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.

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.

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:

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:

Local travel assistance programs include:

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.

Assistance from service and faith organizations

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

National service organizations include:

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.