Elizabeth Chavez, a patient navigator at Susan G. Komen’s Patient Care Center (PCC), shares how she and her team work to reduce the financial barriers to care within the breast cancer community. Read her story below.
No one should have to choose between breast cancer treatment and paying their rent or buying groceries. As patient navigators at Komen’s PCC, one of our primary goals is to reduce breast cancer-related financial distress. To do this, we must often think outside the box to find ways to help people overcome financial barriers, including finding resources for cutting treatment costs, maximizing insurance benefits and securing financial aid so patients can focus on their care.
Here are just a few examples of how PCC navigators help reduce financial barriers to breast cancer care:
We Help Navigate Through Confusing Medical Bills
Medical bills can be very confusing, and patients often need help in understanding their insurance coverage. Some common questions are: “What is this charge for? Is it covered? Is my provider in network? What is my deductible?” I always try to explain these concepts in simple terms. The goal is to give patients the tools and the confidence to understand their coverage and to advocate for themselves.
If a patient receives a bill they do not understand or recognize the charges, we discuss it, and if something doesn’t seem right, I educate the patient on what next steps to take.
I also help explain insurance terms and the different types of coverage. When patients aren’t familiar with the different types of insurance, I’ll often ask them to pull out their insurance card and tell me what it says. Is it a private plan through an employer, a public plan or marketplace coverage? Some patients don’t know how they obtained their policy. We discuss what questions to ask, and I help the patient prepare a list of questions for their insurer.
We Make Health Insurance Easier to Understand and Access for Patients
Another part of our process is guiding patients to better understand and enroll in health insurance plans, including Medicaid, Medicare and Affordable Care Act (ACA) exchange plans. To do this, I first assess the patient’s eligibility for both private and public health insurance coverage options and talk through all the available choices. I also advise them to consider how much coverage they may need for their treatment to minimize out-of-pocket costs.
I can assist patients with completing a Medicaid application online, help them navigate the healthcare.gov website or connect them with an organization or insurance navigator that can help them with enrollment. If a person is not insured, we explore other options, like applying for charity assistance programs through a hospital system or cancer center. The key is finding something that works.
Many people think having insurance means everything is covered, but that’s often not the case. A big part of my role involves explaining how insurance works, insurance terms and how different plans can impact their care and costs. That’s how we, as patient navigators, empower patients to make informed decisions and make a real impact by accessing the care they need.
We Help Manage Non-Medical Expenses
Some of the most common barriers to care encountered by patients are struggles with day-to-day living expenses such as rent or mortgage payments, utilities, transportation, cell phone bills, childcare or eldercare, deductibles, groceries and other out-of-pocket costs. Every patient’s situation is different, and each person faces unique financial barriers.
These challenges can depend on the type of insurance (or whether they have any at all). Another factor is the person’s job, including what kind of work they do and how long they’re able to keep working. Other factors include the person’s treatment plan, support system and access to care based on where they live. Breast cancer is an expensive disease that affects everyone, but the burden is often heavier for those from historically marginalized communities.
PCC navigators support patients through active listening and gaining an understanding of their financial situation, where they live, when they were diagnosed and what their specific financial needs are. This information helps us determine where to find help and assess whether the patient meets the eligibility criteria for available resources.
We Provide Personalized, Trusted Care to Each Individual
Research shows patient navigation is most effective when delivered by someone who shares a lived experience. That is why diversity of navigators is very important. Lack of access to culturally and linguistically appropriate care can be a major barrier. For example, Spanish-speaking patients are often more likely to experience poorer outcomes due to limited available resources and language barriers.
As a bilingual navigator, I believe we are more responsive and effective in helping patients because we understand their culture, speak their language and often share similar experiences. This helps us to connect with patients on a deeper, more personal level.
I’ve worked with patients whose children translate for them and serve as caregivers while they are going through their treatment. I did that for my mom as well. By creating stronger connections through shared experiences like these, we can build trust with patients.
We’re By Your Side, Every Step of the Way
When a patient tells me, “Elizabeth, I got assistance for three months on my car payment,” or they were approved for Medicaid and don’t have to worry about how to pay for their treatment, these are just a few examples of how we can help. And when a patient shares what you have done for them with others, or when they can help other cancer patients, that’s just an added bonus. You know you did something right.
I like to check in with patients even after their care ends, just to make sure they’re still supported and continuing to advocate for themselves. If new resources or funding become available, I will pass that information along, too. Over time, patients need us less, and that’s exactly what we hope for as patient navigators: That they can continue to stay focused on their path to healing.
Do you need help with navigating the financial challenges of breast cancer care? The Patient Care Center is here for you!
Call 1-877-465-6636 or email helpline@komen.org to get started.
The Helpline is available Monday through Thursday, 9 a.m. – 7 p.m. (ET) and Friday, 9 a.m. – 6 p.m. (ET).
Se habla español.
Komen has educational resources available to help you deal with your own diagnosis here,
We also have resources to help those who are supporting someone with breast cancer here.
