When I was diagnosed with cancer I only had a small, independent health insurance policy. I paid $40 a month for what is called “catastrophic insurance”. This means it only kicks in if something really catastrophic happens, like a car accident or – in my case – cancer. I still have this policy, its called “Basic Blue” from Blue Cross Blue Shield of Illinois.
I’m not uninsured, but I am underinsured. My health insurance covered a good deal of the chemotherapy treatments I went through, but not everything. The 7 doctors I went to see and dozens of tests I took before I was officially diagnosed, for example, were not covered. The surgery required to biopsy the tumor was not covered, nor the surgery required to take the medi-port out two years later. While my health insurance covered hundreds of thousands of medical costs in chemotherapy, there were tens of thousands of dollars of medical bills I was left responsible for and I couldn’t afford.
Nevertheless – having cancer didn’t cost me as much as you might think. Here I am a few years later, and I don’t have any cancer-related bills left. I probably paid somewhere between $5,000 and $10,000 over the past few years. Maybe that still sounds like a lot, but its much less than the nearly $350,000 it cost to get through cancer. So how did I do this?
I applied for financial aid at my hospitals. Most hospitals require a certain amount of their budget to go toward charity cases. That is, hospitals sometimes provide care for free to patients that cannot afford healthcare. I don’t advocate exploiting hospitals for free care – but if you would die without it, and would go bankrupt paying for it, you are a good candidate for these programs.
I was one such good candidate. When I was diagnosed I was out of luck. I’d just come back from the ship and I hadn’t found my next job yet. I had crappy insurance, a life-threatening disease that left me unable to work, and a mounting stack of bills. I was in a bad situation. I applied at my hospital and they gave me 100% financial aid. It ended up being tens of thousands of dollars of charity aid over the course of 2 years. It saved me from complete financial ruin.
To apply for financial aid through your hospital, find the financial services office. It might go by a different name – the business office, the patient financial services department, etc. Tell them that you would like to apply for financial aid. Remember, it is for people like you that this department even exists, so don’t be shy.
They will have you fill out an application. It will probably include questions about your average monthly income and expenses, your total savings, your total debt and your diagnosis. You will most likely have to submit your previous year’s tax return. If your income has changed significantly since your last tax return, you will need to provide pay stubs or other proof of your income. Remember to include a cover letter with a personal statement.
If you are unable to pay for your hospital bill and your hospital refuses to help you financially, go to a different hospital. There were two hospitals in my hometown and one was infinitely more helpful than the other.
It will likely take weeks to months for your application to go through. You are not required to pay any part of your hospital bill until the financial aid office has reviewed your aid application and made a decision on what you are to pay.
Go to the hospital and not the doctor’s office. Doctors do not give discounts. I’ve heard advice about paying doctors cash for a discount, but my experience is that this is an unreliable way to lower your medical bills. I was helped by perhaps 15 doctors during my battle with cancer, and I wrote letters to each one of them explaining that I was under-insured and could they please give me a discounted price for cash. Only two doctors agreed. I paid the rest full price.
(I do want to single out my cardio-thoracic surgeon who not only helped save my life, but also never sent me a bill for it because she knew I didn’t have insurance that would pay for it. She is an angel.)
And I can’t say I blame the doctors entirely. In many states the cost of malpractice insurance has sky-rocketed and has started to choke doctor’s budgets. 20 years ago it was the doctors that were raking in the profit, but now that profit margin has shifted to the insurance and pharmaceutical companies. It seems to me that many doctors offices are having trouble adjusting to that shift and they are feeling squeezed. And consequently, 13 times out of 15, they’re not going to cut you a break on your bill.
Moral of the story – if you have a procedure, like your chemotherapy sessions, that you can do either at the hospital or at the doctor’s office, always do it at the hospital, and always apply for financial aid.
These were the main two methods that I was able to get through cancer without proper, affordable health insurance. There are still other ways. In my case, there was the Leukemia and Lymphoma Society, an organization that gives grants to leukemia and lymphoma patients to help pay for medications and even gas to and from chemotherapy sessions.
I was very lucky to be surrounded by a kind and generous community. Two theatre companies and my old high school organized benefits on my behalf. Together they raised over $10,000 toward my medical costs – and believe me, I needed every penny of it to pay my doctors. I can’t tell you what a relief it was to have this support.
I will say, though, at first I was embarrassed to have others organize a benefit for me. But my friends were all good natured about it, nicknaming the event “The Save-the-Dave Show” or “Dave-a-pa-looza”. In the end I found that everyone understood the unfair burden that medical bills put on the underinsured and they were happy to have a way to help.
Remember to apply for financial aid, and always go to the hospital and not the doctor’s office whenever possible. Good luck.
Recent Comments