💰 Financial Help

📊 Understanding Treatment Costs

GBM treatment can cost hundreds of thousands of dollars. Knowing what to expect helps with planning:

Treatment	Estimated Cost Range	Notes
Brain Surgery (Craniotomy)	$50,000 - $150,000+	Includes hospital stay
Radiation (6 weeks)	$10,000 - $50,000	Varies by type and location
Temozolomide (per month)	$1,000 - $5,000	Generic available
Optune Device	$21,000/month	Often covered by insurance
Avastin (per infusion)	$5,000 - $10,000	For recurrence
MRI Scans (each)	$1,000 - $5,000	Every 2-3 months

🏥 Hospital Financial Resources

Start here — most hospitals have programs to help:

Financial Counselors

Every hospital has financial counselors. They can:

• Explain your bills and what insurance covers
• Set up payment plans
• Connect you with charity care programs
• Help with Medicaid applications

Charity Care / Financial Assistance

Most non-profit hospitals are required to offer financial assistance to those who qualify:

• Ask about "charity care" or "financial hardship" programs
• Income limits vary (often 200-400% of federal poverty level)
• Can reduce bills by 50-100%
• Apply even if you have insurance — may cover what insurance doesn't

Social Workers

Cancer center social workers are invaluable. They know:

• Local assistance programs
• Transportation resources
• Housing assistance for treatment away from home
• Food assistance programs

🏛️ Government Programs

Social Security Disability Insurance (SSDI)

GBM qualifies for Compassionate Allowances — fast-track approval:

• What it is: Monthly payments if you've worked and paid into Social Security
• Compassionate Allowances: GBM is on the list for expedited processing (weeks, not months)
• Medicare: SSDI includes Medicare after 24 months (but apply anyway — clock starts at application)
• Amount: Based on your work history, average $1,500/month

Learn about Compassionate Allowances →

Supplemental Security Income (SSI)

For those with limited work history:

• Need-based program (income and asset limits)
• Also qualifies for Compassionate Allowances
• Includes Medicaid in most states

Medicaid

State-run health insurance for low-income individuals:

• Income limits vary by state (expanded Medicaid states more generous)
• Can work alongside Medicare
• May cover services Medicare doesn't
• Apply through your state's Medicaid office or healthcare.gov

Medicare

• Age 65+: Already eligible
• Under 65 with disability: Eligible 24 months after SSDI approval
• Low-income assistance: Medicare Savings Programs can help with premiums and copays

⏰ FMLA — Protecting Your Job

The Family and Medical Leave Act protects your job while dealing with serious illness:

What FMLA Provides

• 12 weeks of unpaid, job-protected leave per year
• Health insurance continues during leave
• Can be taken all at once OR intermittently (for appointments, bad days)
• Applies to both patients AND caregivers

Who Qualifies

• Worked for employer at least 12 months
• Worked at least 1,250 hours in past 12 months
• Employer has 50+ employees within 75 miles

How to Apply

1. Notify your employer (HR department)
2. Get FMLA certification form from HR
3. Have your doctor complete the medical certification
4. Submit to HR — approval typically within 5 days

💊 Prescription Assistance

Manufacturer Patient Assistance Programs

Drug companies offer free or reduced-cost medications to those who qualify:

Co-Pay Assistance Programs

If you have insurance but can't afford copays:

• Patient Access Network Foundation
• Patient Advocate Foundation Co-Pay Relief
• NeedyMeds — Database of assistance programs
• RxAssist — Comprehensive database

🏢 Organizations That Help

Housing During Treatment

If you need to travel for treatment:

• American Cancer Society Hope Lodge — Free housing near treatment centers
• Joe's House — Database of lodging near cancer centers
• Ronald McDonald House — For families with children undergoing treatment

Transportation

• American Cancer Society Road to Recovery — Volunteer drivers
• Medicaid transportation — If enrolled, may cover rides to medical appointments
• Hospital social workers — Know local transportation resources

📋 Insurance Navigation

Know Your Rights

• Pre-authorization: Get it before procedures when required
• In-network vs. out-of-network: Costs can be dramatically different
• Appeals: You have the right to appeal denied claims
• External review: If internal appeal fails, you can request external review

When Claims Are Denied

1. Get the denial in writing — Ask for specific reasons
2. Review your policy — Is the treatment actually excluded?
3. Ask your doctor for help — A letter of medical necessity can be powerful
4. File an internal appeal — Usually have 180 days
5. Request external review — Independent review if internal fails
6. Contact Patient Advocate Foundation — They can help with complex cases

Marketplace Insurance

If you lose job-based coverage:

• Healthcare.gov — Shop for plans during open enrollment or after qualifying life event
• Losing job coverage is a "qualifying event" — special enrollment period
• Subsidies available based on income
• Pre-existing conditions cannot be excluded

💳 Managing Medical Debt

Before Bills Arrive

• Ask for cost estimates before procedures
• Confirm in-network status for all providers
• Apply for financial assistance proactively

When Bills Arrive

• Review bills carefully — Errors are common
• Request itemized bills — You have the right to see what you're being charged for
• Negotiate — Hospitals often accept less than the billed amount
• Set up payment plans — Most hospitals offer interest-free plans
• Ask about prompt-pay discounts — Some offer 10-20% off for quick payment

If Debt Becomes Overwhelming

• Medical debt and credit: New rules prevent reporting medical debt under $500 to credit bureaus
• Nonprofit credit counseling — Free help with debt management
• Medical billing advocates — Professionals who negotiate on your behalf (fee-based)
• Bankruptcy: Last resort, but medical debt is dischargeable — consult an attorney

📝 Financial Checklist

• Applied for SSDI (Compassionate Allowances)
• Met with hospital financial counselor
• Applied for hospital charity care/financial assistance
• Checked Medicaid eligibility
• Applied for FMLA (if still working)
• Explored short-term disability through employer
• Contacted drug manufacturers for assistance programs
• Checked co-pay assistance programs
• Consulted with oncology social worker
• Set up payment plans for current bills
• Reviewed and organized insurance documents