Expecting the Unexpected

Early planning can ease financial and insurance issues.

Betty Garrett advises it’s never too early to start planning for financial and insurance problems. Garrett, founder of CareGivers4Cancer (www.caregivers4cancer.com), a service that assists caregivers and their families, speaks from experience: She cared for her husband, Gene, during his battle with esophageal cancer. 

Finances were not a major concern for her family, Garrett says, but she did find herself having to deal with a frustrating array of insurance issues. In one instance, Medicare paid for home health care when Gene required a feeding tube, only to inexplicably reverse itself and demand that the money be returned. The Garretts appealed, and after documenting that Gene needed the feeding tube to build his strength so he could undergo surgery, Medicare reapproved the payment. Hospital billing issues and conflicting information from Gene’s insurance providers were also common problems. 

“It was never smooth sailing,” Garrett recalls. “Almost every week, something would crop up. There were times when I got so frustrated that I would cry.”

Caring for a loved one who is undergoing treatment for cancer is not easy. It often requires long hours and hard work, all of it made more difficult by the emotional stress that comes with watching a family member go through very grueling times. 

What surprises many cancer patients and caregivers, however, are the financial and insurance issues that often accompany treatment—issues that the caregiver may have to deal with alone while his or her loved one concentrates on getting better. It can be an overwhelming challenge, experts say, but a little advanced planning and a willingness to ask for assistance can help.

Cancer treatment is expensive. And even when private insurance, Medicare or Medicaid is helping cover the costs, patients and their caregivers may still find themselves in financial straits as a result of loss of income and unanticipated expenses, says Catherine Credeur, GSW, OSW-C, a social worker at Louisiana State University Health Sciences Center in Shreveport, La., and volunteer communications director for the Association of Oncology Social Work.

According to Credeur, unanticipated expenses may include medications, especially newer biologic drugs; deductibles for physician and hospital bills; and home health care, as well as travel, lodging and meals if treatment is unavailable locally. In many cases, patients and caregivers may also find themselves paying for housekeeping, yard maintenance and other chores that they handled themselves before illness struck. 

A loss of income may also jeopardize insurance coverage, warns Paul Gada, personal financial planning director for Allsup Inc., which helps individuals and companies navigate Social Security disability and Medicare. “Many times patients and caregivers are forced to stop working, so they lose an income stream,” Gada explains. “As a result, patients may lose their insurance or have to pay for it out of pocket, which can be expensive.”

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