Latest news with #outofpocketcosts
Yahoo
05-08-2025
- Health
- Yahoo
A cancer diagnosis can cause out-of-pocket costs to surge, study finds
A cancer diagnosis increases privately insured patients' monthly out-of-pocket costs, which also rise as the disease progresses, new research shows. Out-of-pocket costs jumped by $592.53 per month for the six months after a diagnosis, according to a recent report published in JAMA Open Network. The study underscores the financial toll a cancer diagnosis can take on individuals, even for those who are insured but don't yet qualify for Medicare. While cancer tends to strike later in life, when most patients in treatment are receiving Medicare benefits, a cancer diagnosis can pose an undue financial burden on younger people with private insurance, the report found. Those out-of-pocket costs highlight the need for policy reform, the report said. The research "underscores the need for policies such as paid sick leave that address both insurance continuity and financial assistance, especially for patients with more advanced cancer," the report states. Out-of-pocket costs increased based on a patient's cancer progression, the analysis found. Patients with stage 0 cancer saw their costs rise by $462 per month compared to non-cancer patients, while stage 4 cancer cost people with private insurance an additional $719.97 per month in out of pocket costs. Costs rise as the disease progresses because patients typically require more treatment during cancer's later stages, leading to greater medical expenditures. "This result seems straightforward; later-stage disease is associated with more intensive workup and treatment that can drive higher medical expenditures," the report states. Researchers analyzed medical claims records from the Surveillance, Epidemiology, and End Results (SEER) cancer registry to compare the out-of-pocket costs of privately insured individuals under the age of 65 who were diagnosed with breast, colorectal, and lung cancer, to those without cancer. New research from the American Cancer Society shows that as more people aged 45-49 undergo screening for colon cancer, more early stage diagnoses are being made. DOGE savings are a fraction of what the department claims, CBS News analysis finds Details on House subpoenas for Clintons and others over Epstein files Trump doubles down on decision to fire labor statistics chief Solve the daily Crossword
CBS News
05-08-2025
- Health
- CBS News
A cancer diagnosis can cause out-of-pocket costs to surge, even for those with insurance
A cancer diagnosis increases privately insured patients' monthly out-of-pocket costs, which also rise as the disease progresses, new research shows. Out-of-pocket costs jumped by $592.53 per month for the six months after a diagnosis, according to a recent report published in JAMA Open Network. The study underscores the financial toll a cancer diagnosis can take on individuals, even for those who are insured but don't yet qualify for Medicare. While cancer tends to strike later in life, when most patients in treatment are receiving Medicare benefits, a cancer diagnosis can pose an undue financial burden on younger people with private insurance, the report found. Those out-of-pocket costs highlight the need for policy reform, the report said. The research "underscores the need for policies such as paid sick leave that address both insurance continuity and financial assistance, especially for patients with more advanced cancer," the report states. Out-of-pocket costs increased based on a patient's cancer progression, the analysis found. Patients with stage 0 cancer saw their costs rise by $462 per month compared to non-cancer patients, while stage 4 cancer cost people with private insurance an additional $719.97 per month in out of pocket costs. Costs rise as the disease progresses because patients typically require more treatment during cancer's later stages, leading to greater medical expenditures. "This result seems straightforward; later-stage disease is associated with more intensive workup and treatment that can drive higher medical expenditures," the report states. Researchers analyzed medical claims records from the Surveillance, Epidemiology, and End Results (SEER) cancer registry to compare the out-of-pocket costs of privately insured individuals under the age of 65 who were diagnosed with breast, colorectal, and lung cancer, to those without cancer. New research from the American Cancer Society shows that as more people aged 45-49 undergo screening for colon cancer, more early stage diagnoses are being made.
Washington Post
04-08-2025
- Health
- Washington Post
After cancer diagnosis, out-of-pocket costs jump, study says
Out-of-pocket costs increased by an average of $592.53 per month in the six months after a cancer diagnosis, according to a recent study published in JAMA Network Open. The study analyzed a sample of over 46,000 patients from the Surveillance, Epidemiology and End Results (SEER) cancer registry, examining responses from 2008 to 2019. The sample consisted of both patients with and without cancer to provide a control group. Within the sample group, breast cancer was the most common form of cancer (74.1 percent), followed by colorectal (14.5 percent) and lung cancer (11.4 percent). On average, out-of-pocket costs rose by a cumulative total of $4,144.71. 'This difference, driven by the onset of cancer diagnosis and its associated treatment, underscores the financial burden of cancer care on patients with insurance who are not yet eligible for Medicare,' the authors write in the study. Cost also increased with stage of diagnosis. Patients with Stage 0 cancer saw an average increase of $462.01 per month, while Stage 4 patients' costs rose an average of $719.97 per month. The authors note that late-stage disease usually is associated with more treatment and higher medical expenditures. This study has implications for policy reform, the researchers argue. 'The variability in [out-of-pocket costs] based on cancer stage underscores the need for policies such as paid sick leave, that address both insurance continuity and financial assistance, especially for patients with more advanced cancer,' they write. — Hannah Docter-Loeb This article is part of The Post's 'Big Number' series, which takes a brief look at the statistical aspect of health issues. Additional information and relevant research are available through the hyperlinks.
