Table of ContentsView AllTable of ContentsMedical Bill TermsInsurance CoverageInvisible CostsQuestions to AskFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Medical Bill Terms
Insurance Coverage
Invisible Costs
Questions to Ask
Frequently Asked Questions
Lung cancerforms in the lung tissues when cells grow out of control.It causes about 25% of all cancer deaths, making it the leading cause of cancer death for people of any sex.
In many cases, people with lung cancer don’t have any symptoms. Some people with lung cancer experience symptoms like chest pain, wheezing, unexplained weight loss, difficulty breathing or swallowing, coughing up blood, hoarseness, or apersistent cough. Sometimes, the cancer is discovered during an imaging test (such as an X-ray) for another condition.
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The cost of lung cancer treatment varies widely, depending on your insurance plan, diagnosis, and choice of treatment, among other factors. Learn more about what to expect, how much is covered, and what you might pay out of pocket.
Costs of Lung Cancer CareA report analyzing costs billed to Medicare for different types of cancer projected the costs per patient in terms of 2019 dollars. These figures do not represent the out-of-pocket costs to the patient.Care for lung cancer in the first year of diagnosis averaged $65,700, plus $3,500 for oral medications under Medicare Part D. For each year after that, care was $11,900, and oral medications $2,700. The cost of care in the last 12 months of life was $106,000 and oral medications were $4,500.
Costs of Lung Cancer Care
A report analyzing costs billed to Medicare for different types of cancer projected the costs per patient in terms of 2019 dollars. These figures do not represent the out-of-pocket costs to the patient.Care for lung cancer in the first year of diagnosis averaged $65,700, plus $3,500 for oral medications under Medicare Part D. For each year after that, care was $11,900, and oral medications $2,700. The cost of care in the last 12 months of life was $106,000 and oral medications were $4,500.
A report analyzing costs billed to Medicare for different types of cancer projected the costs per patient in terms of 2019 dollars. These figures do not represent the out-of-pocket costs to the patient.
Care for lung cancer in the first year of diagnosis averaged $65,700, plus $3,500 for oral medications under Medicare Part D. For each year after that, care was $11,900, and oral medications $2,700. The cost of care in the last 12 months of life was $106,000 and oral medications were $4,500.
When you start looking into the cost of lung cancer treatment, it can be difficult to understand the terminology on your medical bill. Here are some of the key terms you might encounter.
Premium
Thepremiumis the amount that you pay for your insurance plan every month.If you purchase your insurance plan through your state’s insurance marketplace, you may be eligible for tax credits that can help you lower your premium.
Deductible
Yourdeductibleis the amount that you pay for your healthcare visits before your insurer begins to cover costs. Often, insurance plans with lower premiums have higher deductibles (and vice versa).
Co-Pay
A co-pay, or co-payment, is one type of patient cost-sharing—the amount of covered health costs that you pay out of pocket.A co-payment is afixed amountthat you pay for a certain kind of service, such as outpatient visits or lab tests.
Another form of patient cost-sharing is coinsurance. Coinsurance is thepercentageof each medical bill that you pay for covered health services.
Often, insurance plans with lower premiums require higher co-payments and coinsurance payments.
Out-of-Network Costs
Out-of-network costs, including both coinsurance and co-payments, are the costs you pay for healthcare providers and services that aren’t contracted with your insurance plan.To keep costs down, it’s important to use in-network providers for yourlung cancer treatmentswhenever possible.
Treatment Options for Lung Cancer
The two main kinds of lung cancer arenon-small cell lung cancer(which is the more common type) andsmall cell lung cancer.Here are some of the treatment options for each type of lung cancer.
Small cell lung cancer:
Non-small cell lung cancer:
Differences Between Copay and Health Coinsurance
It’s important to know the details about your insurance plan, including what it covers, how much you pay, and in what form you pay it.
Medicare
Medicare provides insurance coverage to Americans over 65 and some people with disabilities.There are several parts toMedicare:
People often pay higher premiums on Medicare than they might with other types of health insurance, but they pay less overall in cost-sharing expenses—especially if they have Medigap coverage.
Medicaid
Medicaid provides insurance coverage to eligible people who are pregnant or low-income, as well as people with disabilities, children, and older adults.
Eligibility for Medicaidcoverage is retroactive. This means that you may be eligible for treatment and testing you underwent during the past three months before your application was finalized. Medicaid also covers some transportation expenses, which can help if you have to visit different specialists.
