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Financial assistance for lung cancer: Options available

There are a range of financial assistance options to help people cover treatment costs. These options include federal and state health insurance, payment assistance programs, and disease funds or grants from charities and organizations.

This article looks at what costs health insurance may cover.

It also provides a list of resources for financial assistance programs to help cover the healthcare, prescription, and out-of-pocket expenses relating to lung cancer.

If people have health insurance, it may cover some of the costs of lung cancer screening and treatment. This may vary depending on the type of insurance a person has.

The American Cancer Society (ACS) advises people to check the Summary of Plan Benefits in their health insurance to find out which services it does and does not cover.

Some services, such as scans and care within a medical facility, may require approval or authorization from an insurance company beforehand.

People may also wish to consider whether an insurance provider covers other costs, such as:

  • medical equipment for home use
  • disposable medical supplies, such as gloves or needles
  • wigs or cranial prosthesis
  • nutritional supplies, although most insurance will not cover grocery supplies

Some insurance companies may exclude these supplies, partially cover them, or need prior authorization for them.

In the United States, the government may sometimes classify lung cancer as a disability if it affects how an individual is able to carry out everyday tasks in the long term.

Americans with Disabilities Act

A person may be able to get help through the Americans with Disabilities Act (ADA) if they are facing any difficulties with work or discrimination due to their condition.

The ADA may apply to individuals:

  • who have a physical or mental health condition that significantly restricts one or more major life activities
  • who have a record of a previous health issue
  • whom other people perceive to have a health issue

Major life activities include everyday functions, such as:

  • breathing
  • speaking
  • walking
  • sleeping

ADA contact information

People can contact the ADA through its information line at certain times on weekdays to find out whether the ADA applies to them.

Social Security Administration

The Social Security Administration (SSA) uses certain criteria to assess disability in people with lung cancer. According to these criteria, a person must have one of the following:

  • non-small cell carcinoma that is either:
    • inoperable
    • unresectable, which means the surgery is unable to completely remove the tumor
    • recurrent
    • a metastatic disease that has spread to the hilar nodes or beyond
  • small-cell, or oat cell, carcinoma
  • carcinoma of the superior sulcus for which people are receiving multi-model anti-cancer therapy

After 18 months of the diagnosis, the SSA will evaluate any impairments from the condition to classify disability.

The SSA will require medical evidence detailing the:

  • type of lung cancer
  • extent of the condition
  • location of the cancer

If people have had any surgical procedures, they will need to provide medical reports, such as a copy of the operative note and pathology report.

The SSA may also need evidence showing any recurring cancer, progression of the condition, response to therapy, and any significant aftereffects.

If people are eligible for benefits, they may receive help through one of two schemes: Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI).

SSI is for children and adults with a disability who have limited income and access to resources.

SSDI may apply to people who have paid Social Security taxes and worked for a long enough period of time. SSDI may also benefit certain family members, such as a person’s spouse, divorced spouse, child, or adult child who has had a disability since before the age of 22.

The medical requirements for each scheme are the same.

What if the SSA rejects the application?

If the SSA rejects an application, people can request an appeal within 60 days of the rejection.

A person will receive a letter from the SSA explaining the reason for the rejection and suggesting one of the following types of appeal they can make:

  • reconsideration
  • hearing by an administrative law judge
  • appeals council review
  • federal court review

SSA contact information

People can apply for disability benefits through the SSA website here.

The SSA provides a list of documents and information people will need to provide, such as:

  • a Social Security number
  • a birth certificate
  • medical records
  • employment details

People can find out more about each appeal and access appeal forms here.

There are a range of charities and organizations that offer financial assistance for individuals with lung cancer.

The HealthWell Foundation

The HealthWell Foundation provides a variety of disease funds when health insurance does not provide enough financial assistance.

