Financial concerns

Home Echo Discussions Module 3 Discussion Financial concerns

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    Most of these costly treatments are not covered by insurance. There are a few non-profit organizations that are available. However they have lengthy applications that must be approved before a referral can be made. This can often cause a delay in care and put added stress on a patient that is already dealing with cancer.


    In the lecture, they alluded to possible insurance coverage given the circumstance. I am wondering if anyone has had any experience with their patients getting insurance coverage for this costly process, and if so, what the experience was like/related delay in treatment? Thank you.


    Ladyluck73 that is a very important point you make about the cost of these treatments and procedures to retrieve the eggs. It is very unfortunate that there are not more provisions in the insurance plans to cover these procedures so that egg retrieval prior to chemotherapy treatment could be more of a realistic option for those who choose to pursue it. I personally have not had any experience with a patient getting insurance coverage for this costly process, but I too am interested to hear from anyone who has and what effect, if any, there was on the start time of treatment.


    I have not had any experience with insurance covering these treatments.  I have been referred patients to assist them with finding resources to help them with the cost with as stated previously by ladyluck can be time consuming due to paper work and protocols.  I have had patients say forget it because they feel the treatment  for their breast cancer is paramount and the waiting for answers causes them more stress and anxiety.


    The financial concerns definitely do play a role in patient decision making.  At my cancer hospital, we have social workers that are able to help find programs and funding for these patients but I have found that it can be a difficult barrier to overcome.


    I can definitely agree with this topic, financial concern is a big issue that arises during discussion about fertility preservation. Our hospital works with some centers that offer a discount, but the cost is significantly greater than male preservation.


    Not for cancer reasons, but my daughter has recently been through the egg retrieval process and embryo freezing.  She and her husband have spend $20,000 to date.  The money was expected upfront at the clinic.  A few surgical expenses were partially covered by insurance. The medications were expensive – $200-$300 a prescription and only partially covered by a Blue Cross/Blue Shield type of insurance.  The storage of embryos is not covered.  Implantation will be additional costs each time they use an embryo.  They moved into a smaller home to be able to afford it.  I can only imagine how the additional costs would cause increased worry and stress to a young woman with cancer expenses also.


    It’s definitely insurance plan specific as well as state specific. I know employees in Massachusetts have wonderful coverage for IVF. I believe storage expenses are a different factor though and can be more expensive.


    I to0 agree.  The financial burden that a patient has going thru treatment is enormous. From days lost from work, drugs, surgical procedures, it can be so overwhelming. From my experience, the patients have no idea on what is covered by their insurance.  This maybe their first catastrophic event, and they do not know where to start.


    As Nurse Navigator I find myself questioning when should I talk about fertility preservation.  Who’s going to start the conversation?  I work in a teaching hospital and residents are the ones rounding on the patient, finally when attending sees the patient assessment about symptoms, and testing and results are always at the top.  Never anything about fertility preservation.   I work alongside with a Social Worker and we both have come to the conclusion that if an AYA is on our unit with a suspicion of cancer and talks of potential treatment, we will initiate the conversation without waiting on the Medical team to do so. a


    This is a very good point.  Overall, the vast majority of insurance companies do not cover assisted reproductive technologies, even in light of a cancer diagnosis/fertility preservation.  Livestrong (I believe) works with some centers on discounting the procedures, storage fees, etc for the oncofertility population.  Out of pocket (with no insurance coverage), average medication cost for one stimulation/egg retrieval cycle would be in the $3,000-5,000 range.  With the Livestrong program and the Heartbeat program, that cost is significantly reduced down to maybe $100, depending on the protocol.  If there is a medication that the clinic has samples of (which doesn’t happen often) or someone who has donated medication to the clinic, the nurses will often donate this uncovered medication to the fertility preservation patients.  The cost of a donor egg IVF cycle in the future is generally in the $25,000 range, not including the $3,000-5,000 medication cost for the donor, and the $100-1,000 medication cost for the recipient.  Comparing just the two, if it’s at all feasible, preserving fertility on the front end is more cost effective.


    I thoroughly enjoyed the great detail of this discussion. As a nurse navigator working with the general cancer population AND the childhood cancer survivor (AYA) population, financial resources are a challenge for many of our patients with regard to fertility. In addition, the patient will have to request time off of work for multiple office visits PRIOR to starting chemotherapy and don’t forget that she just requested time off for surgery. These are concerns that we also must take into account when discussing fertility options.


    From my understanding, Livestrong can be used for reimbursement, but you must pay the fees upfront for fertility preservation. Fertility clinics offer to patients the ability to apply for a credit card and use that as payment, but I haven’t checked the interest rate on the card. I bet its pretty high.

    The price of preservation is astronomical. I think we need to petition our congressional representatives to draft a bill that forces insurances to pay for fertility preservation if the patient is undergoing cancer treatment.

    A lot of doctors I work with opt for Lupron injections, even though its considered experimental. It’s cheaper.



    Thanks for this discussion – everyday we deal with the financial toxicity of cancer. Sometimes we are able to find considerable savings in different areas – for example, a patient couldn’t pay their rent and we found a grant for food and transportation.  I am new to this fertility expense and hope to start providing more services to these patients. I am curious to find out whether there are programs that different centers have developed to offset costs.


    I do agree that it is difficult when there is limited financial coverage for fertility treatments. I recently heard that in California, the SB 600 bill <span class=”ILfuVd”><span class=”e24Kjd”>requires insurance companies to cover fertility preservation such as sperm banking and egg freezing, which is done before medical treatment that can cause infertility.  </span></span>

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