Health Care Planning for a Post-Cancer Future

My husband was supposed to retire last year. After reaching the age of 65, he was looking forward to leaving the company he’d given 40 years of his life to. But as the time approached, he changed his mind. Since I wasn’t yet 65, and with all the recent medical bills we’d accrued due to various tests related to my cancer diagnosis, he felt it wise to keep working a little longer. We had to make sure I’d have health insurance.

Cancer is expensive and even after the initial treatment phase is over, there are always annual checkups, tests and sometimes medications. It can take years to pay off mounting bills and without health insurance, those on fixed incomes may find themselves in quite a pickle.

With his employer benefits, I was covered and would remain under my husband’s health insurance coverage until he retired. Although he hadn’t talked with the human resources department yet, we understood from others that there might be a possibility of continuing coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA) for a period of 18 months after his retirement, but we’d also heard those payments were quite high.

So, how do seniors living on a fixed income pay for continued cancer care? As I began to ponder that question, I felt quite anxious. Without the protective umbrella of the quality provider benefits we’d been accustomed to, would we be able to accept the recommendations of my doctors for future scans and tests or would we be forced to pick and choose according to our financial ability?

My husband and I were blessed to have the company 401K and were thankful they’d matched our contributions over the years. Knowing that cushion was available upon retirement helped, but those funds would also be supplementing our Medicare income to provide for not only health care but living expenses. We’d always lived modestly and felt we could probably make ends meet, but we weren’t quite sure, so we decided to talk with our financial advisor.

The first thing the financial advisor suggested was for us to make a list of all of our monthly expenses versus our monthly income. That, he said, would give us a good picture of where we stood financially. But his suggestion wasn’t easy. How could we plan for unexpected medical expenses like annual PET scans, semi-annual bloodwork and the possibility of unplanned complications that might require surgery?

We did our best to come up with a monthly budget and found some items we could eliminate to lessen our financial burden. But another area of concern popped up – how could we know, when the time came, whether or not the oncologist would accept Medicare assignment and what would we do if he didn’t?

We had a small savings account, but there was only enough in it to cover a few months of our mortgage payment. Any large, uncovered medical expense would wipe that out in a hurry.

The advisor reminded me that I could enroll in Medicare three months before my 65th birthday, but I’d need to purchase drug coverage (Part D) to cover any prescription medications, and I’d need to buy Medicare Supplement Insurance (Medigap) to cover health expenses that Medicare parts A & B didn’t cover.

If we’d known I was going to be diagnosed with cancer, we would have planned accordingly. But since no one can ever predict a catastrophic disease, the point was moot.

As of now, we’re saving every penny we can and I’m doing everything I can to stay as healthy as possible. While we don’t know what the future holds for either of us health-wise, that’s the best we can do.

For those who haven’t experienced a catastrophic disease such as cancer, it may be difficult to understand the continued medical bills associated with a long-term illness. Cancer, whether active or inactive, demands constant observation and care. Together, those expenses can mount quickly, leaving a person financially burdened.

Some hospitals and medical facilities offer cash discounts for those without insurance. Some doctors offer a sliding fee for those on fixed incomes such as Medicare or Medicaid. There are some less expensive generic prescriptions available to help those on limited incomes, but not always.

The best advice I can give as a cancer survivor and senior living on a fixed income is:

• Make a budget. Include all income and all expenses.
• Take a good look at your health care coverage. Read the fine print. If you have questions, call the insurance company and ask for clarification.
• If you or your spouse are about to retire, talk to the human resources department about the possibility of continued coverage and how much it will cost.
• Be prepared to supplement Medicare coverage. While it can offer substantial help, it doesn’t cover everything and definitely doesn’t cover long-term care. Medicaid, depending on a person’s income level, may cover some or all of long-term care expenses.
• Start saving now!

It’d be nice if quality health care was free for everyone, but regrettably it isn’t.

Seniors, especially those with cancer, face additional challenges like uncovered medical expenses, and without proper planning, may find themselves having to forego necessary treatment.

One of the best ways to combat these problems is to be open and honest with your health care provider. If you don’t have health insurance coverage, don’t be ashamed to admit it. Many times, there are other options. Some facilities even offer mercy scholarships paid by wealthy benefactors to aid those less fortunate. Remember the old adage, “It never hurts to ask.” And then, if you’re lucky enough to receive help, “Don’t look a gift horse in the mouth.”

Planning to survive the future post-cancer is critical and requires some work, but it is doable. In the famous words of Benjamin Franklin, “By failing to prepare, you are preparing to fail.”

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