Funding can help with:

  • copayments
  • premiums
  • deductibles
  • out-of-pocket expenses, such as supplies and surgery costs

The foundation has a list of disease funds, including funding for those with small-cell lung cancer (SCLC) who have Medicare.

Contact information and where to apply

People can contact the HealthWell Foundation using the following information:

Family Reach

Family Reach offers the Financial Treatment Program for people with cancer who are receiving treatment or have undergone treatment in the past year.

The program offers financial coaching, connecting people with local financial assistance services, and emergency relief grants.

Contact information and where to apply

People can contact Family Reach using the following information:

  • Online application: People can apply here.
  • Contact form: People can contact Family Reach using this online form.
  • Phone number:

United Way

United Way can help connect people to financial assistance programs within their community.

Contact information

People can contact United Way using the following information:

  • Phone: People can call 211 to get in touch with a trained specialist who can refer them to resources in their area.
  • Online: People can search for their nearest United Way here.

Patient Advocate Foundation

The Patient Advocate Foundation (PAF) Co-Pay Relief Program offers financial assistance to eligible individuals with health insurance who require help paying the out-of-pocket expenses of medical treatment.

The PAF also offers the Scholarship for Survivors program for undergraduate and graduate students who have or have had cancer.

Contact information and where to apply

For financial assistance:

For scholarship assistance, people can find out more here or email scholarship@patientadvocate.org.

The Actors Fund

The Actors Fund helps people in the performing arts or entertainment industry who are in need.

It offers counseling, support groups, and emergency financial assistance.

Contact information and where to apply

People can find contact details for the different locations of The Actors Fund here.

People can apply online here.

Expect Miracles Foundation and The Samfund

The Expect Miracles Foundation and The Samfund offers grants to young adults with cancer to help with living expenses and medical costs.

Contact information and where to apply

People can contact the Expect Miracles Foundation using the following information:

People can contact The Samfund or find out more about the Grants program in the following ways:

Good Days

Good Days offers a range of disease funds, including a fund for non-small cell lung cancer (NSCLC). The funds may change status from closed to open throughout the year.

Funding can help with:

  • copayments
  • premiums
  • transportation
  • diagnostic testing costs

To apply for a Good Days fund, it is necessary to meet its eligibility criteria.

Contact information and where to apply

A person can apply using this online form.

For toll-free patient information, people can call 877-968-7233.

Patient Access Network Foundation

The Patient Access Network (PAN) Foundation offers a free app that searches across nine foundations and over 200 funds to help people locate available funding.

Moreover, the PAN Foundation offers disease funds, including funds for SCLC and NSCLC.

People can also search online here.

Contact information and where to apply

People can contact the PAN Foundation using the following information:

  • Apply online: A person can apply for financial assistance here.
  • Online: A person can submit an inquiry using this online form.
  • Phone: 1-866-316-7261

CancerCare

CancerCare provides a $6,000 grant for people receiving treatment for SCLC who have federal health insurance and are below 500% of the federal poverty level.

CancerCare also offers a financial assistance program to help with transportation and child care costs.

Contact information and where to apply

People can contact CancerCare using the following information:

For more information about the financial assistance program, people can call 800-813-4673.

BenefitsCheckUp

BenefitsCheckUp is a resource from the National Council of Aging that people can use to search for healthcare benefits within their area.

Benefits and programs may help with medication and healthcare costs, copayments, and deductibles.

Contact information

People can search for benefits here.

If people have questions, they can call 1-800-794-6559.

Cancer Financial Assistance Coalition

The Cancer Financial Assistance Coalition provides a search tool people can use to find financial help and other resources supporting individuals with cancer.

The government can help cover the financial costs of lung cancer in the following ways:

Medicare

Medicare is health insurance for people aged 65 years or older. People younger than 65 with a disability may also be eligible.

