Having cancer is certainly difficult enough and when the crisis hits, the last thing you need be concerned with is money. You should not have to worry about health insurance and taking care of all the costs associated with cancer care. But the reality is you need to be prepared with how to deal with the monetary obligations associated with cancer.
Most hospitals and medical facilities have representatives who are able to deal with your questions and insurance problems. Look at your own policy to determine exactly what your coverage provides for. If you are not up to doing this yourself, rely on a family member or close friend who is up to handling the task for you.
There are laws that protect your rights as a patient, and you would do well to make sure you incorporate all of the benefits of these into your care program.
The Family and Medical Leave Act (FMLA): This act provides eligible employees with up to 12 weeks of unpaid, job-protected leave per year beyond whatever sick leave you are entitled to at work. Under this law, your employer is required to maintain your health coverage during the leave.
The Consolidated Omnibus Budget Reconciliation Act (COBRA): This give workers and their families the right to continue group health insurance benefits for a limited time, usually 18 months, after they lose benefits due to a job loss, reduced work hours or other life events.
The Health Insurance Portability and Accountability Act (HIPAA): This prohibits discrimination against employees and their dependents enrolled in group health plans based on their health status, provides for coverage under group health plans that limit exclusions for preexisting conditions and allow individuals to enroll in a new plan under certain circumstances.
For more information on the above resources, go to the Department of Labor’s Web site at www.dol.gov
The Americans with Disabilities Act (ADA): This act prohibits employment discrimination in the private sector and in state and local government employment against qualified individuals with disabilities. For more information, go to the US Equal Employment Opportunity Commission’s Web site at www.eeoc.gov
If you do not have sufficient insurance to cover the costs of care or you need help with co-payments, here you will find some of the resources available to you to provide financial assistance to help you pay the bills.
The Health Well Foundation: This group provides financial assistance to patients with breast cancer, colorectal carcinoma, cutaneous T-call lymphoma, carcinoid tumors and chemotherapy induced anemia or neutropenia. If you qualify, the Foundation will grant you full or partial assistance for up to 12 months.
Please refer to www.healthwellfoundation.org for details.
The Patient Advocate Foundation: This co-pay relief program provides direct financial support for prescription co-payments to insured patients being treated for breast, lung, prostate, kidney, colon, and pancreatic cancers, head and neck cancers, malignant brain tumors, multiple myeloma and chemotherapy related complications. For more information go to www.patientadvocate.org
CancerCare Inc.: Limited financial assistance for pain medication, home care, childcare and transportation for patients with all types of cancers as well as limited assistance to pay for hormonal and oral chemotherapy is provided here, as well as anti-nausea medication, lymphedema supplies and durable medical equipment
for patients with breast cancer. See www.cancer- care.org for more information
The Chronic Disease Fund : The Fund offers to pay some out-of-pocket expenses for underinsured patients with breast cancer, colorectal cancer, multiple myeloma, and non-small cell lung cancer. The fund considers income levels by geographic area and the number of household dependents. See more at www.cdfund.org
Children’s Leukemia Research Association: They help to pay for care not covered by insurance. www.childrensleukemia.org
Bone Marrow Foundation Patient Aid Program: This program can cover the cost of donor searches, compatibility testing, bone marrow procurement, medication, transportation, housing expenses and many other ancillary costs associated with a transplant. Go to their web site at www.bonemarrow.org.
Free or Low Cost Prescriptions: Most of the major pharmaceutical companies and
biotechnology companies offer patient assistance programs (PAP’s) to uninsured patients to help you get needed cancer medications. There are income eligibility requirements to qualify for assistance, but the requirements vary widely.
Most PAP’s require and income ceiling of about twice the federal poverty level, but some go as high as $60,000. Biotech companies generally have higher income limits to qualify because their products can be more expensive. PAP’s also require patients be uninsured for drugs, a US citizen and proof of income.
Additional Sources of Information:
Amagen Reimbursement Connection: www.amgen.com/patients/assitance.html
Bristol-Meyers Squibb Patient Assistance Foundation: www.bmspaf.org
Genetech’s Single Point of Contact: www.spoconline.com
GlaxoSmithKline’s Commitment to Access: www.commitmenttoaccess.gsk.com
Lilly Cares: www.lillycares.com
Needy Meds: www.needymeds.com
Partnership for Perscription Assitance: www.pparx.org
RxAssist and Rx Outreach Patients Assistance Programs: www.rxassist.org
Together Rx Access: www.togetherrxaccess.com
While we hope to offer useful information and helpful tips about things that may make the process of coping with cancer easier, please remember that this feature series is in no way meant to act in place of medical advice or prescribed treatments. It is meant as a resource and a tool to be used in conjunction with other aides that patients, their families and caregivers may benefit from. Always speak to your doctor or a qualified medical professional before taking steps or making changes in your healthcare regimen.