Connect with others who understand.

sign up log in
About MyBCTeam

Medical Bills 'Toxic' for Some Breast Cancer Patients

Posted on October 30, 2018

By Amy Norton, HealthDay Reporter

WEDNESDAY, Oct. 24, 2018 (HealthDay News) -- Many women living with advanced breast cancer face significant financial strains -- from paying for their care to simply covering monthly bills, a new survey finds.

Researchers found that of the more than 1,000 women they surveyed, nearly 70 percent said they were worried about the financial fallout related to their cancer. Many said they'd refused or delayed
treatments, failed to pay non-medical bills, or been contacted by collection agencies.

It all amounts to a "financial toxicity," experts said, that could take a toll on patients' mental and physical well-being.

The costs of cancer go well beyond paying for medical care, said lead researcher Stephanie Wheeler, an associate professor of health policy and management at the University of North Carolina, Chapel Hill.

Patients may have to travel long distances to their cancer center, pay for lodging or arrange for child care or care for elderly parents -- to name just a few expenses.

So, having health insurance is no guaranteed protection, Wheeler said.

In fact, the study found, breast cancer patients with health insurance actually reported more distress over their financial situation, versus those who were uninsured.

It's a surprising finding, Wheeler said. But she speculated on some potential explanations: For one, women with insurance may have been taken off-guard by high out-of-pocket expenses. And some may have had to spend down assets they'd built over years -- which can be "very distressing," Wheeler pointed out.

Caitlin Donovan is a spokesperson for the Patient Advocate Foundation, a nonprofit that offers financial assistance and other services to people with serious chronic diseases.

It was no surprise to her that many women in this study faced financial woes.

"To us, there's no difference between the 'direct' and 'indirect' costs of medical care," Donovan said. "We've found that one of the biggest [financial] concerns people have is transportation."

If you live far from your treatment center, the cost of gas alone can be daunting, Donovan noted.

And even if you live in a city and take the subway, she added, there's the time off from work -- whether it's for the patient or family member -- and possibly additional expenses like child care.

The strain of dealing with all of that can take a toll on patients, both emotionally and physically, Donovan said.

"That's why they call it financial toxicity," she said. "It affects the 'whole' person."

The findings are based on 1,054 U.S. women with metastatic breast cancer -- which means the disease has spread to distant sites in the body, like the bones or brain. Close to half had been living with it for one to two years, while around one-quarter were at the two- to five-year mark.

Overall, the study found, nearly 70 percent of the patients said they were worried about financial problems related to their cancer.


Many women -- 35 percent -- lacked health insurance, and nearly all of those women said they had delayed or refused a treatment. That was true for 41 percent of insured women, the findings showed.

It's not clear what type of care the women put off, or when, Wheeler noted.

"But it's absolutely concerning," she said.

In addition, about three-quarters of uninsured women said they'd been contacted by a collections agency, while 40 percent had skipped paying non-medical bills.

Insured patients also reported those problems, albeit at lower rates. And when it came to the emotional strain from financial worries, they tended to be faring worse than uninsured women.

It's a striking finding, Donovan said. And she agreed that insured patients may be less prepared, mentally, for the financial toll.

"Anecdotally," Donovan said, "patients are often surprised by what their insurance plan doesn't cover."

The picture is not all bleak, Wheeler stressed. "The good news," she said, "is that there are financial resources -- at hospitals, in the community, and even from industry."

She cited the Patient Advocate Foundation as one national group. She suggested, though, that patients "start at the place where they're receiving care."

Large cancer centers will generally have more financial assistance programs, Wheeler noted. But smaller hospitals usually have resources, too -- such as social workers who can help families navigate the financial side of care.

Wheeler did, however, point to a shortcoming: "Many of the resources that exist are limited to uninsured patients. And clearly, patients with insurance need help, too."

Donovan
agreed, and said the "disjointed" nature of the U.S. health care system sets up roadblocks. Many patients either have difficulty accessing the financial services that are out there -- or are not aware of them at all, she added.

SOURCES: Stephanie Wheeler, Ph.D., associate professor, health policy and management, University of North Carolina, Chapel Hill; Caitlin Donovan, director, outreach and public affairs, Patient Advocate Foundation/National Patient Advocate Foundation, Washington, D.C.; Sept. 29, 2018 presentation, American Society of Clinical Oncology Quality Care Symposium, Phoenix


Copyright © 2018 All rights reserved.

