Battling cancer’s financial ruin

Ten years ago, Scott Lazerson took three months off from his job as an independent media strategist — but not for a sabbatical or vacation. He had stage three testicular cancer, and he was so ill after he started his second round of chemotherapy that he simply couldn’t work.

“I think I was in bed most of the time,” said Lazerson, now 44, who lives in Utah in the US. “I was just so, so sick.”

Although Lazerson applied for Social Security disability benefits (available as a stop-gap support measure from the US government) to help cover his missing income, he never received any — Social Security disability doesn’t kick in until the sixth full month of disability, and as the owner of his own PR firm, Lazerson didn’t have an individual disability insurance policy (or access to employer-sponsored benefits).  

His wife was able to do some consulting to cover their major bills, and they received some financial assistance from family and a former employer who graciously paid their mortgage for three months.

“We had to cut back on everything, and we were truly in survival mode,” Lazerson said.

Lazerson isn’t alone. A surprising number of cancer patients don’t receive any employer-funded or government support during a medical crisis — either because their employer doesn’t offer it, they didn’t opt into it or they don’t qualify. Those that do might only receive a fraction of their typical salary.

In the US, 30% of middle-income cancer survivors racked up $10,000 or more in debt, according to a study by the Washington National Institute for Wellness Solutions. And people diagnosed with cancer are more than 2.5 times more likely to experience bankruptcy, according to another study from the Public Health Sciences Division in the US. In the UK, cancer patients on the whole owe as much as £2.8million ($4.38 million) in overdue payments to providers, according to Macmillan Cancer Support.

Getting through cancer treatment is difficult enough, without the additional financial burden. Here are some ways to minimise the damage.

What it will take: You’ll need fortitude and discipline to manage what may be a decrease in income at a time when your medical expenses are climbing. 

How long you need to prepare: Most people aren’t prepared for cancer before they’re diagnosed — with the exception of those who’ve built up an emergency fund. From the moment you’ve been diagnosed, you’ll want to start reducing expenses and putting as much money away as possible, in case you have to take an unpaid or reduced-pay leave from work.

Do it now: Understand your health insurance. Your medical coverage — particularly in the US — will often dictate how much of your costs for care will be out of pocket. Find out how your plan deals with prescription drugs, home care, experimental cancer therapy and counselling. If you don’t understand something, call your insurer or the government body that administers insurance, such as your province or territory’s health ministry in Canada, and keep track of dates, times and contacts for each conversation. Knowing how your policy handles certain expenses will help you make choices that can keep costs down — such as using in-network providers whenever possible.

See what benefits are available to you. In Canada, there is a federal program called Employment Insurance (EI) Sickness Benefits. “That is for individuals who are unable to work because of sickness, injury or quarantine, and provides 15 weeks of benefits,” said Gabriel Miller, director of public issues at the Canadian Cancer Society. After 15 weeks, there are social-assistance programs available through provinces.

In the US, find out from your human resources department whether you have short-term or long-term disability insurance, which replaces 60% to 70% of your income.

“Keep in mind that it can hurt you to put off going on short-term disability,” said Katherine Sharpe, senior vice president of cancer control patient support and survivorship for the American Cancer Society. “Some people have had to go to great lengths to prove that they can’t do their job after they’ve spent weeks forcing themselves to go to work when they could barely get out of bed.” You might also be eligible for Social Security disability income, although qualifying can be tough, and benefits don’t start until your sixth calendar month of disability.

In Australia, you may be entitled to Centrelink payments (Social Security) while you are unable to work for an extended period and not receiving any income. You may also have an income-protection insurance policy attached to your superannuation, or retirement fund. “There is a waiting period before income-protection insurance payments are made, and they are typically paid as a percentage of your usual salary,” said Annie Miller, manager of practical support for the Cancer Council NSW in Australia.

Cut back — on everything. If your income has decreased, every dollar matters. Let go of your premium cable channels, and contact creditors and utility companies if payments are going to be an issue. Keep in mind that some costs may increase due to treatment or illness — you may have to crank up the heat to deal with chills or add some expensive foods to your diet.

Seek financial guidance. “Do not wait until you are in deep financial crisis before seeking advice and help regarding your financial matters,” said Annie Miller. “Financial counsellors can act as an advocate requesting mortgages to be frozen or to arrange extended credit card repayment plans.”

Ask about a flexible work plan. Depending on your employer and occupation, you may be able to fashion an arrangement that still allows you to work, even part time. Telecommuting or working more flexible hours might help, as could scheduling medical treatments late in the day or before the weekend, so you have time to recuperate before you have to hit your desk again.

Do it later: Keep track of your expenses. In the US, for instance, you can deduct medical expenses on your taxes once they exceed 10% of your adjusted gross income. That includes payments for prescription medications, appointments, tests and even transportation if it’s primarily for medical care.

Do it smarter: Don’t be shy about asking for aid. “Most families find it hard to turn to others, or to public agencies and outside groups for financial help,” Sharpe said. “The extra expenses of cancer may be the first time a family has had problems with money. Families should remember that their problems in this situation are often short-lived and not unique.”

You can also find a wealth of information and support at cancer societies and associations in your area.