Job loss is stressful no matter the circumstances. More recently, millions of people have lost their jobs during the COVID-19 pandemic. To make matters more difficult, job loss in the United States can often mean a loss of health insurance. For people with cancer, losing a job is an especially challenging time because of the costs that come with cancer treatment.
If you’ve lost your job while expecting to have, while still undergoing, or while having follow-up visits for cancer treatment, you may now be wondering if you should refill your prescriptions or continue seeing your doctors. No one wants to miss medical care, especially while being treated for cancer. Here are tips to cope with the anxiety that comes with a job loss during cancer and what to consider in order to continue paying for your cancer care.
Finding emotional support
“It’s scary to lose your job,” says Rebecca Nellis, executive director of Cancer and Careers, a nonprofit that helps people with cancer navigate the workplace. “It’s scary to spend every day wondering if you’re going to lose your job.”
It’s important to find emotional support during a time of career uncertainty, says Nellis. One possible option for talking through that anxiety is reaching out to a social worker at the hospital where you receive or received treatment.
Another option is a support group, which is often done online these days. CancerCare and Cancer Support Community both have online support groups, among many other resources. Nellis also recommends that people ask within their own communities for referrals to cancer support groups. Your health care provider or hospital may have a list as well.
Paying for ongoing and upcoming cancer treatment
Layered onto the anxiety of job loss are the practical aspects of paying for cancer treatment while experiencing a loss of income and/or health insurance coverage. There are typically 4 options for health insurance coverage after you’ve lost your job:
The Consolidated Omnibus Budget Reconciliation Act (COBRA) (federal or state)
Your spouse’s or a parent’s health insurance plan
The Health Insurance Marketplace
Medicare or Medicaid
The first step after losing your job is to figure out whether you are eligible for COBRA, says Monica Bryant, COO of Triage Cancer, a national nonprofit that educates people with cancer and their families on legal and practical issues. COBRA gives you and your family the right to keep the same health plan that you had at your job. This federal law applies to private businesses with 20 or more employees, as well as to state and local governments of any size. Your state may also have COBRA laws that protect you if you worked for a smaller business. Triage Cancer provides an online chart of health insurance laws by state. While the prices of coverage through COBRA may be very high, if you’re in active cancer treatment, don’t dismiss COBRA just because of the price, says Bryant. If you have already met the deductible or out-of-pocket maximum, it may actually be more affordable to elect COBRA because you will only have to pay the monthly premiums for the rest of the year.
Other options for health insurance coverage might include joining an existing health insurance plan that your spouse or your parent is enrolled in (if you’re younger than 26). Looking for a new health insurance plan on HealthCare.gov’s Health Insurance Marketplace is an option if you’ve lost your employer-provided insurance. Enrolling in Medicare, which covers people 65 and older and some people with disabilities, or Medicaid, which traditionally covers people with a low income, may be another option under your new circumstances.
An estimated 2 million people fall into the “coverage gap” in which they do not qualify for Medicaid or for subsidies in the Health Insurance Marketplace. This is because their income is above the eligibility criteria for Medicaid but below the lower limit to pay for Health Insurance Marketplace premiums. After losing your job, you often have 60 days to make a decision on health insurance.
What to consider when looking for a new health insurance plan
Be on the lookout for short-term plans that look affordable but can exclude coverage of preexisting conditions like cancer. When selecting a new plan, consider these questions:
Are all my providers covered? The plan should cover your oncologist, as well as your primary care physician, other specialists like a dermatologist, etc.
Are my current prescription drugs covered, and at which tier? Cancer drugs often fall under the most expensive specialty tier.
Do you anticipate taking any new prescription drugs in the next 6 months? If yes, then check whether those drugs will be covered.
From there, calculate the total annual cost of the insurance to see how plans might compare. To do this, multiply the monthly premium by 12, then add the out-of-pocket maximum. Keep in mind that it’s best to choose a sustainable and appropriate plan that you know you can afford for that year. Once you choose a plan, you typically cannot switch to another plan until the next open enrollment period.
Special considerations during COVID-19
Typically, if you qualify for COBRA, you would have 60 days to decide whether to keep your employer-based insurance after losing your job. However, a new rule by the Internal Revenue Service (IRS) and Employee Benefits Security Administration gives people more time to decide during the COVID-19 pandemic. For the duration of the pandemic and an additional 60 days after the COVID-19 emergency ends, people are able to choose COBRA. There is currently no specified end date for this period.
Other ways to pay for cancer treatment
What about covering the other costs that come with cancer care, such as travel to and from appointments or in-home care? Cancer.Net provides a list of Financial Resources for people with cancer, and CancerCare provides a Financial Assistance Program.
Communicate with your health care team
Be honest and direct with your health care team about your situation. This includes talking with a social worker or other member of the health care team who may help you find available financial resources. Ask your doctor about lower-cost options for your treatment plan, if possible. Remember: You are not alone after a job loss. There are resources to help you continue your cancer care even in the most difficult circumstances.