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The Out-of-Pocket Costs for Cancer Can Be Astronomical. Here Are Ways to Curb Expenses
How to ease the financial strain so you can focus on healing
Out-of-pocket costs for a person with breast, colorectal or lung cancer averaged $592.53 per month during the first six months after diagnosis.
Chris Gash
Key takeaways
- The average cost of chemotherapy for the uninsured ranges from $8,000 to $50,000 per treatment cycle, with complete courses potentially exceeding $200,000, depending on the drug regimen, the type of chemotherapy treatment and other factors.
- If your insurance company refuses to pay for a certain treatment or medication, you can appeal the decision.
- Your hospital or provider may agree to a no-interest payment plan that allows you to pay what you owe over time if you have a large medical bill.
Nearly five and a half years ago, my life — and my finances — were turned upside down when I received a devastating diagnosis of pancreatic cancer, which has a 13 percent five-year survival rate. While today I’m one of the lucky ones who is cancer-free, the financial effects of my treatment remain.
During my illness, I endured a year of chemotherapy, a month of radiation and a Whipple procedure, a surgery in which my pancreas was removed. I spent nearly six weeks in hospitals, including one month-long stay, and lost so much weight that I needed a feeding tube to supplement my eating for a year.
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My insurance covered most of the treatment costs, which surpassed $400,000, but I was still left with thousands in medical bills and travel-related debt because of frequent visits from my home in Maryland to be treated at the Mayo Clinic in Rochester, Minnesota.
Unfortunately, my situation is not unique. Cancer is one of the most expensive health conditions to treat, according to the National Institute for Health Care Management (NIHCM) Foundation. For the uninsured, the average cost of chemotherapy ranges from $8,000 to $50,000 per treatment cycle, with complete courses potentially exceeding $200,000, depending on the drug regimen, the type of chemotherapy treatment and other factors. The median cost for one session of proton radiation therapy ranges from $4,707 to $6,690, according to a study published in 2022, while surgery can easily top $40,000. Cancer immunotherapy treatments often cost more than $100,000.
Health insurance only covers so much. One study found that out-of-pocket costs for a person with breast, colorectal or lung cancer averaged $592.53 per month during the first six months after diagnosis.
For some patients, these costs can be financially devastating. There’s even a term for it: “financial toxicity,” which describes the negative impact of high cancer care costs. Researchers at Beth Israel Deaconess Medical Center and Harvard Medical School reported in 2024 that people who had received a cancer diagnosis were nearly five times more likely to have filed for bankruptcy, and had average credit scores nearly 80 points lower than non-cancer patients.
It’s hard for patients who are living with any chronic disease to manage health care costs, but the financial pressure is especially acute right now, with living costs increasing so rapidly, says Amy Niles, chief mission officer of the Patient Advocate Foundation, an organization that helps people with chronic and life-threatening illnesses get the care they need. “People are dealing with the reality of the cost of medical treatment at the same time that they’re dealing with rising food and energy costs,” she says.
Fortunately, there are resources and strategies that can help cancer patients offset their out-of-pocket expenses.
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Determine how much treatment will cost
After you receive a cancer diagnosis, contact your insurance company to find out what your plan will and will not cover. Ask about out-of-pocket costs, such as whether you have to meet a deductible before coverage kicks in or if there is a copayment for certain services like imaging tests or chemotherapy.
If your plan covers only a limited network of providers and you’d prefer to see a specialist outside the network, find out how much more you would have to pay. Also, ask your insurer whether your plan covers second opinions, clinical trials and complementary treatments, such as meditation and massage, that are outside of conventional medicine but can improve your well-being during treatment.
Some insurers require “step therapy,” in which patients must try a lower-cost treatment or medication before insurance will cover a higher-cost option — after the lower-cost one fails to treat the patient’s condition.
Insurers sometimes assign case managers to clients with major health conditions. I had one, and she proved invaluable. Having a single point of contact who knew the ins and outs of my case meant I didn’t have to keep explaining my situation to different representatives when I called with questions about my coverage or treatment, and I always knew what to expect regarding co-pays. If you’re not automatically assigned a case manager, you can ask your insurer if your plan covers one.
