AML Access and Affordability Archives

The impact of cancer isn’t just physical, it’s also financial. Navigating coverage and out-of-pocket expenses is a minefield for many AML patients and care partners.

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Financial Empowerment for Cancer Patients

The Kaiser Center reports that one-third of Americans aged 18-64 years are put into debt because of cancer. The debt is caused as a direct or indirect result of high medical costs, an inability to work and loss of income. More than half of those incurred debts of at least $10,000. The risk of debt or bankruptcy is further exacerbated among younger patients and those with lower incomes. The National Cancer Institute estimates that there are 454.8 new cancer cases per 100,000 men and women each year. Now, more than ever, financial preparedness is a key strategy to battle the disease. Financial healthcare empowerment is going to play a significant role in the fight against cancer. If survival rates are going to improve, it is imperative that everyone is prepared from day one to deal with a shocking news that will affect all fronts of your life from physical and mental to psychological and financial implications.

Preparing for the High Cost of Care

Healthcare, in general, is a costly affair especially if you don’t have a good insurance. In this regard, it is important to squirrel money away even if it is only a small amount. If you are not familiar with the 50-30-20 (regular expenses, wants and savings) rule, you might need to think about it and adopt this strategy to maximize savings that you could put away. Even simple lifestyle changes (strict budgeting and ditching credit cards) already bring you a step closer towards financial independence.

Coping with Financial Stress

Unfortunately, while you are steadily creating your personal wealth, the devastating news of cancer can quickly knock you a few notches down. Resiliency to financial stress is key in getting through the illness. This means smarter management of assets and finding ways to get help for your treatments.Seeking the services of a financial counselor or social worker upon diagnosis is imperative to check out what resources are available to you.

Better Cancer Treatment Options but Rising Healthcare Costs

The good news is that treatment options for cancer are getting better as the years passed. The bad news is that these therapies are pricey and are likely to eat up the budgets of cancer patients. Although it might be difficult to come to terms with your diagnosis, it is important that you start researching treatment options immediately. Your healthcare insurance might not be enough to pay for treatment.

Dealing with Healthcare Finances, Loss of Income and Even Bankruptcy

There are several state and federal programs that offer financial support to individuals and families. Known as entitlements, they are directed at low-income groups, the elderly and disabled persons. Pharmaceutical patient assistance programs also exist to help with reimbursements, referrals for co-pay relief programs and discounted/free medications. You can also participate in paid clinical trials to help defray costs of treatments. Cancer organizations and general organizations can support treatment plans for patients.

Cancer is a devastating disease that has serious financial repercussions. It can cause physical and emotional stress as treatments and therapies can literally cost a fortune that in turn may in debt you or at worse, lead to bankruptcy. Being prepared financially for any disaster can mitigate these negative effects and taking charge of money matters is empowering.

Fight Financial Stress for Better Health

Receiving a diagnosis of cancer is immensely challenging; it can provoke a blend of anxiety, sadness, and fear, much of which can be allayed as we commence our treatment plan, working alongside a team of health professionals we trust. Sometimes, we can feel anxious or depressed while receiving treatment; we can feel tired and can grow impatient with the wait, eagerly wishing to simply get back to our day-to-day lives. The stress we feel can be compounded if we are also struggling financially. This post discusses the relationship between finances and health, suggesting ways to nip the problem in the bud.

Financial Stress and Mental Health

Studies on financial stress among particular groups (for instance, students burdened by debt) have found a greater risk of mental illness. Debt, low wages, or bankruptcy take their toll on our energy levels, but also affect our motivation, sleep, and lifestyle choices. Indeed, the relationship between stress and our finances is cyclical; the more burdened we feel, the more likely we are to make poor financial decisions (including spending money impulsively and getting deeper into debt). The more in debt we are, meanwhile, the more anxious or depressed we can feel. These states affect our ability to think clearly and formulate a strategic plan to rescue our finances.

Stress and Physical Health

Because our mental and physical health are interrelated, when we are in constant ‘fight or flight’ mode, we can make lifestyle decisions which hamper our physical health. For instance, binge eating and other eating disorders can be trigger by stress. Overeating, meanwhile, or indulging in processed and sugary foods, can lead to obesity, insulin resistance, and even Type 2 diabetes.

Seeking Financial Advice

If you are battling cancer and struggling to meet work and health needs simultaneously, do not be reticent to ask for help. Ask friends or family about a trusted accountant or financial assessor who can give you handy advice on how to save, consolidate, or refinance existing debt.

Accountants can point you in the right direction by suggesting that you automate savings. They can help you figure out which debts to pay first, and formulate a retirement plan. They can also advise you on small ways to save that can add up, such as the use of cashback cards, which can return you up to 2% of everything you purchase. This is not for everyone; there are options which can consolidate and reduce costs, but also others to help raise short term funds. Financial apps, meanwhile, can make it much easier to save money every month. Small steps such as this can make a big difference; they can mean having enough to pay someone to help you with housework or to have an occasional massage and other soothing treatments.

