By Lisa Seachrist Chiu

Paying for Cancer

There’s no magic solution to the insurance problems that plague cancer survivors, but a patchwork of aid may help

By Lisa Seachrist Chiu

Roseanne Nabhan hopped out of the shower in April 2007 and found herself facing a nightmare many women fear: She felt a lump in her breast.

The Indiana waitress and bartender was 47 years old when she learned her lump was not a typical breast cancer but a sarcoma—a cancer that begins in the body’s connective or supportive tissues, such as muscle, fat or fibrous tissue. “I was panicked trying to figure out how I was going to live,” she says.

Radiation and a lumpectomy drove her cancer into remission, but Nabhan’s worries quickly turned to her finances. Her health insurance plan, for which she pays about $100 a month, covers only $2,000 for radiology services per diagnosis and $160 for diagnostic tests. During her care, she racked up roughly $60,000 in medical bills, of which her insurance covered about $3,000.

“I never knew cancer treatment involved so many tests, scans and treatments,” Nabhan says. She still owes approximately $20,000 for her care and pays $550 a month to eliminate the debt.

Nabhan’s story, which is outlined in a February report by the Kaiser Family Foundation and the American Cancer Society, has an increasingly familiar ring to cancer patients across the U.S. who struggle with obtaining or maintaining adequate, affordable health insurance coverage. The report, Spending to Survive, documents insurance pitfalls for cancer patients, such as caps on benefits, high cost-sharing, difficulty staying in an employer-sponsored health plan, trouble obtaining coverage in the individual market, the high costs of “high-risk” insurance pools, and waiting periods and eligibility restrictions for public programs.

“When we think about access to health care, we tend to focus on the uninsured,” says Karyn Schwartz, a senior health policy analyst at the Kaiser Family Foundation, who is one of the co-authors of the report. “This report really illustrates all the problems and challenges cancer patients can face even when they do have insurance.”

That’s not to say that cancer patients who find themselves facing significant medical bills and difficulty keeping insurance have no recourse. While far from perfect, advocacy organizations, co-pay assistance programs and other public and private assistance programs do help patients manage the cost of cancer care. Such aid, however, needs to be knitted together on a case-by-case basis.