer. Coverage of preexisting conditions begins on the first day your plan starts.
Your insurance company does have the right to deny claims for a particular diagnostic test, treatment, or other service. If your provider denies a claim, they must tell you why, and you have the right to appeal the decision.
The process starts with an internal appeal. “An internal appeal is a request to the insurer to reconsider their decision. You will need to provide additional information and documentation from your doctor,” says Stefani Griffiths, director of patient access for City of Hope Orange County in Irvine, California. If that initial appeal doesn’t work, you can have an external review done by an independent third party.
Ask someone who specializes in health insurance law to guide you through the appeals process, Whelan suggests. If you don’t have an attorney, reach out to a nonprofit organization like Triage Cancer for advice.
One thing you shouldn’t do is skip a treatment or oncologist appointment because you’re worried about money. Instead, ask your hospital’s billing or financial department if they offer charity care — discounted care for uninsured or underinsured patients.
Another option is to ask your oncologist if you’re eligible to enroll in a clinical trial that’s investigating a new treatment for your cancer type. You'll get either the standard treatment for your cancer type or a new drug, and the study's sponsor should cover many of the costs involved. Talk to your cancer doctor and the clinical trial coordinator before you enroll so you understand what is — and isn’t — covered. “Your care team should explain the costs and other details involved so you have a clear understanding before deciding whether a trial is right for you,” Griffiths says.
Some pharmaceutical companies have patient assistance programs that provide their drugs for free or at low cost to people who need them. You can find one of these programs by searching PhRMA's Medicine Assistance Tool.
Many nonprofit organizations help people with cancer navigate the costs of their treatment and related expenses (like transportation and housing), including:
This nonprofit organization of oncology social workers offers support, including financial assistance, for cancer patients and their caregivers.
Enter your ZIP code and diagnosis into CFAC's search tool, and you'll find many different types of financial assistance, from copays to housing.
This organization provides free financial assistance and help with navigating resources.
This nonprofit reduces the financial barriers that stand in the way of underinsured patients getting medical care.
This is an American Cancer Society program that gives people with cancer a free place to stay when they travel for treatment.
This organization provides free transportation to medical care across the United States.
The Patient Access Network Foundation provides financial assistance to pay for prescription medications.
PAF offers case management services and financial aid to Americans with serious illnesses.
Other good sources for financial support are organization specific to your cancer type, such as Susan G. Komen for breast cancer, or the Colorectal Cancer Alliance for colon cancer.
Check with your local Department of Social Services to see if they offer help paying for food, housing, or other costs associated with cancer treatment. The American Cancer Society can also point you to programs in your area.
Have a conversation with your cancer doctor early on in your treatment, so you’ll know what to expect and how much you’ll have to pay. Also lean on the resources available at your cancer hospital. “The best sources are your cancer center’s financial or social services counselors,” says Griffiths. “They are knowledgeable about local resources that help families with a variety of expenses, including managing day-to-day family needs.”
These professionals can explain your insurance benefits and anticipated out-of-pocket costs, help you navigate insurance authorization, and offer ways to manage financial burdens like time off from work, transportation, and childcare. They can also recommend financial assistance programs to help you pay for your care.
Your hospital's social worker and financial counselor can take at least the economic burden of cancer off your plate. “The goal is to reduce financial-related stress and provide support to our patients and their loved ones so they can focus on their treatment,” Griffiths says.
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Walter Tsang, MD, is a board-certified medical oncologist, hematologist, and lifestyle medicine specialist. Inspired by the ancient Eastern philosophy of yang sheng ("nourishing life"), Dr. Tsang has developed a unique whole-person oncology approach that tailors cancer care and lifestyle recommendations to each patients’ biopsychosocial-spiritual circumstances. He partners with patients on their cancer journeys, emphasizing empowerment, prevention, holistic wellness, quality of life, supportive care, and realistic goals and expectations. This practice model improves clinical outcomes and reduces costs for both patients and the healthcare system.
Outside of his busy clinical practice, Tsang has taught various courses at UCLA Center for East West Medicine, Loma Linda University, and California University of Science and Medicine. He is passionate about health education and started an online seminar program to teach cancer survivors about nutrition, exercise, stress management, sleep health, and complementary healing methods. Over the years, he has given many presentations on integrative oncology and lifestyle medicine at community events. In addition, he was the founding co-chair of a lifestyle medicine cancer interest group, which promoted integrative medicine education and collaborations among oncology professionals.
Tsang is an active member of American Society of Clinical Oncology, Society for Integrative Oncology, and American College of Lifestyle Medicine. He currently practices at several locations in Southern California. His goal is to transform cancer care in the community, making it more integrative, person-centered, cost-effective and sustainable for the future.
Stephanie Watson is a freelance health writer who has contributed to WebMD, AARP.org, BabyCenter, Forbes Health, Fortune Well, Time, Self, Arthritis Today, Greatist, Healthgrades, and HealthCentral. Previously, she was the executive editor of Harvard Women’s Health Watch and Mount Sinai’s Focus on Healthy Aging. She has also written more than 30 young adult books on subjects ranging from celebrity biographies to brain injuries in football.
