[Robert]

Because of my history of cancer, health insurance is very expensive for me, even though there is a good chance that my cancer is cured. I have my college loans to pay back, and a new job, and I was afraid I could not afford to keep going back to the doctor for check-ups.

[Felicia]

I first started having bleeding problems almost a year ago. I did not go to the doctor then because I did not have insurance. I thought I might have cancer, but I did not have the money to pay for treatment anyway. I was so afraid. I felt hopeless.

[Cynthia]
 
When I was diagnosed with melanoma, my insurance company said it would not pay for a new kind of diagnostic test that the melanoma specialist wanted me to have, and they wanted me to be treated in the local hospital, where there is not even a melanoma specialist.
 
[Nate]

Even though I am 83 years old, I have always been healthy and active enough to swim laps every day. I cut quite a figure on the ballroom dance floor too, even if I do say so myself. But, when I got cancer, my doctor just referred me to hospice. I was not ready to die.

[Lucy]

When I took my prescription to my Indian Health Service pharmacy, I was told the pharmacy did not have this medicine. I did not have a choice of where to get this medicine - and I just did not want to make trouble. I thought that maybe I should just do without it.

[Arlene]

I was having quite a bit of pain. The prescription for the pain medicine was very expensive - over $500 per month. Medicare did not pay for outpatient prescription medicines. I thought I had to choose between paying for this medicine to get pain relief, and paying for food for my dog and me.

[Janet]
 
Like a lot of artists, I don't have a regular job that offers me benefits like health insurance. I'm a nightclub singer and work whenever I can. For me, the loss of my breast to cancer was very difficult. The lovely - and sexy - gowns I wear for performances are an important part of my act. Medicaid paid for my cancer surgery, chemotherapy, and radiation treatment. But, I wanted to have breast reconstruction and Medicaid does not cover what they see as "cosmetic" surgery.

[Narrator]

The people we've just heard from share something aside from being cancer survivors: For each of them, the lack of insurance or denials from an insurance plan created a barrier to getting the cancer care service they needed. The ways they went about finding and paying for care show just some of the ways cancer survivors can use basic skills for communication, negotiation, information gathering, problem-solving and decision-making to advocate for their unique needs as they face the challenges of cancer and cancer treatment.

Welcome to this session of The Cancer Survival Toolbox, entitled "Finding Ways to Pay for Care." Like the first six sessions, this session of the Toolbox was created to help cancer survivors learn and develop important survival skills. Throughout each session of The Cancer Survival Toolbox, you will hear the term "Cancer Survivor" used - instead of other terms like "cancer patient" or "cancer victim." You might like to listen to session number 6 in the basic Toolbox set - called "Standing Up for Your Rights" to get a better idea of why we think the term "survivor" is an important one. We define "cancer survivor" in this way: From the time of diagnosis and for the balance of life, a person diagnosed with cancer is a survivor.

The cancer survivors, nurses and social workers who created The Toolbox are very aware that many people with cancer or a history of cancer have trouble finding ways to pay for the care, medicines, and supplies they need. Many people either have no health insurance or have problems with the insurance they have, that can make it a challenge to get quality cancer care. This session specifically deals with these problems and highlights ways to use basic skills covered in The Cancer Survival Toolbox to find and get quality cancer care.

The examples provided by the cancer survivors you meet in this session, we hope, provide ideas about how and where to look for help, and what sort of help you could expect to find. We hope the stories you hear offer hope and encouragement. Finding care when you don't have insurance is difficult, but, as you will see through these survivors' stories, not impossible. Insurance problems need not stand in the way of finding and getting quality cancer care. The reference booklet that comes with the Toolbox lists all the important telephone numbers, mailing addresses, and internet addresses that are mentioned in this program.

Many people find it helpful to follow along with written material while listening to each Toolbox program.  If you'd like a transcript, please visit the Toolbox website at www.cancersurvivaltoolbox.org to print this section.

Now, let's listen to Linda, an oncology social worker, as she talks about the issue of paying for care.

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