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What You Should Know About Costs of Chemotherapy

Medically Reviewed by Laura J. Martin, MD on June 12, 2020

When your doctor says you need chemotherapy, you'll have lots of questions about the treatment, but you might also have concerns about the cost. The expenses you face depend a lot on the kind of chemo you get and your health insurance plan.

Understand Your Treatment

Chemotherapy could be your main cancer treatment, or you may combine it with surgery, radiation, hormone therapy, targeted therapy, or immunotherapy. You'll have cycles of treatment followed by recovery periods.

Ask your doctor to carefully explain your treatment plan before you get started, so you'll know what kinds of costs to expect. For instance, find out if you need to get your treatment in the doctor's office, a clinic, the hospital, or at home. Also ask how often you'll have treatment and for how long.

Check how you can expect to feel during treatment and what kinds of tests or procedures you need. See if it's OK to work and whether you might need help at home.

Kinds of Costs

Your chemotherapy will have many different elements, and each has a price tag. Start by asking your doctor to estimate the total cost of your treatment. Expect charges for things like:

  • Office or clinic visits
  • Lab tests
  • Imaging tests
  • Consultation with specialists
  • Chemo drugs
  • Other drugs for treating side effects, like pain and nausea

You may also have related costs that aren't part of the treatment itself, such as:

  • Rehabilitation or home care
  • Mental health services
  • Transportation or hotel costs if you have to travel for your treatment
  • Child or elder care while you get chemo
  • Help around the house, like cooking and cleaning
  • Personal items, like a wig

You may also have indirect costs. If you have to cut back on work, for instance, you may lose income. If you have to leave your job, you may pay more for health insurance or lose it entirely.

Understand Your Insurance

What you pay for your chemotherapy treatment will be very different, depending on whether you have insurance, and what kind. It's important to learn how your policy works so you get as much of your bills covered as possible.

Some common insurance rules that may affect your costs are:

Copayments/coinsurance/deductible. Many policies have you pay a set price to see a doctor or get a prescription. Others charge you part of the bill and they pay the rest. You may have to pay a certain amount yourself, called a deductible, before insurance kicks in.

In-network/out-of-network. Your insurance plan may want you to use certain doctors and hospitals. If you use someone else, you may pay more or even foot the entire bill yourself.

Preapproval. You may have to get the OK from your insurance company ahead of time for certain procedures, hospital visits, or to see a specialist.

Know how to submit your claims and what to do if the insurance company says it won't pay for something. All policies have limits, but other kinds of insurance can help with some of these bills. Disability insurance, for instance, helps replace your income if you can't work. And supplemental insurance can cover things like copayments and transportation.

Where to Get Help

Ask your treatment team which person at your doctor's office, clinic, or hospital handles financial questions. Hospitals typically have nurse navigators and social workers on staff who can help. They can explain your bills and help you deal with insurance. Your medical facility might be willing to work with you on a payment plan.

Your insurance company may assign you a case manager who'll know all the details of your particular policy and treatment. And your company's human resources department can explain benefits you may have, including health, disability, and supplemental insurance.

If you can't afford some of your costs, ask your doctor whether there's an alternative treatment that's cheaper. You might save money with a different brand-name chemotherapy drug or a generic. Ask whether over-the-counter drugs, rather than prescriptions, may work on your side effects, or price-shop at different pharmacies.

An internet search will turn up organizations offering help with medical expenses. Your doctor's office might know about some also.

Some organizations that you might want to check for info about financial help are:

  • Your city or county's office of social services
  • Local charities like faith-based groups and lodges
  • National health organizations like the American Cancer Society
  • Advocacy groups like the Patient Access Network
  • Drug companies that offer help with prescription costs
  • Local legal societies that can find you free or low-cost help with workplace rights and insurance issues

See if a close friend or family member is willing to help you keep track of bills and other paperwork. They can come with you to appointments and make sure you get your questions answered.

Keep careful records of your expenses. You may be able to deduct things like drug costs and transportation mileage from your taxes. A financial adviser can guide you through the rules.

WebMD Medical Reference

Sources

SOURCES:

American Society of Clinical Oncology: "Understanding Chemotherapy," "Managing the Cost of Cancer Care," "Going to Work During and After Cancer," "Health Insurance."

American Cancer Society: "Things to Know About the Cost of Your Cancer Treatment."

Cancer Support Community: "Tips for Managing Cost of Care," "Employment and Cancer," "Health Insurance for Cancer Patients," "Help Managing Cancer Costs."

CancerCare: "Managing the Cost of Cancer," "Legal Assistance: Finding Resources and Support," "Doctor, Can We Talk?: Tips for Communicating With Your Health Care Team."

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