Medicare consists of different parts:

  • Part A: This is hospital insurance, which helps cover hospital, nursing facility, hospice, and home care.
  • Part B: This refers to medical insurance, which helps cover services from healthcare professionals, outpatient and home care, durable medical equipment, such as wheelchairs, and preventive services, such as screenings.
  • Part C: This is a combination of Parts A and B and may include some additional benefits.
  • Part D: This refers to drug coverage, which helps cover prescription drugs and many vaccines.

People can find out more about Medicare plans and general costs here.

Here, learn more about what coverage Medicare provides for lung cancer.

If a person needs extra help paying Medicare premiums, the state offers Medicare Savings Programs for those with limited incomes and resources.

People with Medicare or Medicaid can also apply for the Program of All-Inclusive Care for the Elderly (PACE), which helps people aged 55 years or older receive help in their community, instead of going into a care facility.

Contact information and where to apply

Medicare:

Medicare has a 24-7 live chat, or people can call 1-800-MEDICARE (1-800-633-4227).

A person can learn more about how to apply online here.

Medicare Savings Program:

A person can find the contact information of their Medicaid office using this tool. They should select their state and choose “Other insurance programs.”

PACE plan:

A person can find a PACE plan near them here.

Medicaid

Medicaid is a federal and state program that helps people with limited income and resources cover medical costs.

Medicaid includes fees that Medicare may not cover, such as nursing facility costs and personal care services.

Full coverage with Medicaid and Medicare will likely cover most healthcare costs.

If people have an income that is too high to qualify for Medicaid, they may be able to “spend down.” This means they can deduct their medical expenses from their income to become eligible.

Individuals with limited income and resources may also qualify for Extra Help, a program that helps a person pay for Medicare drug coverage.

Contact information and where to apply

To find out whether a person qualifies for Medicaid, they should call their State Medical Assistance Office at 1-800-MEDICARE (1-800-633-4227).

Learn more about how to apply for Medicaid here.

To find pharmaceutical assistance programs in their state, people can use this search tool.

Each program may set out certain eligibility criteria, and there may be options for people with and without health insurance.

NeedyMeds

NeedyMeds allows people to search for programs that assist with prescription and healthcare costs. People can search using the NeedyMeds website.

Contact information

A person can contact NeedyMeds using the following information:

Medicine Assistance Tool

A person can use the Medicine Assistance Tool (MAT) to search for resources and programs to help reduce the out-of-pocket expenses of healthcare.

People can enter any medications they require to find available resources. The website also offers a search tool for finding free and low cost health clinics in a person’s area.

Additionally, the MAT provides a list of drug cards, which may help people make savings on prescription drugs.

Contact information

A person can contact the MAT using the following information:

According to the ACS, clinical trials can be a way for people to access treatment that may not otherwise be available to them, possibly increasing treatment options.

Some clinical trials may pay some or all of a participant’s medical care and expenses, although not all clinical trials offer this.

People can search for current clinical trials through the following organizations:

People can find out more information about taking part in clinical trials through the ACS and the ALA.

A person can also search for clinical trials through Cancer Support Community (CSC).

People may find the following resources helpful for finding further information and support:

  • HealthCare.gov: A person can find information on health insurance here.
  • Foundation for Lung Cancer: A person can find information on resources and support here.
  • Lungevity: People can find resources or support here. They can also call 844-360-5864.
  • CSC: This organization offers a range of resources and has an online community and a helpline at 888-793-9355.
  • ALA: A person can find more information here and a list of financial assistance programs.
  • CancerCare: People can use this online tool to find community resources.
  • ACS: A person can use this online tool to look for resources.
  • Livestrong: This organization offers a range of resources and support for people with a cancer diagnosis.

There are numerous financial assistance options for people who require additional help covering the costs of lung cancer treatment.

Financial assistance can include federal and state health insurance and payment assistance programs, charitable organization funds and grants, and prescription assistance programs.

There are also many organizations offering help with transportation, food supplies, and finance counseling services.

People can contact a healthcare professional to discuss available options, or use the contact information in this article to find out what financial assistance they are eligible for.

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