Insurance-Related and Financial Challenges Reported by Managed Care Enrollees With Breast Cancer

Abstract

Cancer survivors in the United States often encounter significant challenges in obtaining and paying for medical care. Multiple research studies have examined these issues in Medicare and Medicaid populations and the underinsured, but very little is known about insurance-related challenges encountered by cancer survivors enrolled in private insurance programs such as managed care. This secondary analysis of data explored the insurance-related and financial challenges reported by women enrolled in a managed care organization during cancer treatment and early follow-up. The researchers reviewed semistructured interviews with 14 women with breast cancer near the time of diagnosis, midway through treatment, and after treatment completion. Most women reported considerable stress related to performance of insurance-related tasks during or immediately after treatment, which resulted in negative emotional and psychological experiences. This article presents recommendations for how oncology nurses can intervene to assess and address these challenges and their effects. Future research should examine best practices related to nursing management of insurance-related and financial challenges during cancer.

Cancer Support and Resource Needs Among African American Older Adults

“…As in other studies (Klimmek et al, 2010; Mathews & Park, 2009), few participants reported having discussed financial limitations related to treatment with their providers. Men were particularly unlikely to admit to or raise issues of financial inadequacies or difficulties.…”

“…Patients have identified cancer costs as contributing to treatment barriers, increasing stress, and decreasing quality of life (Klimmek, Snow, & Wenzel, 2010; Wagner & Lacey, 2004). The high cost of cancer treatment is borne by patients and caregivers (Chang et al, 2004; Mathews & Park, 2009) and may be a greater barrier to treatment for African Americans (Chu, Miller, & Springfield, 2007; Mosavel & Sanders, 2011) with significant societal consequences (Adler & Page, 2008).…”

Dealing with the financial burden of cancer: perspectives of older breast cancer survivors

“…The inability of predicting out-of-pocket costs is frustrating to cancer patients [28]. This may explain the weight given by our participants to the need of having information upfront about costs and resources available to deal with them.…”

“…This is not unique to this group of participants. Other breast cancer survivors on managed care, for example, reported stress and frustration related to the considerable challenges in dealing with their insurance companies during and after treatment [28]. Challenges were related to understanding written information, obtaining authorizations for care or assistance with insurance-related tasks, paying bills that kept coming, as well as planning for the cost of their care.…”

“…Challenges were related to understanding written information, obtaining authorizations for care or assistance with insurance-related tasks, paying bills that kept coming, as well as planning for the cost of their care. These challenges in planning led women to feel unable to plan for their families’ future and to fear being unable to “leave something behind” for their loved ones [28]. …”