Covering Out-of-Pocket Expenses

While health insurance will pay a portion of many medical costs, it will not cover all of them.

Families may face new expenses such as transportation to and from treatment, temporary housing and other needs.

Social workers at the cancer center can advocate for families and refer them to resources that can help them with these extra costs.

A graphic of hands holding a sheet of paper that says Health Insurance at the top, with one of the hands holding a pencil.

Charity Care

Non-profit hospitals are required by the Affordable Care Act (ACA) to provide a certain amount of care at a discount or free of charge to patients in need. Every hospital that offers charity care must post a notice in the emergency room and admissions areas.

Hospitals must also provide information to patients when they are admitted, discharged, and on every billing statement. Even if someone has health insurance, charity care may cover high deductibles or co-pays. If a child receives care at a non-profit hospital, ask a hospital social worker or billing office for details.

Negotiate a Better Price

Sometimes people can lower their bills by negotiating with the hospital’s billing staff. Be assertive. If the staff member won’t negotiate, politely ask to speak with a supervisor or the provider’s business manager. If this individual denies the request, ask who has the final say within the office. Politely ask to speak with that person.

Ways to receive a lower or modified bill include:

Paying the whole bill up front
Inquiring about a payment assistance program
Agreeing to an extended payment plan
Asking out-of-network providers to charge an in-network price. The insurance network is the group of doctors, hospitals, pharmacies, and other health care providers that the insurance company contracts with to provide services.

To lower the amount paid for drugs, ask if there is a generic version of the same drug. If a generic is not available, discuss with the provider if there is a lower-priced drug that will work equally well.

Most drug companies have assistance programs that help pay some or all of the cost for patients in need. Search for the contact information for the patient assistance department of the manufacturer. Make a call to request a discount.

Assistance Programs

You may need to buy insurance through the state or federal marketplace, a service that helps people shop for and enroll in affordable health insurance. Assistance programs may help lower the cost of premiums paid each month to the insurance company. If a family qualifies for assistance, subsidies will automatically be applied to the insurance premium.

Within the state or federal marketplace, certain health plans offer cost-sharing reductions. These plans lower the amount paid each time a participant receives care. To qualify for these reductions, a family must enroll in specific plans.

Tax Savings Programs

Many employers offer pre-tax savings programs such as health care flexible spending accounts (FSA) to help defray medical costs. Pre-tax accounts save money by using pretax dollars to pay for certain medical expenses. When money comes out of a paycheck on a pretax basis, the total income taxed is lower, decreasing overall tax payments.

An HSA is a medical savings account available to taxpayers in the United States who are enrolled in a high-deductible health plan (HDHP). The funds contributed to an account are not subject to federal income tax at the time of deposit.

HSA funds may be used to pay for qualified health care expenses such as co-payments and deductibles. HSA funds do not expire. If the money is not spent, it rolls over to the next year. Dollars saved can be invested in an interest-bearing account to use for qualified medical expenses.
FSAs are an employee benefit that allows employees to put pre-tax dollars in an account to use for qualified out-of-pocket healthcare expenses. Because employees don’t pay taxes on the money, they save an amount equal to the taxes that would have paid on the money in the account. Not all employers offer the benefit.

The process begins by estimating the family health expenses for the year. The employee decides how much money to save in their FSA up to the employer’s annual FSA limit. Money is evenly taken out of each paycheck. The money may be accessed through a debit card or by completing an expense report.

Housing and Meal Expenses

Cancer care may require a move away from home to be closer to the treatment center. Lodging options will vary depending on the city where treatment takes place. Social work staff at the hospital may help find lodging that is close to the treatment facility.

Some hospitals have short-term housing options available for families on site. Placements are usually based on length of stay, medical needs and availability. Some facilities provide meal assistance through gift cards that can be used at hospital cafeterias, grocery stores, and other approved locations.

As each treatment facility is different, contact a social worker at the treatment facility for questions about housing needs and meals.

Additional housing resources include:

Ronald McDonald House Charities – For families of seriously ill children, these charities offer free or discounted lodging options at nearby hospitals.
Healthcare Hospitality Network – This housing collective brings together more than 200 nonprofit organizations for families receiving medical treatment away from home.
Joe's House – This online service helps cancer patients and their families identify housing options close to treatment centers.

Hotels near medical facilities may offer patient discounts. Inquire when making reservations.

Travel Costs

Travel expenses can add up quickly. Gas, parking, and time spent away from work can put a financial burden on families.

Air travel resources include:

Air Care Alliance – This organization provides a list of free transportation services offered by more than 60 volunteer pilots and charitable aviation groups.
Air Charity Network – This network offers access to free air transportation for individuals traveling to specialized health care facilities.
Along Comes Hope® – This group provides financial assistance to families getting to and from treatment, including airfare, lodging, and gas.
Angel Airline Samaritans – This organization negotiates no-cost or reduced-rate commercial airline tickets for needy cancer patients and their families.
Corporate Angel Network – This network pairs empty seats on private planes and corporate jets to transport cancer patients to the hospital at no cost.
LifeLine Pilots – This group donates time and flight expenses to people in need of free transportation for ongoing treatment, diagnosis, and follow-up care.
Mercy Medical Angels – This organization flies patients to treatment either for free or at a deep discount.
PALS (Patient AirLift Services) – This service arranges free air transportation in the Northeast for people with chronic illnesses at no cost.

Local travel assistance programs include:

Mercy Medical Angels – This group provides ground-based long-distance and local travel assistance, including gas cards, bus and Amtrak tickets, either for free or at a deep discount.
Road to Recovery – This organization provides transportation for cancer patients.

Some hospitals partner with taxi or ride-sharing companies like Uber and Lyft to facilitate transportation to and from treatment. Ask a hospital social worker if there are any partnerships in your area. There may be a community transportation solution like ChemoCars, based in Charlotte, North Carolina.

Assistance from Service and Faith Organizations

A number of service organizations help families facing the financial burden of pediatric cancer.

National service organizations include:

Cancer Financial Assistance Coalition – This coalition provides a searchable database of national organizations that offer financial assistance to families and patients.
CancerCare® – This organization offers free, professional support services and information to help people manage the practical and financial challenges of cancer. It provides limited financial assistance.
HealthWell Foundation – This foundation assists patients and families in navigating the cost of prescription co-payments, health insurance premiums, deductibles and coinsurance, treatment, and travel costs.
Leukemia & Lymphoma Society – This organization helps patients with significant financial needs who have been diagnosed with a blood cancer.
National Foundation for Transplants – This foundation provides trained fundraising consultants to help with transplant expenses.

Some local organizations offer grants to help cover the cost of treatment and other expenses. Others focus assistance on specific services or products, such as travel or medications. Organizations to contact include Catholic Charities, Jewish Social Services, the Lions Club, Lutheran Social Services, and the Salvation Army.

Other local resources to consider include:

The Department of Social Services in your city or county may provide help with services such as food, housing and, in some cases, direct financial assistance. Check online for contact information.
Faith and community-based groups, such as lodges, churches, synagogues, and mosques, may also provide assistance.

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Together does not endorse any branded product mentioned in this article.

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Reviewed: June 2018