Chemotherapy treatment costs vary depending on a number of factors:
- The kind of chemotherapy drugs used
- The drug dosage
- How long it takes to receive a treatment
- Treatment frequency
- Where treatment is administered
Since the cost of chemo differs depending on the type of drug you take and how often you are treated, it’s crucial to make sure all of your financial questions are addressed.
Be sure to ask your doctor about all treatment options, not just those covered by your insurance plan. It’s possible that the treatment that’s best for you may be overlooked due to its restrictive formulary status. Although many health insurance policies do not cover the full cost of chemo, there are organizations that may be able to provide financial assistance or otherwise assist you in obtaining the treatment prescribed. Talk to your nurse or social worker to find out more about these types of organizations.
Although money may be the last thing on your mind at a time like this, you should know your options for paying for chemotherapy. Don’t worry—help is out there. In addition to this site, the AstraZeneca Cancer Support Network and the ARC of Support can give you helpful information on health coverage and paying for treatment for certain AstraZeneca and Abraxis Oncology breast cancer treatments.
Clinical trial insurance coverage
While a new cancer treatment is being studied, you may be eligible to participate in a clinical trial involving that new treatment. Various clinical trials offer to cover part of your treatment cost. Not all health insurers will cover the costs associated with clinical trials, so discuss options with your doctor. Consider the following when taking part in or contemplating a clinical trial:
- Ask your doctor about other patients in the trial and how their insurance dealt with the costs. Did their insurers pay for the treatment? Did they run into any problems regarding treatment costs?
- Have your doctor go over the insurance paperwork with you. The way he or she explains the treatment to the insurance company may affect the company’s decision about insurance coverage
- Examine your insurance policy for any exclusions, specifically for “experimental treatment”
It’s likely your insurance company doesn’t have a specific policy about clinical trials, but rather handles new treatments on a case-by-case basis. Ask your nurse or social worker to discuss the matter with your insurance company.
Medicaid—health care coverage for those in financial need—is available in some states to help pay for certain treatments. Contact your state’s social services department to see if you qualify for Medicaid and whether chemo is covered in its plan.
Using your insurance policy to your advantage
- Find out exactly what your health insurance covers before you begin chemo treatment
- Record all of your covered expenses and claims
- File all of your covered claims right away
- If you’re unsure of how to file a claim, ask a friend, family member, or social worker to help
- If your claim is rejected, contact your insurance company to find out its reasoning. Have your doctor contact your insurance company to explain why your services meet its policy. File your claim again, and, if you are turned down a second time, see if you can appeal the decision
Address your health insurance issues with confidence. It’s not always easy to get your questions answered, but be persistent. Don’t give up until you get the information you need. See a list of possible questions to ask your insurance company regarding treatment coverage.