Stress Busting Strategies

Because the relationship between finances and our mental health is so interdependent, it is important to battle stress actively. Yoga and meditation are two activities which have been found to lower levels of stress hormone, cortisol, in numerous large-scale studies. In the end, stress reduction is a very personal pursuit; for some, experiences in Nature are a great source of relief. For others, hobbies such as art, music, or even gardening, do the trick. The key is to find something that resonates with you; the more mindful the activity, the better.

It is vital for patients, family, and friends to be aware of the effects stress can have on their physical and mental health; this is the first step towards putting an end to the stress-anxiety conundrum. By putting your finances in order and taking active steps to quell stress, you will find that neither has such a powerful hold on you as it may initially seem.


About the Author: Chrissy Fielding is a Content Manager and is working to build one of the best senior resource sites.

Qualifying for Disability Benefits with Cancer

Have you been diagnosed with cancer? If so, you might be eligible for financial aid. If so, the Social Security Administration (SSA) might be able to help. The SSA offers monthly financial resources for people with serious illnesses who are unable to work. While a cancer diagnosis does not automatically qualify, thousands of people with cancer are eligible for assistance.

Medically Qualifying for Disability

The SSA will refer to its own medical guide, known colloquially as the Blue Book, when you apply for disability benefits with cancer. The Blue Book contains details on exactly what medical results you’ll need for cancer to qualify. Cancer has different qualifying criteria depending on your specific diagnosis, so there’s no way to know if you’ll qualify without first consulting the Blue Book. Here are a couple of examples on how to qualify:

Prostate Cancer

Prostate cancer is one of the most commonly diagnosed forms of cancer, but the good news it’s highly treatable. Because of how receptive prostate cancer is to treatment, the criteria for qualification for prostate cancer are challenging to meet.

You will qualify for disability benefits with prostate cancer if your cancer has progressed or returned despite one round of anticancer therapy (usually three months’ hormonal therapy or chemotherapy will qualify), OR

Your cancer has spread to an internal organ, OR you have small-cell prostate cancer

Prostate cancer usually has to be Stage IV to qualify, but again, if your cancer has returned despite treatment you may still qualify at a lower stage.

Esophageal Cancer

Esophageal cancer is typically aggressive and challenging to treat, so you’ll actually qualify for Social Security disability benefits with just a diagnosis. Other forms of cancer that qualify with only a diagnosis include:

  • Acute Leukemia
  • Gallbladder cancer
  • Brain Cancer (malignant, not benign tumors)
  • Inflammatory Breast Cancer
  • Liver Cancer
  • Pancreatic Cancer
  • Salivary and Sinonasal Cancers
  • Thyroid Cancer

The entire Blue Book is available online, so you can review the cancer listings with your oncologist to determine if you’ll meet a listing. Typically, if you can meet any one of the following criteria you’ll qualify:

  1. Your cancer is inoperable or untreatable
  2. Your cancer is Stage IV
  3. Your cancer returned despite treatment

Starting Your Application

Applying for benefits is a tedious process, but fortunately you can complete the entire application from the comfort of your own home. Apply online at the SSA’s website—you can even save your progress to be completed at a later date.

If you’d prefer, you can also apply in person at your closest Social Security office. There are over 1,300 offices located across the country. You can schedule an appointment to apply in person by calling the SSA toll free at 1-800-772-1213.

Once approved, you can spend your monthly benefits on medical bills and upcoming treatments, childcare, housing for your family during treatment, food or utility bills, or any other daily living expenses.


Additional Resource:

Social Security Administration: https://www.ssa.gov

Social Security Disability Evaluation: https://www.ssa.gov/disability/professionals/bluebook/

Qualifying Criteria: https://www.disability-benefits-help.org/resources/medical-evidence

The Blue Book: https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm

Social Security Disability Application: https://www.ssa.gov/applyfordisability/

Social Security Offices Locator: https://secure.ssa.gov/ICON/main.jsp

Bills Social Security Can Cover: https://www.disability-benefits-help.org/blog/bills-social-security-disability-benefits-cover


This article was provided by Disability Benefits Help (www.disability-benefits-help.org), an independent resource dedicated to helping people across the country receive the disability benefits they need. For more information, feel free to reach out to our team at help@ssd-help.org.

Medical Bills, EOBs, and You

Medical bills are confusing, and often frightening. Even if it’s for something simple, the numbers add up fast, and to sometimes alarming levels. Add the Explanation of Benefits (EOB) documents you get from your insurer for the same clinical visit or hospital stay, and you can find yourself wondering how much you owe whom, and for what, exactly?

“Not A Bill”

This will be printed on all EOBs, and is the only sure way to tell which is an actual medical bill, and which is an EOB. However, an EOB can be confusing – other than that clear “Not A Bill” printed somewhere on the form.

