Donna Scarfo appreciates every day. Nearly five years ago she had stage 3 breast cancer and had a lumpectomy. The trauma didn't stop there. Financially she was devastated too.
"I was overwhelmed with bills," says Scarfo, 59, a single, self-employed human resources consultant from West Babylon. She had catastrophic health insurance, but she still paid $22,000 for out-of-pocket cancer-related expenses. "I borrowed the bulk of it from my sister and used my savings," she says.
Scarfo is like countless other breast cancer survivors. They are grateful for having beaten a deadly disease, but the financial impact mutes the celebration. Recovering financially can be another epic battle. According to a study led by University of Michigan Comprehensive Cancer Center researchers, four years after being treated for breast cancer, a quarter of survivors surveyed say they are worse off financially, at least partly because of their treatments.
"While fighting for their lives, many women and men in active treatment for breast cancer lose their livelihoods. Unable to work and without a paycheck, they face the potential for catastrophic financial losses, like the loss of a home," says Molly MacDonald, founder and president of The Pink Fund, a nonprofit based in Bloomfield Hills, Michigan, that provides short-term financial aid during breast cancer treatment and recovery.
In six months a health crisis can throw a family into bankruptcy or homelessness.
"We are seeing a number of instances where the woman is the breadwinner, and when she goes down, the financial impact is immeasurable," says Carla Tardif, executive director of the Family Reach Foundation, a nonprofit based in Parsippany, New Jersey, that provides grants to help families with a child or parent with cancer deal with the financial and emotional burdens.
Copays add up
Insurance is a safety net of sorts, but copays can add up to thousands of dollars. What's covered and what's not can be complicated, and varies. Depending on the plan, whether you're self-insured or have insurance via an employer, deductibles can be huge, sometimes as much as $10,000 before coverage kicks in. And for some plans, the traditional 80/20 coverage-to-copay ratio has been replaced by 60/40, explains MacDonald. "Imagine having a deductible of $10,000 in-network inpatient and then having another $40,000 to cover. That is more than the average U.S. household annual income," she says.
It's trickier still without insurance, as was the case for Mary Sagarino of Farmingdale. In 2009 the self-employed hairdresser was diagnosed with stage 2 breast cancer. She was able to get her breast surgery paid for by the Nassau University Medical Center's breast grant program. She also got Medicaid.
Sagarino had invasive ductile carcinoma that spread to her lymph nodes. Chemo and radiation took a toll on her body. She was unable to resume hairdressing as it was too taxing on one of her arms. Now 40-plus and unemployed, she says she's just not the same. "Even though I don't have cancer, I still have chronic issues from the poison put in my body," says Sagarino.
She says people assume that once the cancer is gone, everything is OK. "I'm scraping the barrel, I lost my profession. I'm limited in what I can do. If I do too much with my arm, I feel it. Because of the size of the tumor, they went underneath, up and in, which affects the nerve endings. I try to stay positive, to focus on the fact that I'm now into my sixth year of being cancer-free."
She is grateful for the social workers and others at Adelphi University's Breast Cancer Program. "They were with me all the way," she says. "They helped me with money. I couldn't have gotten through this without Adelphi."
Pam Praetorius, 55, of Huntington, was luckier. She says she "flipped out when the word cancer was attached to me" just shy of her 40th birthday, but says she had amazing insurance through her husband's employer and didn't suffer financially from her breast cancer battle 15 years ago.
Since then, she's fought cancer another way. She is a board member of the Maurer Foundation in Hauppauge, which works to save lives through a focus on breast cancer prevention, healthy lifestyle choices, early detection and risk reduction. And through her church, St. Paraskevi Greek Orthodox Shrine Church in Greenlawn, she founded The Good Neighbor Fund, which provides financial relief, typically around $1,500, for those suffering from an illness or accident.
"So many of those we help have breast cancer," she says. "A lot are single mothers who can't work, or they only work part-time. We have seen people lose homes. If you're lower-middle-class, you may not be eligible for federal aid. We help short-term, like pay their rent for a month," says Praetorius.