LLS is part of the Cancer Financial Assistance Coalition (C-FAC), which helps cancer patients manage their financial challenges by:
- Helping members communicate and collaborate
- Educating patients and providers about resources and links to other organizations that provide information about C-FAC's resources
- Advocating for cancer patients regarding the financial burdens of cancer care
Help for Prescription Drug Costs
For people with cancer, medication coverage can also become quite costly, and a prescription drug plan, if you have one, may not cover all costs for the drugs you need.
Insurance companies, states and hospitals all have their own “formulary” — a list of prescription drugs they approve for coverage. A formulary typically includes procedures that enable access to nonformulary drugs when they're documented as medically necessary. A plan sponsor must have a process in place to grant exceptions. If the plan denies an exception, you can appeal the decision through an established process. You may also be able to negotiate with your insurance company to get a particular drug added to its formulary.
If you don't have adequate insurance to cover the cost of your prescription drugs, talk with your doctor or social worker about how to finance treatment and explore the following resources that may be able to help with your expenses:
- Co-pay assistance programs and foundations, such as the LLS Co-pay Assistance Program, help pay costs for prescription drug insurance plan premiums or co-pay obligations for specific diseases. LLS also provides information about other co-pay assistance programs. Call (877) LLS-COPAY (877-557-2672).
- Patient assistance or prescription assistance programs, sponsored by major pharmaceutical manufacturers, provide free or reduced-cost drugs if you can't afford them. Visit RxAssist for a directory of patient prescription assistance programs and information on obtaining affordable or free drugs.
- Prescription savings programs, such as Together Rx Access, often offer a free prescription savings card if you're not eligible for Medicare, don't have prescription drug coverage and meet certain household income levels. Most cardholders save between 25 and 40 percent on more than 300 brand-name prescription products.
- State programs such as the National Association of Counties provide ways to cut drug costs.
- Clinical trials for promising cancer drug therapies may offer free or reduced cost prescriptions. Check with your healthcare provider, insurance representative or study contact. Coverage varies significantly depending on the health plan and clinical trial. You may be able to gain access to investigational drugs through "Expanded Access" or "Special Exception/Compassionate Exemption" programs, sometimes offered by drug companies.
- The Partnership for Prescription Assistance (PPA) brings pharmaceutical companies, doctors, other healthcare providers and patient advocacy and community groups together to help eligible patients who don't have prescription drug coverage get their medicines for little or no cost. The partnership offers access to many public and private patient assistance programs, including programs offered by pharmaceutical companies.
- NeedyMeds is a central source of information for people who can't afford medicine or other healthcare expenses. Programs such as assistance for specific diseases and conditions, application assistance, state-sponsored programs and Medicaid sites are available.
- PhRMA (Pharmaceutical Research and Manufacturers of America) maintains a directory of patient assistance programs for prescription drugs. Through these programs, PhRMA member companies supply free medicines to millions of eligible low-income patients. Call (800) 762-4636.
- Medicare has information about public and private programs that offer discounted or free medications as well as Medicare health plans that include prescription coverage.
Help for Stem Cell Transplantation Costs
Stem cell transplantation is expensive and may not be fully covered by health insurance. In addition to treatment cost, you may have significant expenses for travel, lodging, meals, childcare, donor testing and aftercare. You may need to use multiple strategies to secure enough funding to cover these costs, such as:
- Working closely with the transplant center to obtain maximum reimbursement from your insurance company
- Negotiating with healthcare providers to reduce or waive medical fees or adjust the payment schedule in cases of financial hardship
- Applying for grants and financial aid from employers, labor unions, community service agencies, religious and fraternal groups or cancer support organizations
- Forming a committee of volunteers to conduct fundraising events, sales, raffles, canister collections and letter-writing and publicity campaigns
- Cashing in on benefits from life insurance policies through "viatical settlements" (selling a life insurance policy at a discount to someone else who will collect the face value when the policyholder dies) or accelerated benefits, which can provide cash payouts to seriously ill policyholders — but be sure to discuss this strategy with a financial adviser first
These nonprofit organizations provide information, support, financial support services and patient advocacy for transplant candidates, recipients and their families:
- Blood & Marrow Transplant Information Network (BMT InfoNet), (888) 597-7674
- National Foundation for Transplants, (800) 489-3863
- National Marrow Donor Program, (888) 999-6743
ExploreBMT, (888) 999-6743
- Download or order The Leukemia & Lymphoma Society's free booklet, Cancer and Your Finances
- Contact an LLS Information Specialist for more information