Jill, her husband and her two children were enjoying a busy family life when she received the news in 2015 that she had breast cancer. She began to worry about treatment costs straight away:
I was just diagnosed with breast cancer and one of the things which frightened me the most was the unknown financial impact of surgery, scans and hospitals and what would be the impact on my family.
Jill worked part-time and had a second job as a sessional lecturer. Her husband worked full-time and the family lived in a home they were in the process of owning. Her son was in year five and her daughter had just started at a Catholic high school. While the family had budgeted to afford the school fees, they were in a comfortable financial position.
This changed when Jill had to start paying large out-of-pocket costs for her cancer treatment. These costs tightened the family’s budget considerably:
Before surgery were the out-of-pocket expenses for the mammogram, ultrasound, biopsies and MRI scan. The initial costs of visits to the breast surgeon, plastic surgeon and the medical oncologist were also very high. The first visit to the medical oncologist was $380. It is all very sudden and puts significant strain on the family budget even before surgery.
Following surgery and during the initial stages of chemotherapy, Jill kept working her usual part-time hours. Her workplace was supportive of her situation and allowed her to work from home. As the side effects of treatment started to affect her, she had to reduce her hours at work. Jill’s workplace had a ‘sick leave bank’, where employees could donate their sick leave to help their colleagues. She was able to use this to partially supplement her income for a short period of time and was very grateful for the generosity of her colleagues.
Jill worked reduced hours for as long as possible, although it affected how soon her income protection insurance benefits could be paid. It took more than 120 days after Jill finished work for her income protection insurance payments to come through, as the result of long processing times. This meant financial support was not available when the family needed it.
Jill was aware she could access good care via the public health system, however she chose to use her private health insurance as she wanted to choose her own breast surgeon, medical oncologist and plastic surgeon for a range of reasons. This included the need for a long-term (10 year) doctor-patient relationship with her care providers.
Jill had opted to have a breast reconstruction at the same time as her mastectomy and sourced quotes from three plastic surgeons. She was very surprised: not at having to pay out-of-pocket expenses, but at the extremely high cost of these expenses.
Aware that she would be facing these high costs, Jill spoke with her plastic surgeon who suggested she pay the out-of-pocket costs – around $5,000 – on a payment plan:
Our plastic surgeon was fantastic. He recommended a monthly payment system which was very beneficial. This was the difference between affording to do the breast reconstruction at the same time as the mastectomy or delaying it.
Jill found herself becoming more assertive in asking about costs of treatment and out-of-pocket expenses for doctors and scans. She found people generally responded well to her questions.
Jill advises other women in her position to not be afraid to ask about costs:
Don’t be afraid to ask what the costs are going to be. And do not be afraid to ask whether or not you can do a no-gap or if you could do a payment plan. It will help to ease stress if you know what the financial implications will be. The thing women should be worrying about is themselves and getting through the surgery with their family, not how they’re going to fund it.
While she is 12 months on from finishing her treatment and back at work, the financial impact of breast cancer is still an issue for Jill and her family. Costs such as medicines, doctors’ appointments, wire-free bras, follow-up scans and MRIs, and seeing a specialist to deal with the menopausal symptoms caused by her treatment all have to be built into their budget. Jill questions the value of private health insurance after her experience of having such high out-of-pocket costs:
It is important for other women to realise that just because they have private health insurance they may still be potentially significantly out of pocket. The best way to alleviate financial stress during this time is to ask questions of the doctors before treatment or when trying to make decisions about treatment options. Whilst dollars should not dictate a newly diagnosed woman’s treatment decisions the reality is, it will.
Jill’s experience of cancer was hard enough, but the out-of-pocket costs made it even more difficult:
When something like this happens I do feel the financial impact of treatment increases stress levels when we should be recovering.