Financial & Insurance Navigator

Before you start

Most skin cancer is treated with a single office procedure, and cost is rarely a crisis. But melanoma, advanced or recurrent disease, Mohs surgery with reconstruction, immunotherapy, and clinical-trial travel can add up fast. A little organization early makes every later step easier.

• •Keep one binder or folder (paper or digital) for every bill, Explanation of Benefits (EOB), letter, and note from a phone call — with the date, the name of who you spoke to, and a reference number.
• •Know your plan's key numbers: deductible, coinsurance, copays, and out-of-pocket maximum. Once you hit the out-of-pocket max, covered in-network care is paid at 100% for the rest of the plan year.
• •An EOB is not a bill. Wait for the provider's bill, then check that it matches the EOB before paying anything.
• •Ask your cancer center for a financial navigator or patient advocate. Most larger centers have one, and the service is free.

Understanding what your plan covers

Help with medication and treatment costs

• •Manufacturer copay cards can cut the out-of-pocket cost of a brand-name drug to a small monthly amount if you have commercial insurance. Search the drug name plus "copay card." (These generally can't be used with Medicare or Medicaid.)
• •Patient assistance programs (PAPs) from drug makers may provide medication free or at low cost if you're uninsured or underinsured and meet income limits.
• •Independent copay foundations (below) help people on Medicare when a disease-specific fund is open — funds cycle, so check back if one is closed.

Hospital bills and financial assistance

• •Nonprofit hospitals must have a financial assistance policy (sometimes called charity care). Ask for it by name — many people who qualify never apply. Approval can reduce or erase the balance even after treatment.
• •Request an itemized bill and check it against your EOB for duplicate charges, services you didn't receive, or in-network care billed as out-of-network.
• •Ask for the self-pay or prompt-pay discount if you're uninsured, and set up an interest-free payment plan rather than putting balances on a credit card or medical credit card.
• •Don't ignore bills. Call, explain your situation, and ask about hardship options before an account goes to collections.

Clinical trial costs

If you're weighing a trial (for example, melanoma or advanced SCC trials), the money questions are usually manageable:

• •The study sponsor typically pays for the investigational drug and any tests done only for the research.
• •Routine care costs (standard scans, office visits, standard treatment) are generally billed to your insurance. Federal law requires most plans to cover routine costs of a qualifying trial.
• •Ask the research coordinator about travel stipends, lodging, or parking reimbursement — many trials offer them.

Travel, lodging, and getting to treatment

Protecting your job and income

If you're uninsured or between plans