Using a Co-Pay Assistance Program
Last updated: February 2023
Immunotherapy is an incredibly expensive cancer treatment. On average, it can cost a patient over 100,000 dollars per year in drug costs alone for this life-saving treatment.
Oftentimes due to expense or the newness of such treatment, even insurance companies will provide little or no coverage for patients receiving this type of cancer treatment.
It can make the choice between receiving life-saving care or paying bills a difficult situation.
Treating cancer costs a lot of money
When I initially began immunotherapy I was accepted into a small cancer center's charity program. They helped to defer the cost of my treatment while I was there. But when I needed to move back to the large academic hospital I was suddenly faced with the reality that I would now meet my annual out-of-pocket maximum every year on my very first treatment.
For me, that is four thousand dollars right at the start of the year. Now I don't know about you, but I do not have the ability to write a check for 4,000 dollars and even a payment plan would impact my finances drastically and I would most likely be carrying a balance year to year.
An impossible situation
This is the impossible situation so many cancer patients find themselves in. The bills keep coming, the deductible resets and it feels like you never stop paying hundreds of thousands of dollars just to stay alive.
And so we look towards grants, charitable foundations, and co-pay assistance programs in the hopes to make the cost of cancer more manageable.
Stumbling on co-pay relief
I applied to every program I could find, but found myself in the weird place of being too young, with too rare a disease, a cancer type that doesn't get the type of funding it should, and worst of all, still working full time.
Many programs are designed for those who are on Medicare, unable to work, or just don't cover bladder cancer. But I managed to stumble upon a hidden page on Keytruda's website that announced they had a co-pay assistance program.
The website didn't give much information, like requirements or how much financial assistance would be given, but I filled out the paperwork anyway.
By some miracle, I was approved. The co-pay assistance will pay whatever my insurance does not and I just need to cover 25 dollars per treatment. I do have to apply and hope I'm accepted every year, I also have to do the leg work of filing claims to have my bills paid or reimbursed, but it's a start towards financial recovery while battling cancer.
Navigating the relief program
And that is where my next frustration begins. My cancer center did not provide any information about assistance programs or any advice on how to manage the overwhelming bills I was receiving for my care.
When I was accepted into the co-pay program I found out my cancer center wouldn't do anything proactively to help facilitate claims and paperwork to make sure my bills were paid in a timely manner. It all falls on me.
So not only do I need to be a detailed calendar keeper for all my appointments, a financial planner in regards to saving for the other out of pocket costs I have (ie. scans, tests), but now I must also play claims broker between my insurance company, the hospital, and Keytruda.
Co-pay assistance programs
As wonderful as co-pay assistance programs may be, accessing and using the benefits can be incredibly difficult. It is my hope that soon cancer care providers, insurance companies, and pharmaceutical companies will start streamlining the process of patients being able to receive care and afford it!
Navigating the financials of cancer treatment is difficult. Tell us about any successful experiences you had in the comments below, or share your story with the community.
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