What is financial toxicity?
Financial toxicity or financial distress, as it is sometimes referred to, is a result of the financial burden of out-of pocket expenses incurred for medical care that is not covered by your health insurance.
Examples of these costs include:
Deductibles: The amount you are responsible to pay for care before your health insurance plan begins payment.
Co-insurance: The percentage of the cost you pay after your deductible has been met. Ex. Insurance policy covers 80% of cost and you are responsible for the remaining 20%.
Co-Payments: The amount you pay for each doctor’s visit or prescription.
Cancer research has made remarkable strides, yielding new, sophisticated technologies and treatments resulting in improved patient outcomes. However, progress has not come without a cost. As costs increase, the health insurers have shifted some of the burden to patients resulting in higher deductibles and increases in coinsurance and co-payments, all of which are out-of –pocket expenses.
Despite having insurance, many of the out-of-pocket expenses of treatment are significant and people are finding themselves “underinsured”. Several studies have described a variety of strategies patients have adopted to minimize the impact of the out -of -pocket costs of their treatment.
The research shows that the majority of “underinsured” patients altered their life styles in an attempt to afford prescription medications. Some subjects took less than the prescribed amount while others didn’t fill the prescription at all. A large percentage of the study population reduced spending on food and clothing or used their savings in order to meet out- of -pocket demands. A smaller percentage sold property or possessions to defray the cost of their treatment. More research is needed to determine what effect such strategies are having on quality of life and treatment outcomes.
Will you be affected by financial toxicity? The following factors may help you determine your risk.
- The costs related to your care
- The amount of debt you currently carry
- Your assets
- If you are the primary income earner
- Your treatment’s affect on your ability to work
- The breadth of your insurance coverage
- The type of cancer you have been diagnosed with and its severity
One of the first recommendations I make is for clients to assess the assets they have. As a private medical advocate, I have at my disposal a network of vetted professionals and resources to assist clients who are experiencing the very real side affect of financial toxicity.
One such partner is Tracy Shen of The Florin Group. www.floringroup.com
Tracy has been able to review a client’s current portfolio and identify small adjustments that, if made, would yield an increase in their cash flow blunting the impact of out- of- pocket expenses associated with their care.
In addition to consulting your financial planner, you also want to schedule a review with your insurance agent. Depending on your diagnosis and current situation you may be eligible to access cash from an existing policy without penalty.
Additional financial support resources include but are not limited to:
- Co-Payment assistance programs, such as, Cancer Care Inc. Financial Assistance
- Cancer Support Community – coping with out-of-pocket expenses https://www.cancersupportcommunity.org/living-cancer-resources
- Cancer Financial Assistance Coalition, https://www.cancerfac.org/
- Crowdfunding platforms such as YouCaring http://www.giveforward.com/
If you find you are suffering the very real side affect of financial toxicity due to a cancer treatment give me a call to see how I can help. 703-403-7600 or email me at mailto:firstname.lastname@example.org