Here are some Q+A threads from MyBCTeam about medical bills:

Where can I find low-cost lymphedema sleeves? I am having a terrible time with pain and swelling in my arm, but my insurance won't cover the cost of the sleeve.

Agendia just sent an $8100 bill to me for my Mammaprint. This is quite a shock! It seems my PPO insurance which paid for every other aspect of my DX, Surgery, and radiation has denied the claim. Any advice?

What to do when your doctor prescribes a medication and your insurance company denies you access to that particular drug?

Here are some conversations about medical bills from MyBCTeam:

"Unfortunately I found out the insurance company denied my nipple tattoos. At first, they said it was because it was cosmetic, which I contested. Then they came back, that I have used up the maximum benefits for this occurrence. How do you limit benefits with so many variables? I am beyond upset."

"Haven't been online in a while. Between the move and my medical insurance issues, it has been stressful. I can't seem to catch a break."

"My insurance is gone and now I will be seeing into another way to pay for my follow-ups and blood work. Never thought this would be my new reality... This is a downer."

Have you ever delayed treatment due to costs?
Share in the comments below or directly on MyBCTeam.

A MyBCTeam Member said:

I totally agree with this. Most people think that individuals with insurance have no issues paying their bills. That's very untrue.

posted 4 months ago

hug

Recent articles

Coronavirus
Article written by Kelly Crumrin According to Harvard Medical School, those of us living with...

Canceling Is Kindness: Keeping Safe From COVID-19 With Breast Cancer

Article written by Kelly Crumrin According to Harvard Medical School, those of us living with...
Setting intentions for 2020 with breast cancer
Eat healthier. Exercise more. Learn a new skill. Pay off a credit card. Many of us have made...

Setting Intentions for 2020 With Breast Cancer

Eat healthier. Exercise more. Learn a new skill. Pay off a credit card. Many of us have made...
Practicing gratitude with breast cancer
This time of the year can be overwhelming with expectations around the holidays, and living with...

Practicing Gratitude With Breast Cancer

This time of the year can be overwhelming with expectations around the holidays, and living with...
How to enjoy the holidays despite breast cancer
Living with breast cancer may change your holidays, but you can still have enjoyable and...

How to Enjoy the Holidays Despite Breast Cancer

Living with breast cancer may change your holidays, but you can still have enjoyable and...
Mht af justdiagnosed olderwoman
We all respond differently to information about our health. After learning you have breast...

You’ve Just Been Diagnosed With Breast Cancer. Now What?

We all respond differently to information about our health. After learning you have breast...
Angelo pantazis h0angggseio unsplash
Swimming can be great exercise following a mastectomy or lumpectomy, but returning to the pool...

Swimming After Breast Cancer Surgery

Swimming can be great exercise following a mastectomy or lumpectomy, but returning to the pool...
Eyelashes  eyebrows  and breast cancer
Losing eyelashes and eyebrows to breast cancer treatment can be an emotional blow for women on...

Eyelashes, Eyebrows, and Breast Cancer

Losing eyelashes and eyebrows to breast cancer treatment can be an emotional blow for women on...
Lymphedema %28swelling%29 after breast cancer treatment
If your lymph nodes were removed during breast cancer surgery or damaged during radiation...

Lymphedema (Swelling) After Breast Cancer Treatment

If your lymph nodes were removed during breast cancer surgery or damaged during radiation...
How good boundaries make life with breast cancer easier
There is an old saying: “Good fences make good neighbors.” Having healthy boundaries in...

How Good Boundaries Make Life With Breast Cancer Easier

There is an old saying: “Good fences make good neighbors.” Having healthy boundaries in...
Mht af saying thinking 2
Living with breast cancer can mean having limited energy, time, and bandwidth. You may find...

Tap Into the Power of Directness: Use "I"

Living with breast cancer can mean having limited energy, time, and bandwidth. You may find...
MyBCTeam My breast cancer Team

Get the latest articles about breast cancer sent to your inbox.

Not now, thanks

Privacy policy
MyBCTeam My breast cancer Team

Thank you for signing up.

close