Financial Resources for CLL Patients

HealthTree Foundation’s financial program manager, Diahanna Vallentine, shared financial resources CLL patients can use to help pay for the costs of their treatment. Watch her presentation below or read the summary of the event.

8 Key Tips from Our Financial Expert 

1. The most important part of your financial foundation is to get the best insurance you can afford. 
2. Ask your doctor upfront about the costs of treatment, which include things like lab tests, scans, medications, and doctor visits. 
3. Keep a written record of everything. 
4. Be aware of potential changes mid-year to Medicare Advantage plans. 
5. Ask your doctor if there are any generics available for your CLL medicines. These generics are less expensive than name-brand medications. 
6. Visit HealthTree for CLL Financial Resources to find information about organizations that provide financial support for medicine costs, utilities, travel, housing, and child care.  
7. Each hospital should have a free patient financial resource navigator/social worker who can help answer your questions. To get their help, all you have to do is ask.  
8. Contact Diahanna at diahanna@healthtree.org for a free CLL financial consultation. 

An Important Foundation: Your Insurance 

The most important thing you can do for your medical financial welfare is to get the best insurance coverage you can afford. After this, understand your prescription coverage. For private insurance plans, get a copy of your plan documents and read all of the parts. If you are on Medicare, understand the cost associated with coverage as well as deductible limits and the out-of-pocket max.

What Will Medicare Cover? 

If you have Medicare, Medicare Part A will cover things like inpatient cancer treatments, inpatient hospital stays, and some home healthcare. Medicare Part B covers doctor visits, diagnostic tests, and some medicines taken orally. You may need other services and treatments that Medicare does not cover. Know what your treatment plan covers to be aware of additional resources you’ll need. 

Assessing the Cost of Your Medicine 

• Ask your doctor if there is a generic/biosimilar version of your medicine available. Generic versions are almost identical copies of the brand name medicine but for a lower price. Some brand-name medicines have generics, and others do not. 
• Check with your insurance how much the medicine costs. 
• Pharmaceutical companies often have co-pay cards accessible on their website you can apply on top of your insurance to increase savings. 
• Other organizations that offer medication discounts include NeedyMeds, RXAssist, and GoodRX.  

Applying for Medical Financial Assistance: What Do You Need to Know? 

• There are many organizations, such as charities and pharmaceutical companies, that offer financial assistance to patients for medicine costs. For a list of these organizations, visit HealthTree for CLL Financial Resources.
• When applying for financial assistance with charity organizations, do so as early in the year as possible. If the charity runs out of funding money, check back later, as it may receive more funds later in the year. 
• If the charity notifies you that you will be receiving funding, call your doctor and alert them that they can expect to receive a verification of treatment letter from the charity. Encourage your doctor to return it to the charity as soon as possible. 
• You can apply to multiple organizations. Make sure to note what you are requesting the money for (co-pay assistance, premium reimbursement).
• For non-profits like the LLS, you can apply for fund assistance every 12 months. Acceptance will depend on available funds. 
• If funds are not used in a timely manner, you may forfeit the remaining balance. 
• Some financial assistance programs like Urgent Need (LLS) and Catholic charities are one-time grants. 
• Each non-profit and pharmaceutical company has its own criteria for applicants. They may require income verification, request your doctor verify your treatment, ask about your type of insurance, and review if you are Medicare. 
• Application rules may vary for Medicare patients. Ask the organization what their specific rules are. 
• Pharmaceutical patient assistance programs may require you to apply for non-profit grants before reaching out to them. 
• If you receive grant money:
  • Take personal notes about the amount you received and which medicine it was spent on.
  • The grant money for covering medicine costs is tax-free for you.
  • The grant money does not go towards your medical deductible. 

The Importance of Written Documentation

When you speak with individuals such as insurance carriers, the hospital, or charity organizations, note the day, the time, and the name of the person you spoke with. Request documents in writing. Examples of this include promises to pay, what your responsibilities are, and itemized bills to compare next to the explanation of benefits (EOB) document (this will ensure that you are being billed correctly). If you see discrepancies in bill line items, you can challenge the bill. 

Patient Questions & Answers 

• How do I receive free financial counseling from a HealthTree Foundation financial coach?
  • Reach out to a financial coach by clicking here. Or, you can email your financial questions to Diahanna at diahanna@healthtree.org. 
• If a patient has private insurance, where can they see if their insurance covers the CLL medication? 
  • There should be a number for members to call on the back of their insurance card. Ask your insurance agent which medications are covered and how much you would be paying. The agent can also likely send you printed materials. 
• If insurance denies coverage for a CLL medication, is there an appeal process the patient can go through? 
  • Ask your doctor or oncology nurse navigator to conduct a peer-to-peer review on your behalf. This will usually happen quickly; if it is an urgent medication, you can have an answer within 24 hours. 
• Do the travel and housing assistance programs for cancer patients actually help?  
  • Yes. Diahanna received financial support for travel from the American Cancer Society during the time her late husband received treatment. They received reduced rates and vouchers for different types of travel like Uber, planes, trains, buses, and car rides. 
• If a patient has medical debt, can that debt be negotiated to a lower amount? 
  • Yes, medical debt can be negotiated and reduced. As soon as you realize you can’t afford it, contact the facility that is holding the debt (try to do this before it goes to collections). Let them know you can’t afford it. The patient financial resource navigator/social worker at the facility can help you fill out the paperwork.