When one member of a middle class family is diagnosed with cancer, there are several roadblocks that often causes them to waver at the edge of the income class, and in the worst cases, entirely destabilizing their financial well being.
Cancer care costs are constantly on the rise In America, with the average yearly cost for recently introduced FDA approved cancer treatment drugs normally exceeding $100,000, according to the IMS Institute for Healthcare Informatics.
While this is certainly unaffordable for families who are currently living in poverty, there are also instances where the exorbitant cost of effective treatment even has the potential to push middle class earners into unbearable financial straits that may lead to an emergency bankruptcy.
The sad reality behind this is much more deeply embedded into the circumstances. As we delve deeper into the issue, we find a more troublesome issue at play:
Once middle class families burn through their savings entirely in efforts to stave off the suffering caused by the diagnosis of malignancy in a loved one, public and private options for financial support seem widely unavailable to this demographic.
The overall costs of cancer treatment varies depending on every patient’s individual circumstances, but in general, families must find ways to compensate for lost wages, costly prescription medications, diagnostic procedures and treatment at proper facilities, transportation to medical facilities, and in cases of the elderly or disabled, the costs of an in-home nurse or residency at a long-term care facility.
Middle class earners often have a financial cushion that allows them to save for emergencies, but when this fund dries up, the substantial amount of financial obligation that comes with maintaining a middle class household may come crashing down, further disrupting the quality of life of the patient and their family during their time of crisis. Because middle class families facing a cancer diagnosis may not have been exposed to significant financial hardship in the past, they might not recognize that systems do exist to aid them and not just families that have already descended into poverty.
While cancer patients are 2.5 times more likely to file bankruptcy than healthy individuals, this article will share several options for financial assistance that middle class cancer patients can explore before it is too late.
In the United States, the Social Security system stands as a federal program designed to provide social insurance and benefits to individuals who currently have inadequate income, or no income at all.
A common perception of this program is that it is designed only to aid families who are currently unemployed and the elderly who are, for the most part, unemployable.
While the system does serve these individuals, it also has a section of benefits designed to help relieve the financial burden from patients who have been diagnosed with cancer.
Social Security Disability Benefits (SSDI) are quite useful for alleviating a portion of the financial burden faced by many cancer patients, but unfortunately not all middle class families will qualify. The major qualifying conditions for SSDI are that the afflicted must have a terminal illness, or another disability that will prevent them from performing paid work for a period spanning at least 12 months. The Social Security Administration generally draws upon a stringent list of eligibility regulations that is available in a manual called The Blue Book. In this manual, each type of cancer is listed based on where the cancer was first discovered, allowing patients and their families to determine if their cancer meets the specific criteria that would allow them to become recipients of Social Security Disability Benefits. Patients often need to produce evidence of their cancer in the form of a pathology report and copies of documentation from related procedures, though there are also alternative options for when these documents are not immediately available.
Middle class families who are currently battling a cancer diagnosis need to explore how they can benefit from Social Security Disability Benefits.
You can find the Blue Book Listing for Cancer (Section 13) Here: Social Security Administration Blue Book
Certain cancer patients may also be eligible for the Social Security Administration’s Compassionate Allowance Program, a program implemented in 2008 that prioritizes severe or time-sensitive Social Security Disability claims during processing stages.
You can find the current list of conditions that qualify for the Compassionate Allowance Program Here: Compassionate Allowance Program Condition List
The Centers for Medicare and Medicaid Services manages other federal welfare programs designed for certain elderly and/or disabled citizens. Medicare is a federal health insurance program offered to Americans aged 65 years or older, and people below this threshold who suffer from significant disabilities. Medicare can be used to cover the costs of inpatient hospital treatment, nursing support, and in-home health care. There are several options for being deemed eligible to tap into this vital financial resource, but middle class families will benefit most from learning about the following.
- Working in a federal, state, or local government to meet local state Social Security program requirements.
- Recipient of Social Security Disability Benefits for a minimum of 24 months.
Medicaid Spend Down
If cancer has left your family sitting on the verge of financial collapse, and you have found yourself unable to properly afford the costs of treatment without assistance, a Medicaid spend down stands as a promising last resort. This process involves removing liquid assets in order to qualify for free or low-cost health care through Medicaid, another welfare program offered through the United States federal government.
Eligibility for Medicaid requires prospective beneficiaries of the program to be residents of the state where they will receive benefits who have full citizenship or qualified non-citizen status in the United States. The financial requirements are determined on a state by state basis, but an asset or resource test is conducted on individuals who apply for the program. In general, eligible applicants will not be allowed to retain more than $2,000 in liquid assets, but they are allowed to maintain several categories of exempt assets. These exempt assets include:
- Homes are exempt in the instance that the applicant plans on living in the home during or after treatment or they have a spouse or disabled child living in the home.
- Personal belongings
- One car
- Pre-paid final expense purchases and burial assets.
- Life insurance policies valued beneath $1,500
- The spouse of a Medicaid recipient may also be allowed to maintain their own retirement accounts to ensure that they run less risk of falling into poverty if the afflicted fails to fend off the malignancy.
- If necessary, families can also look to spend additional assets on a lawyer for the purpose of preparing for the worst case scenario, drafting a will and dictating medical power of attorney.
Another important aspect that must be considered by middle class families hoping to qualify for Medicaid is the set of limitations placed on earned income. Recipients are required to maintain an income level below a state specified amount, but if their monthly income is in excess of this amount, individuals determined to be “medically needy” in states that offer medically needy programs can “spend down” their excess income on medical expenses that are not covered by insurance to still qualify for Medicaid.
In some states, this excess income can also be allocated to a Qualified Income Trust, which places the excess income into a trust fund that is put into the control of a trustee, who is generally a family member. This fund can then be used to pay for some personal needs to the Medicare recipient and medical costs and premiums that are not covered by federal programs.
Though it may be a stressful process, liquidating nonexempt assets and leveraging spend-down protocols to qualify for Medicaid support is an often overlooked but immensely rewarding option for middle class families that need to to stave off the growth of crippling debt in the wake of expensive medical treatments.
Middle class families dealing with a cancer diagnosis can look to viatical settlements as an option for regaining financial stability. Viatical settlements are private settlements that involve the sale of a life insurance policy owned by an individual to a third party in exchange for cash. The amount of cash offered is normally much greater than the cash surrender value offered by the company that maintains the life insurance policy and will be paid in the form of a lump sum that can be used by a cancer patient to afford medical expenses, household expenses, and other personal costs. While these settlements are generally offered to insured patients who have been determined to be terminally ill, those facing chronic illness or potentially fatal illnesses can also use viatical settlements to fight off their condition.
This means that patients who have been diagnosed with cancer can utilize this resource without worry about meeting stringent eligibility requirements like a terminal prognosis.
To limit the disruption a cancer diagnosis brings to your family’s life, consider consulting with a professional at Hidden Gem Life Solutions today for more information about whether a viatical settlement can help you.
Crowdfunding uses online platforms to bring donors together to get cash gifts together to help individuals pay their medical expenses. Though middle class families may not have frequently needed to turn to friends and family for financial assistance in the past, these platforms offer the potential for massive financial support in dire times. Click here to learn more about using crowdfunding to afford cancer treatment expenses.
People that are grouped into the middle income class are often portrayed as generally well-off, but a malignant cancer diagnosis can introduce financial hardship that is even capable of stripping away decades of tediously saved earnings.
If you are an individual who has a family member fighting cancer, you can win the battle by tapping into the resources listed above. Even though you may not currently be impoverished, you still deserve adequate care and financial support in your time of need, so please take action immediately to secure the financial stability that you and your family deserve.