Renal Cell Carcinoma
The financial aspect of renal cell carcinoma (RCC) treatment and care can have a great impact on your overall health, happiness and well-being, so it deserves significant attention. Understanding the costs involved is the first step. When you know what to expect during your treatment and recovery, you can plan your budget and determine what kind of financial assistance you may need. Costs related to RCC vary from person to person, primarily according to the specific subtype, recommended treatment plan, follow-up care and level of insurance coverage.
Estimating expenses and income
RCC-related costs affect your household budget in two ways. First, you will have new categories of expenses, such as office and/or clinic visits, treatments, drugs and caregiving. Second, your routine living expenses will increase because of new necessities related to your care, such as transportation and travel-related expenses, child or elder care, meal preparation, housecleaning services, and employment, legal and financial services.
These additional expenses have a substantial effect on their own, but the effect is often greater because at the same time, your income may be reduced when you or your significant other is unable to work the same number of hours during your treatment.
Take control early by listing your sources of income as well as your medical expenses, both actual and estimated. Next, create a budget that accounts for your medical expenses and for decreases in income due to less time working. Reviewing the differences between the two totals will help you make better estimates for future months.
Managing RCC-related paperwork
Most patients find that managing the financial paperwork related to RCC is a challenge they are not ready for. But well-organized paperwork is the key to following up on insurance matters, seeking financial assistance, and finding documents at tax time. Your RCC-related paperwork should include a variety of important records and documents, including statements and bills from health care providers, insurance papers, receipts for cancer care, medical reports, health care contact information, legal documents and life/household instructions. You will notice that some of these documents are not related to finances, but they all should be part of your RCC-related paperwork because they are integral to handling financial matters.
Handling insurance matters
Many people with RCC have health insurance, but it is unlikely that any plan will protect you from all of the costs related to your cancer. If you are currently covered, make sure you know what services your plan covers and what your out-of-pocket financial responsibilities are. If you do not have insurance, you should get coverage as soon as possible. Under the new Patient Protection and Affordable Care Act, plans in each state make health coverage available to people who have been denied coverage because of a pre-existing condition (such as cancer) and have been uninsured for at least six months. If you have Medicare, learn about your coverage by reviewing the most recent version of the Medicare and You handbook. Several programs are described in the handbook, including the Extra Help Paying for Medicare Prescription Drug Coverage (Part D), which can help you with such costs as monthly premiums, annual deductibles and prescription co-pays.
When choosing a treatment plan, your priority should be effectiveness. However, you must also balance that with cost, so talk to your health care team about alternative treatment options that may be less expensive but just as effective. Choose the treatment with the most likelihood of positive results, and then focus on getting assistance.
Many people can help you handle financial and insurance matters. Doctors’ offices typically have a billing person; the cancer care team usually includes a social worker; most medical facilities have financial counselors on staff; and many medical facilities have patient navigators. Among the ways these people can help are the following:
Answer questions about your medical bills
Estimate the cost of your RCC treatment and tell you if the cost might exceed any coverage limit in your health insurance, so you can plan for the extra expense
Set up a payment arrangement with terms you can afford
Help you with insurance claims and appeals
Refer you to financial assistance organizations if you have difficulty paying expenses not covered by insurance
Learning about health care-related federal laws and programs
As you begin your search for financial assistance, make sure you learn about federal laws and programs that offer benefits, protect from loss of health insurance, and guard against discrimination on the basis of your health. The laws and programs that follow provide only highlights of the most important information for people with cancer. For more details, refer to the contact information inside the box above.
American with Disabilities Act (ADA)
This act mandates that all employees (and their spouses and dependents), regardless of medical condition or medical history, must be treated equally, especially in terms of the benefits offered to them.
Family and Medical Leave Act (FMLA)
The FMLA requires that employers (with at least 50 employees) provide up to 12 weeks of unpaid, job-protected leave to eligible employees for certain family and medical reasons, which include cancer. The law also requires that the employer maintain the same terms of the employee’s health insurance benefits for the duration of the covered leave.
Social Security Disability Benefits
In some instances, people with cancer may be entitled to Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. The primary eligibility requirement is disease that is severe enough to prevent you from performing “substantial gainful activity.” It is recommended that you have a qualified Social Security attorney or advocate help you with the application and potential appeal process.
More information on federal laws