Private Insurance
Private insurance plans are offered through your employer or purchased individually. Surgery, radiation, and chemotherapy are generally covered under private insurance plans, but you may have co-pays or coinsurance.
It’s important to make sure that your plan offers the protection of an out-of-pocket limit, as cancer treatments often reach the maximum quickly.
The ACS reports that patients with private insurance plans through a large employer often pay the lowest out-of-pocket costs. Meanwhile, those withhigh-deductible plansthrough a small employer or individual marketplace plan usually have to pay more upfront.
Average Costs
The costs billed to insurance providers and programs such as Medicare can be high. But the average out-of-pocket costs for lung cancer treatments vary widely, depending on the insurance coverage and the duration of treatment. Here are some of the average costs for common lung cancer treatments:
How to Choose the Best Health Insurance Plan for You
In addition to the costs of medical care—such as blood tests, imaging tests, hospital stays, specialist referrals, clinic visits, drug costs, radiation treatments, surgical procedures, and more—there are many other possible invisible costs associated with lung cancer treatment.
These indirect costs may include:
Questions to Ask Before Treatment
If you have financial concerns about lung cancer treatment, talk to your oncologist or oncology nurse. They can connect you with a social worker, patient advocate, financial counselor, or case manager who can get to know your situation in-depth and help you come up with a financial plan that works for you.
Here are a few questions you can ask about your treatment costs:
ResourcesTo find resources for financial assistance or affordable options for lung cancer treatment, use the searchable database at the Cancer Financial Assistance Coalition.
Resources
To find resources for financial assistance or affordable options for lung cancer treatment, use the searchable database at the Cancer Financial Assistance Coalition.
Summary
Lung cancer treatment costs vary widely, depending on your insurance plan, supplemental coverage, duration of treatment, location, diagnosis, and choice of treatment. It’s important to know the details of your insurance plan, including your premium, deductible, cost-sharing requirements, and out-of-network costs.
Medicare, Medicaid, and private insurance plans cover many of the costs associated with nonexperimental lung cancer treatment. Additional costs may include travel, transportation, counseling, lost earnings, rehabilitation, household upkeep, caregiving expenses, and more.
If you have financial concerns about your lung cancer treatment, talk to your oncologist. They can point you toward a variety of resources, including charitable organizations, social workers, case managers, financial counselors, and patient advocates. Before starting treatment, ask questions about the estimated total cost, payment plans, and financial assistance options.
A Word From Verywell
If you’re already wrestling with the lung cancer diagnosis of yourself or a loved one, it can be difficult to think about the costs of lung cancer treatment. Talk to your doctor about meeting with a social worker or financial counselor to connect you with the resources to lower your costs as much as possible.
Under the Affordable Health Care Act, insurers in the United States are required to cover chemotherapy.However, not all chemotherapy drugs or other treatments are covered in full. There may also be out-of-pocket costs associated with clinic visits and other related services.
The costs of stage 4 lung cancer treatment vary widely, depending on your insurance plan, supplemental coverage, treatment option, and duration of treatment.
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Lung cancer.
American Cancer Society.Key statistics for lung cancer.
Mariotto AB, Enewold L, Zhao J, Zeruto CA, Yabroff KR.Medical care costs associated with cancer survivorship in the United States.Cancer Epidemiol Biomarkers Prev. 2020;29(7):1304-1312. doi:10.1158/1055-9965.EPI-19-1534
Healthcare.gov.Premium.
Healthcare.gov.Deductible.
Healthcare.gov.Cost sharing.
Healthcare.gov.Copayment.
Healthcare.gov.Coinsurance.
Healthcare.gov.Out-of-network copayment.
American Cancer Society.The costs of cancer, 2020 edition.
Facing Hereditary Cancer EMPOWERED.Coverage of cancer treatment - Medicare and Medicaid.
CostHelper.Cost of lung cancer treatment.
Paravati AJ, Boero IJ, Triplett DP, et al.Variation in the cost of radiation therapy among Medicare patients with cancer.J Oncol Pract. 2015;11(5):403-409. doi:10.1200/JOP.2015.005694
American Society of Clinical Oncology.Understanding the costs related to cancer care.
American Society of Clinical Oncology.Questions to ask about cost.
American Cancer Society.Things to know about the cost of your cancer treatment.
Cancer Financial Assistance Coalition.Resources for people with cancer.
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