OHSU

Legal and Financial Impacts of Cancer and Cancer Treatment

In addition to undergoing treatment and dealing with the emotional and physical issues of cancer, you may also face financial or legal issues. It’s necessary for you to understand the potential financial repercussions you could confront. Regardless if you have insurance or are self-pay, chances are you will have out-of-pocket costs you may not have initially anticipated.

Some insurance companies may not pay for cancer treatments that they deem experimental. In the case of clinical trials, even if the trial sponsor and your insurance are covering the trial’s costs, you may require extra doctor visits or need to budget for additional travel time or child care. Costs for travel for patients or family members and time off work may also cause financial concerns.

You can also talk to our social workers to determine if there are other financial alternatives or health care assistance options available. You might qualify for federal and state benefit programs.

Some useful information, definitions and resources include:

Financial:

  • Assessment: The LIVESTRONG site lists many financial planning resources geared toward people with cancer.
  • Income alternatives: These include Social Security disability income and supplemental security income.
  • Life insurance: You may have flexibility in using your life insurance policy, either selling a part or investigating other benefits through it.
  • Managing your money: Consider getting credit disability or credit life insurance on your card, if available.
  • Medical coverage: You may be eligible for Medicare or Medicaid. Medicare is a Federal health insurance program that pays for hospital and medical care for elderly and disabled Americans. Medicaid is a health and medical services program for those with low incomes and few resources.
  • National Cancer Institute offers a comprehensive list of emotional, practical and financial support resources for those with cancer and their families.
  • Retirement plans: Your retirement plan may have options due to hardship provisions. Contact your employer to learn more.

Legal:

  • Advance directive: If you are unable to make health care decisions on your own, an advance directive informs doctors of your wishes. Advance directives are legal documents; they apply to your health care decisions only (i.e., not financial). You can also designate another person to make decisions about your health if you cannot.
  • The Americans with Disabilities Act: The Americans with Disabilities Act makes it illegal to be denied a loan or other financial service based on your cancer history. The U.S. Department of Health and Human Services Office of Civil Rights has basic information to help you learn more.
  • Employment discrimination: If an employer decides about your ability to work based on your race, religion, gender or medical concerns without evaluating if you can do the job’s duties, then that can indicate employment discrimination. If cancer and its treatment don’t affect your ability to perform your job acceptably, you’re not required to tell your employer about your cancer. The LIVESTRONG website offers detailed, up-to-date information on discrimination. 
  • Family and Medical Leave Act (FMLA): FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for up to 12 weeks for a serious health condition or to care for an immediate family member with a serious health condition. It may also be used for the birth or adoption of a child. FMLA requires your group health coverage be maintained during the leave.
  • Informed consent: This means you’ve been informed of the risks and benefits of a medical treatment. You will need to sign a form, perhaps several forms if you are getting more than one kind of treatment. Informed consent is more than just signing a form, however; it’s the action of learning and understanding everything you need to about a treatment before you agree to it. If you are participating in a clinical trial, you may need to sign additional informed consent paperwork regarding experimental treatment.
  • Patient Bill of Rights: This protects you through policies such as banning insurers from denying coverage to children with pre-existing conditions and making lifetime dollar limits on coverage illegal. The Bill of Rights addresses complaints and appeals, consumer information, emergency services access, providers and plans, treatment decisions, non-discrimination, patient information and privacy of health information. However, there are exceptions; check with your insurance plan for the most current information.

*OHSU Knight Cancer Institute does not provide legal or financial advice.  The information provided is an overview of services.