Cancer Truth Note: #50
Cancer is expensive. Financial toxicity is real.
The No Surprises Act was passed federally in 2020 and the law went into effect on January 1, 2022. If you have been to a doctor lately you will probably see a paragraph on the back of any medical bill explaining what surprise billing is and that it is no longer allowed under this law. While “surprise” billing, also called balance billing, is now illegal, charging high prices for newer (anything younger than 10 years old falls in this category) targeted therapies and chemotherapies used in cancer treatment is an accepted practice. Having insurance helps to reduce costs for the patient, but that depends on the insurance companies’ agreements and the plan that you have.
When I was diagnosed, I had an ACA plan. It was a silver plan with reasonable copays. It was early in the ACA history; my monthly cost was $287. For a plan close to what I had the monthly premium is $342 and the out-of-pocket maximum is $3000 more than the plan I had. This does not include prescription coverage which I also had.
My bills in the first seven months of treatment exceeded $300k. Because I had good insurance coverage, my total out of pocket costs were just under $9k. That included my premiums for the entire year and my maximum out of pocket costs.
Because I had a significant other helping with the household bills, I was able to keep my head above water and pay for everything. No one ever talked to me about options that might be available. Today that number would be closer to $12K for someone with similar coverage to what I had.
With approximately 63% of Americans living paycheck to paycheck, financial toxicity is real. Have you or someone you know been impacted by medical debt?
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