Deadly as cancer may be to a person’s health, it also wreaks havoc on one’s finances.
According to a January study by the Hutchinson Institute for Cancer Outcomes Research, one-third of cancer survivors go into debt, and 3 percent file for bankruptcy.
“Research shows that financial distress is [at least] equal to the fear of dying from the disease,” says Dan Sherman, owner of the NaVectis Group, which educates hospital personnel on how to assist with financial navigation for cancer patients. “Some who are diagnosed with cancer do everything they possibly can, and go through a lot of [financial] resources. Others try to keep their families from becoming destitute.”
While he recalls an extreme example — a man who chose to forgo treatment and hasten his death so he could pass away before a $200,000 term life insurance policy expired — many patients spend money first and deal with consequences later. Here are a few who did what they had to in order to stay alive — along with expert advice that might have helped salve the financial pain.
Deferred retirement
For middle- to upper-middle-class people, even those with gold-standard insurance policies, it’s not always the cost of care that does them in financially. More often, it’s having to stop working during treatment, as was the case with Forest Hills resident Bob Tufts, who felt the sting of losing two incomes after he was diagnosed with a blood-related cancer in 2009. The 61-year-old former Wall Street executive had expenses that included his daughter’s college tuition and recalls 14 months of not working — and the double whammy of his wife taking off work to be his caregiver.
“She was running all over the place, and trying to work was almost impossible,” he says. After digging through a good chunk of his savings in order to live, he wound up pulling $10,000 to $15,000 out of his 401(k), which comes with heavy tax penalties.
Laurel Wiley was also well-off. The 50-year-old, who had been raised in Tenafly, NJ, and Vestal, NY, had access to good doctors and knew how to cut corners, such as staying at no-cost Hope Lodge, near Herald Square, while getting cancer care. Yet she still moved in with her parents after treatment, partly to help them out as they deal with old age. Despite good insurance and resources, Wiley says she has $15,000 in debt that she can’t pay. “I lost my 401(k) and my BMW,” she says.
The expert says: Wiley and Tufts are precisely the kinds of cancer sufferers whom Family Reach, a national nonprofit funded by private and corporate contributions, wants to help.
“We step in and pay bills not covered by insurance,” says Family Reach CEO Carla Tardif. “We cover mortgages, car payments, utilities for cancer patients. This is for the middle class — lower-class people already have systems in place to support them. Our goal is to prevent people from having to go into their 401(k)s.” (Qualified patients can apply via a single-page application submitted by hospital social workers.)
A new Family Reach program launching in 2017, Financial Treatment Project, aims to let people know early on about the financial challenges they will face and address them ahead of time, with monetary assistance and enrollment in expense-covering programs.
Even though Family Reach helped 3,000 to 4,000 people in 2015, Tardif is frustrated by the umber of eligible patients who remain unaware of what’s out there.
“There are resources,” she says. “But people don’t know about them. We need to open up the conversations.”
When insurance goes bust
In early 2016, Eden Lake checked into the Memorial Sloan Kettering Cancer Center and paid $17,000 out of pocket, some of which was raised via GoFundMe, for crucial lung cancer surgery. The 48-year-old photographer from Gary, Ind., expected Assurant Health to pick up most of the cost. However, in late 2015, the insurer went out of business, and potential replacement carriers refused to cover the out-of-state procedure.
But Lake wanted treatment at one of the world’s premier facilities and took the plunge.
“Indiana is not the place for great doctors,” she says. Today, Lake is on the mend, but her post-surgery finances have hit rock bottom.
“A couple weeks ago I had 76 cents in the bank, and my car isn’t running,” Lake says. “But I manage.”
The expert says: Caitlin Donovan, spokesperson for the National Patient Advocate Foundation, says those like Lake could have shopped for a more agreeable option, in terms of cost and care.
“A business called MediBid does reverse eBay,” says Donovan, explaining that the web-based medical marketplace lets providers bid to sell you health care services, with the idea of coming in low rather than high.
“If you are open to where you want to go and when you want to do it, you may be able to find a less expensive option that could be just as good as Sloan Kettering,” says Donovan. “Overall, Sloan may have the best cancer care, but there are other facilities that excel at treating specific types of cancer.”
Premature bankruptcy
Floridian Fiona Finn, 48, survived colon cancer, but she’s yet to recover from the disease’s monetary toll. Early on, she hesitated to go for a colonoscopy — she didn’t want to spend money on the co-pay — but 14 months later, when symptoms became too blatant to ignore, she got tested.
“They told me right then and there that I had colon cancer,” Finn says.
Visits to an oncologist, a radiologist and a colorectal surgeon quickly followed the diagnosis.
“Within 30 days, I was getting bills, and they piled up,” she says. At the time, Finn was married, had a job and owned a home with her husband. Within a year, she was out of the house she had been living in, her husband had divorced her and she had to stop working as a result of the disease. Finally, a premature declaration of bankruptcy left her saddled with $40,000 in bills.
“There is no way to avoid the debt that accumulates unless you have a reserve of savings,” says Finn. “I had a credit rating of 815 before all this began. I can’t even tell you how bad my credit score is now.”
‘A couple weeks ago I had 76 cents in the bank, and my car isn’t running. But I manage.’
- Eden Lake
The expert says: Bad as all that sounds, Finn isn’t alone. According to Sherman, 60 percent of bankruptcies in the United States are related to medical bills, not surprising when you consider average out-of-pocket cancer costs are $35,000 per year. One way to prevent bankruptcy, he says, is to apply for programs that help with co-pays.
“If the patient is insured and receiving, say, chemotherapy, there are co-pay assistance programs,” he says. “There are pharmaceutical companies that will help out with co-pays if you are using their medicine. The restriction is that you must have commercial insurance. Most have liberal income criteria — for some you can make $150,000 and still qualify.”
Also, a health care technology company called Vivor has a system called PayRx that providers can use to find offers for patients. A similar resource, usable by patients, is called NeedyMeds.
“It is [estimated] that 80 percent of people who receive infusions or oral medication are eligible [for co-pay assistance], but only about 20 percent are enrolled,” says Sherman.
He stresses the importance of hospitals being aware of these programs and the hospital agreeing to bill the companies.
“It can be difficult,” he says, “but the more people make a stink, the more hospitals listen.”