This is one of the EOBs I got during my own cancer treatment. It’s for my lumpectomy, but the only way I’d know that is the dates on the form. The singular lack of information on what the EOB is for is one of the distinguishing characteristics of these forms, so knowing what the services were, and what your plan’s coverage is for those services, are important details. The numbers are indeed scary, given the Provider Charges of $50,231.25, and the Amount Paid of $0.00. Someone unfamiliar with EOB-ese might have a panic attack before getting to the important phrase “there is no liability on your part for these services” in Remark(s) Explanation 3.

“Statement of Account”

Here’s the summary bill from the hospital that covers the same services (my surgery), but this might only add to the potential for confusion.

The bill has slightly more detail than the insurer’s EOB, but not that much. It mostly seems to be to a series of magic incantations that take the starting amount – New Charges or Adjustments, $53,911.00 – and bring that down to an Amount Due of $50.00. My insurer paid $5,430.02, and there were Adjustments of $48,430.98, which leaves $50.00. On the one hand, hallelujah; on the other hand, what’s the story with that $48,430.98 “adjustment”?

If I didn’t have insurance, would I be on the hook for that whole $53,911.00? Probably, but it’s hard to know exactly. This is where the “chaos behind a veil of secrecy” that is healthcare pricing is most visible: hospital charges.

I learned a lesson from this bill, by the way: always ask for an itemized bill, not a summary bill. Ask for that during the admission process (if it’s a hospital), or at the medical office or testing facility during check-in.

Staying ahead of the healthcare cost curve

Here are my tips for figuring out your medical bills, and your EOBs, to ensure you get what you pay for, and only pay for what you get:

  • ALWAYS ask for an itemized bill, don’t just take a summary bill (the mistake I made with the billing for my own cancer surgery).

  • Review that bill, line by line. Make sure that it doesn’t have anything on it that you did NOT receive. Use CMS’s CPT code look-up tool to help you break down the blizzard of numbers. [CPT codes are the five digit service codes used by all medical providers; they’re in the column labeled Svc Code in the bill example above.]
  • Have your insurer’s Summary of Benefits documentation handy while you review the bill(s). That will be available on your insurer’s website.
  • Do not pay a bill until you get the EOB associated with those billed services.
  • Line up the EOB, and the bill, to make sure the dollars and the codes are correct.
  • Challenge any billed items that are for services you didn’t receive.
  • If services you received are listed as not covered by your insurer on your EOB, challenge that with your insurer’s customer service crew.

Yes, it takes work. And it’s a little crazy that the American healthcare system expects people, particularly sick people, to manage this blizzard of paper with scary dollar figures on it. But the only way to make sure you don’t pay more for your medical care than you should is to be proactive. It’s what empowered patients do.

Health Cost Literacy: “How much is that?”

The title of this post asks the $3.5 trillion-with-a-T question in American healthcare: how much is that? It often feels like healthcare is split into two camps, with one side working away feverishly to find more cures for life-threatening conditions like cancer and ALS, while the other side is working at an equally feverish pace to figure out just how many millions of dollars they can make of the latest breakthrough.

A recent example of this Tale of Two Healthcares was the roaring headlines about the first FDA-approved gene therapy, Kymriah (tisagenlecleucel), for leukemia. The business side of healthcare was ecstatic, pricing the drug at $475,000, which made Wall St. happy, and Novartis (the drug’s maker) ecstatic. The patient side of healthcare? Not so much.

Kymriah is an extreme example of healthcare pricing, but even trying to get a CT scan can turn into a trip down the rabbit hole, if you try to find out before the scan how much it will cost you. Asking “how much?” can seem like shouting down a well the first time you do it – you’ll hear an echo, because the person you’re asking will likely say “how much?” right back, in total shock at the question. However, asking questions is how we get answers, right?

Here are tips for asking “how much is that?” and getting meaningful answers:

  • Find out if your insurer has a cost-estimator tool. If so, use it. For everything required for your care. You’ll need the insurance billing code for the test, scan, or procedure (called the CPT code), so get that from your doctor’s billing office.
  • Use online price-check tools like Clear Health Costs or Fair Health Consumer to reality-check the pricing information you get from your insurer’s cost-estimator tool.
  • When your doctor refers you to a lab for testing, or an imaging center for scans, ask if they know what the cost is. They likely won’t at first, but the more of us who ask the question the more they’ll want to know the answer.
  • Call around to labs and imaging centers in your insurer’s network to ask about their cash price for the test or scan that’s been ordered for you. Depending on the cash price, you might be better off not using your insurance, and actually paying cash for the test or scan. If you have a high-deductible plan, you’ll need to assess which medical services are worth going off-the-books for if you haven’t yet met your annual deductible.

I know a lot about “how much is that?” because I was uninsured for five years after my own cancer treatment ended. I discovered that asking the question got me the answers I needed, and I could choose the providers that could give me a cash price for the mammograms and follow-up oncology services I needed. I’ve continued to use the simple question “how much is that?” every time a doctor has ordered tests or scans, because even with insurance, you’ll wind up with a bill for some part of the service.

If we all work together, asking “how much is that?” before receiving any medical service, we’ll start to shift the system, and the culture of healthcare. It takes a village, not just to raise a child, but also to change a status quo.

It’s your turn. Start asking.