Medscape
28-07-2025
- Health
- Medscape
Cancer Care Costs High Among Privately Insured Patients
TOPLINE: A recent analysis found that privately insured US patients with newly diagnosed cancer, especially those with more advanced disease, had 'substantial out-of-pocket costs.' Monthly out-of-pocket costs among these patients increased by a mean of almost $600, on average, but increased to nearly $720 per month for those with stage IV disease. METHODOLOGY: Out-of-pocket costs for cancer care in the US are rising, but most research has focused on Medicare beneficiaries. It's important to understand privately insured patients' financial burdens, especially with cancer rates growing among younger Americans. Researchers conducted a retrospective study of 19,656 patients with cancer, using a dataset that links claims from a large private insurer to the Surveillance, Epidemiology, and End Results cancer registry. Overall, 74.1% had breast cancer, 14.5% had colorectal cancer, and 11.4% had lung cancer. Analyses also included 26,502 individuals without cancer who were assigned pseudo – diagnosis date. Monthly out-of-pocket costs (copays, co-insurance, and deductibles) were calculated from claims and inflation-adjusted to 2024 US dollars. TAKEAWAY: After a cancer diagnosis, monthly out-of-pocket costs rose by $592, on average. Those added costs increased with disease stage, from $462 per month for stage 0 cancer to $720 per month for stage IV cancer. Out-of-pocket costs spiked in the month of diagnosis and remained elevated for 6 months compared with those in individuals without cancer — totaling an average of $4145 in cumulative additional costs (over 7 months). IN PRACTICE: 'In this cohort study, patients with private insurance were found to have high OOPCs [out-of-pocket costs] after an incident diagnosis of cancer, and those with the most advanced cancer had the highest OOPCs,' the authors wrote. 'The variability in OOPCs based on cancer stage underscores the need for policies such as paid sick leave, that address both insurance continuity and financial assistance, especially for patients with more advanced cancer.' SOURCE: This study, led by Liam Rose, PhD, Stanford University School of Medicine, Palo Alto, California, was published online in JAMA Network Open. LIMITATIONS: Differential insurance attrition could have affected the results: Patients with stage IV cancer were most likely to drop their coverage. The study could only capture direct medical costs, which misses other potential financial burdens, such as lost income and travel expenses. DISCLOSURES: This study received funding support through a grant from the American Cancer Society. One author reported receiving grants from the Department of Veterans Affairs and National Institutes of Health during the conduct of the study. No other disclosures were reported. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Health Line
23-05-2025
- Business
- Health Line
Why Are Some Medicare Advantage Plans Free?
Medicare Advantage plans aren't free. Sometimes called Medicare Part C, private insurers administer these plans, and they may offer $0 premium options. However, plans may have other out-of-pocket costs. Private insurance companies administer Medicare Advantage plans. They're available to anyone eligible for Medicare. Plans include all of the benefits of Original Medicare but typically also include prescription drug coverage and additional benefits, such as: dental vision hearing fitness How can a Medicare Advantage plan be free? If you shop around for a Medicare Advantage plan, you may notice that private insurers advertise some plans as 'free.' Some insurers may refer to Medicare Advantage plans as free because the plans offer a $0 monthly enrollment premium. This offer makes them attractive for people looking to save money on monthly Medicare costs, but other costs exist. A free Medicare Advantage plan means the insurer offers a $0 monthly premium. However, there may be other costs, such as deductibles, coinsurances, and copayments, and you must still pay the Medicare Part B premium to Medicare, which in 2025 is $185. When a private insurance company contracts with Medicare, it receives a set amount of money to cover parts A and B insurance. The company could save money elsewhere by using in-network doctors and facilities. In that case, it could pass those extra savings to members, resulting in a 'free' monthly premium. These 'free' Medicare Advantage plans are also great for companies to advertise attractive savings to potential beneficiaries. Are $0 premium Medicare Advantage plans really free? Even though private insurers advertise $0 premium Medicare Advantage plans as free, you still have to pay some out-of-pocket costs for coverage, such as: Medicare Advantage plan monthly premium: If a Medicare Advantage plan is truly free, you don't have to pay a monthly premium to enroll. Part B monthly premium: You still need to pay the Part B premium to Medicare. In 2025, the Part B premium is $185 per month for most people, although it may be higher depending on your income. Deductibles: Most Medicare Advantage plans have two types of annual deductibles. One is for the bundles of inpatient and outpatient coverage for Part A and Part B, and the other is for prescription drug coverage if the plan includes it. Coinsurance/copayments: Most Medicare Advantage plans charge copayments. A copayment is the out-of-pocket fee you pay every time you receive medical services. Some plans may also charge coinsurance, which is a percentage cost toward billed services. Medicare Advantage plan costs can also differ based on their structure. For example, Preferred Provider Organization (PPO) plans charge different out-of-pocket costs based on whether you use a provider that's in or out of your network. Do you qualify for $0 premium Medicare Advantage plans? There are no qualifications for free Medicare Advantage plans. When searching for a Medicare Advantage plan online, you can usually sort the search results page by 'lowest monthly premium' to see $0 premium Medicare Advantage plans in your area. Another way to keep track of your Medicare Advantage costs is to pay attention to the Evidence of Coverage (EOC) form and annual notice of change (ANOC). Your plan sends them each year, and they can help you stay on top of any price changes or fee increases. Resources to help cover Medicare costs One of the most important ways to manage your Medicare costs is to use the resources available to help cover or lower your costs. These resources include: Medicare savings programs: These programs can help low income beneficiaries pay Medicare Advantage premiums, deductibles, copayments, and coinsurance. Supplemental Social Security: This benefit offers a monthly payment to people who are disabled, blind, or above 65 years old. This payment can help cover Medicare costs. Extra Help: This program can help with prescription drug costs and is available to people with low income and limited resources. Programs of All-Inclusive Care for the Elderly (PACE): This program can help you manage your healthcare needs from within your community. The takeaway Free Medicare Advantage plans mean private insurance companies don't charge a monthly premium. While private insurers advertise these plans as free, you still have to pay the standard out-of-pocket costs, including premiums, deductibles, and copayments. You also still need to pay the Part B premium directly to Medicare. If you qualify for Medicare and are a part A and B enrollee, you can search for $0 premium Medicare Advantage plans in your area. The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.
