Managing Finances When You Have Breast Cancer

Tips for planning, budgeting, and more

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Expenses are probably the last thing you want to think about when you learn you have metastatic cancer. In some ways it simply doesn’t feel fair that people should have to worry about the bottom line financially when facing the physical and emotional turmoil of cancer.

Yet, we live in a world in which cancer is very expensive. In an equation in which expenses go up and ability to work goes down or away entirely, the sum isn’t always what we would wish.

While this can sound discouraging, it can make a big difference to take just a few moments to think about your finances early on, and to begin keeping track. It may also help calm some of your fears to learn whether you will need assistance and, if so, explore the options that are available.

Tracking Expenses

The most important thing you can do financially is to begin keeping track of your expenses, either when you are diagnosed, or as soon as possible. Many people find it helpful to purchase a notebook devoted only to tracking your costs. At the same time you might wish to pick up a folder for holding any important receipts.

This doesn’t mean that you need to sit down with an accountant for hours at a time. You have more important things you need to focus on, but a few minutes now could save you and your family time and headaches later on.

Tax Planning

One reason to begin keeping track of costs right away is that many expenses related to cancer are tax deductible.

You may be discouraged realizing that medical deductions need to exceed 10 percent of adjusted gross income to qualify, but many people are surprised how quickly this number is reached.

Simply taking the time to record your expenses as they occur (even mileage to your visits is deductible) and dropping receipts in a folder can save countless hours (and money) in the long run.

Budgeting

Once you have your notebook to record your expenses it’s helpful to get an idea of your bottom line. This doesn’t have to be an intricate spreadsheet detailing all assets and all expenses, but rather a brief sketch of income and debts. This will give you a better idea of whether or not you will have to look into additional options to meet the expenses of your care.

Insurance Concerns

Taking a look at your medical insurance coverage is one of the most important parts of preparing financially when you have metastatic cancer. Here are a few tips:

  • Review your policy – Most people have a general idea of their medical insurance coverage, but this is a good time to review your policy more closely. This will give you an idea about costs that are covered and whether or not you are underinsured.
  • Understand the difference between in network and out of network providers – Many insurance policies have different tiers of coverage depending on whether a clinic or hospital is in network or out of network. While a few clinic visits out of network may not add up that much, the cost difference for an out of network hospitalization can add up quickly.
  • Learn about the prior authorization process – If you find that a treatment you desire is only available out of network, call your insurance company. If you can show that a treatment only available at a higher tier cancer center is superior or has fewer side effects, your insurance may well cover your costs at the in network rate.

    Keep in mind that these issues need to be figured out before your treatment and this can be frustrating when you’re already coping with the symptoms of cancer. If you have a friend or family member who can help you navigate these steps, strongly consider allowing them to help.
  • Review your bills – It’s a good idea to take a moment to review your bills from visits and hospitalizations. Errors are very common and are easier to rectify if discovered early on.
  • Review your coverage for home care and hospice care – Even if you’re feeling well and hoping you won’t need these options, take a look to see what coverage you have for both home health care and hospice care. Most plans cover these needs but the particulars can vary significantly.

Disability Insurance

Loss of income is one of the greatest concerns for those facing metastatic cancer. If you have recently been diagnosed with metastatic cancer, it may feel like it is too early to consider disability, but the best time to consider this is long before you need it.

You may have disability insurance through your work or through a private policy, or you may need to consider social security disability.

Since the process of applying for social security disability is lengthy, the best time to apply is as soon as you need it. In order to qualify, you will need a physician to sign a form saying that you are unable to work because of a medical condition that is expected to last at least 12 months (or result in death.) Keep in mind that if you continue to do well and decide you are later able to work, you can always discontinue the program.

You may be confused with the difference between social security disability (SSI or SSDI) and supplemental security income (SSI). The difference is that SSD is provided for those who have accumulated a specific number of work hours, while SSI is available to those who are low-income or have not worked outside the home enough to earn the work credits needed to qualify.

Financial Support

Even with good insurance coverage, the costs of cancer treatment can be tremendous. By looking at your bottom line as noted, you will have a better idea of whether or not you will need extra support.

Exploring options for financing your treatment

If you don’t have the cash you need in the bank—as a large number of people with metastatic cancer do not—take a moment to think about what options you may have. For example:

  • Could you take out a loan on your life insurance policy?
  • Could you take out a second (or third) mortgage on your home? For those over the age of 65, could you take out a reverse mortgage?
  • Do you have any friends or family members who would be willing to loan you money?
  • Can you tap into your retirement income? You may need to take a loss, but in the long run a loss such as this up front may save money down the line.
  • Do you have any valuables you would be willing to part with that you could sell?
  • Do you have any friends who would be willing to plan a fundraiser in your community or online? Fundraisers are a very common way for people with metastatic breast cancer to raise funds and is usually very effective. There are many online options through social media that you could explore. If you have a friend who enjoys organizing fundraisers, it’s amazing how many businesses in most communities will gladly donate services, meals, or other items for a silent auction.

You may think of additional options, but taking a moment to think through some of these possibilities may give you some reassurance.

Financial Assistance

If you’re still in the red after evaluating your options, you may wish to check into the various types of assistance available.

There are several organizations which provide assistance for people coping with metastatic breast cancer, though the types of assistance vary. Some offer help with rent or transportation. Others offer financial assistance for childcare. Yet others offer college scholarships for children of those with metastatic breast cancer.

Prescription drug assistance programs may offer you the chance to receive your treatments or medications at discount. There are even free flight programs for cancer patients in some regions.

Since there is such a wide array of options, a great way to get started is by talking to your cancer center social worker. Most cancer social workers have helped others like you find the help they need. You may also wish to enlist an energetic friend or family member to research options for assistance, as this can be a time consuming and tedious task.

Sources:

DeVita, Vincent., et al. Cancer: Principles & Practice of Oncology. Cancer of the Breast. Wolters Kluwer, 2016.

American Cancer Society. Cancer Facts and Figures 2016. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2016/cancer-facts-and-figures-2016.pdf

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