If you’re covered by Medicare and have limited income and resources, you may qualify for Extra Help, a federal program that pays for certain out-of-pocket pharmaceutical costs. You can apply for the program on the Social Security website at any time. You’ll be enrolled automatically if you get Medicaid, Supplemental Security Income (SSI) payments from Social Security or help from our state’s Medicare Savings Program.
If your insurance company refuses to pay for a certain treatment or medication, you can appeal the decision. Typically, you would first file an internal appeal, asking your insurer to reconsider. If they refuse to reverse their decision, you can file an external appeal with your state’s insurance regulator. When it’s medically necessary to begin treatment quickly, as is often the case after receiving a cancer diagnosis, you may be able to file an expedited appeal with your insurance company and state regulator at the same time.
If your appeals are denied, you still have options. Your doctor might be able to suggest a lower-cost treatment, Niles says. You may also be eligible for a clinical trial, which offers experimental treatments that are often free or less expensive than traditional treatments, though there are risks involved, such as unexpected side effects or reactions. (Many clinical trials offer travel reimbursement for expenses like gas, parking, tolls and, in some cases, rideshare services or public transportation.)
To help you determine what financial options are available, some oncology practices have financial navigators on staff who can help you find assistance programs and other ways to manage your treatment costs. Ask your provider if they offer this service.
Keep in mind that some expenses go beyond medical costs, says Christine Ebert, a Minneapolis-area financial adviser with Ameriprise Financial Services. There could be the cost of gas to get to and from treatment, for example, and flight and hotel expenses if you need to see a specialist in another state, as I did. Ebert recommends identifying the additional expenses you’ll need to account for.
Also consider your regular financial obligations such as your mortgage, credit card balances and day-to-day expenses, so that you don’t miss any payments in those areas. Take the time to compile a physical list, advises Taylor Jessee, founder of Impact Financial in Richmond, Virginia, who volunteers with CancerLINC, a Richmond-based organization that connects cancer patients to financial, legal and community resources. “It doesn’t have to be anything fancy,” he says. Seeing your expenses in a simple spreadsheet can help you get a clearer picture of your finances.
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Softening the financial blow
Once you have a sense of the costs you’re likely to incur, these strategies can help you prepare for them and potentially save money.
Look for sources of funding. Several organizations provide financial assistance to people living with cancer and other serious health conditions. Some are national organizations that offer funding and support to combat cancer broadly, such as CancerCare, the Healthwell Foundation and the American Cancer Society. Others focus on specific types of cancer, such as Susan G. Komen (breast cancer) and Blood Cancer United, or provide assistance regionally, such as the Angel Foundation in Minnesota and the Texas Oncology Foundation.
FundFinder is a free website that helps you identify patient assistance opportunities from health care advocacy nonprofits such as the Patient Advocate Foundation, CancerCare and the Healthwell Foundation. Some groups assist with lifestyle challenges during cancer treatment. For example, the Patient Advocate Foundation has a transportation fund that helps patients cover the costs of getting to and from treatment. Other organizations, including the Foundation for Financial Planning, Triage Cancer and Family Reach, provide free financial resources to people who are fighting cancer.
Explore pharmaceutical patient assistance programs. Check with your state’s health department to see if it offers a State Pharmaceutical Assistance Program that can help pay for medications. Also, many pharmaceutical companies offer patient-assistance programs that can slash the cost of your prescriptions, whether you have insurance or are uninsured. (These corporate programs don’t typically cover patients who have Medicare or other types of federal health insurance, Niles says.)
Negotiate a payment plan. If you have a large medical bill, the hospital or provider may agree to a no-interest payment plan that allows you to pay what you owe over time. This approach beats paying interest, and it can help you avoid taking out personal loans or lines of credit to pay your medical expenses.
Negotiating a payment plan with my hospital helped make my bill more affordable. I’m on track to pay off the remaining balance by December.
Fundraise on your own. Websites like GoFundMe, Spotfund and FreeFunder can help you raise money from family and friends. There’s also Help Hope Live, a nonprofit that helps individuals experiencing a medical crisis raise money from people in their communities through virtual and in-person events.
Determine what assets you can tap. Once you’ve exhausted outside funding options, take a look at your assets and see what you can draw from, Ebert says. You may want to start by pulling money from your emergency fund, if you have one. If you’re working and have a health savings account (HSA) or a flexible savings account (FSA), you may be able to pay for certain medical-related expenses with tax-free money.
For some patients, out-of-pocket costs for cancer treatments can be financially devastating.
Chris Gash
Consider maxing out your contributions to these accounts so that you’re in a position to pay for long-term treatment, Ebert suggests. Cancer treatment can last for years, depending on your diagnosis and how your body responds to treatment. For 2026, you can contribute up to $3,400 in an FSA. The HSA contribution limit for 2026 is $4,400 for individual coverage and $8,750 for family coverage; you can contribute an extra $1,000 if you’re 55 or older.
If you own a home, your equity may be a useful source of cash through a home equity loan, a home equity line of credit or a cash-out refinance. I did a cash-out refinance to get extra money to pay for my recurring travel to and from Minnesota for treatment. The process involved taking out a new, larger mortgage to pay off my old one, allowing me to tap some of the equity I had built up in my home.
Be cautious about tapping retirement funds to pay for cancer treatment, Ebert says. Under SECURE 2.0, a 2022 federal law designed to bolster Americans’ retirement savings, you can withdraw funds from an eligible retirement plan, such as a 401(k), traditional IRA or Roth IRA, before age 59½ without penalty if you’ve been diagnosed with a terminal illness, but if your treatment is expected to lead to recovery, such early withdrawals will come with an additional 10 percent tax. If you have a 401(k) plan, you may be able to borrow from your account’s balance, but if you leave the job, you may have to pay it back in full or face the 10 percent penalty.
What about using credit cards? With average interest rates topping 20 percent, that’s a risky option if your medical costs are too high to pay off on the next bill. I used a credit card to book flights and hotel stays in Minnesota, but I was able to take advantage of a 0 percent promotional interest rate for a year. I paid more than the minimum whenever I could and paid off the balance about two months after the introductory rate expired, so the interest I paid was negligible.
Take advantage of tax breaks. If your health care costs exceed 7.5 percent of your adjusted gross income — your total income minus adjustments, certain qualified expenses that are not taxable — you may be able to deduct the amount over that threshold, including travel and lodging expenses for out-of-town medical treatment. Be sure to keep records of your expenses in case you get audited.
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Bouncing back financially after recovery
Depending on how you pay for your cancer treatment, the financial ramifications can linger long after you’ve physically healed.
You may have been so focused on paying your medical bills that you stopped contributing to retirement accounts, or you depleted a significant portion of your nest egg. You might also have bills remaining, as I do four years after being declared cancer-free.
Depending on your situation, these tactics may help you recover financially.
Rebuild your savings over time. Take small steps to shore up your finances. If your emergency savings have been depleted, the first thing you should do is try to set a little money aside each month to rebuild them, Jessee says.
If you’re still working and stopped retirement plan contributions, restart them, perhaps at a smaller percentage, and increase them over time, Jeesee adds.
Be strategic about ongoing medical costs. Completing your primary course of treatment probably won’t end your cancer-related care costs. Follow-up visits and scans can go on for years. Ebert, a cancer survivor herself, says she tries to schedule multiple tests in the same year so that they apply to the same deductible.
Because I know how suddenly a serious illness can strike, I’ve tightened my budget so I can save more for unexpected medical costs.
Be patient with yourself. “Making it through a cancer diagnosis is no small feat in and of itself,” Jessee says. “You’ve made it through one of the hardest experiences imaginable.” Celebrate small wins, and know that rebuilding your finances may take time. “Financial recovery is not a sprint, it’s a marathon,” he says.
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