Cancer Costs: How To Manage Housing Expenses During Treatment

By Melissa Brock

January 31, 2019

A cancer diagnosis can be heartbreaking without adding financial worries to the mix. If bills pile up and wages grind to a halt, it can become impossible to manage expenses and can lead to an unbearable degree of stress. Amid crushing medical bills and smaller paychecks, you and/or a loved one may even face the harsh reality of a home loss.

These financial realities can wreak havoc on even the most savvy investor’s savings, but there are various assistance options that can help. If you’d like to stay in the comfort of your own home while undergoing cancer treatment, it can be a wise move, as cancer can be a temporary condition.

Sarah Manes, vice president of programs and community relations for the Angel Foundation, assists adults in active cancer treatment who live or receive treatment in the Twin Cities, Minnesota metro area. The Angel Foundation provides emergency financial assistance for non-medical expenses, and Manes says she sees a lot of families who are concerned about groceries, utilities, gas for vehicles and mortgage payments — the basics. “They’re worried about, ‘How am I going to get gas in my tank because I’m going to the Mayo Clinic five times a week and it’s 100 miles away?’” Manes says. “Or, ‘I’m one payment away from losing my house.’”

In one 2017 Duke University survey, more than one-third of 300 cancer patients who were interviewed reported that they spent more on their treatments than they had initially anticipated. Sixteen percent of those interviewed reported high or overwhelming financial stress. These individuals, who had health insurance, said they spent about a third of their total household income on health care-related costs, not including insurance premiums. More than 60% of this particular group claimed that private insurance was their primary source of health care.

A 2017 report from the Cancer Action Network reported that U.S. cancer patients paid nearly $4 billion out of pocket for cancer treatments. The U.S. spent a total of $87.8 billion in 2014 on cancer-related health care through employers, insurance companies and taxpayer-funded public programs like Medicare and Medicaid and through cancer patients and their families.

Assess your financial situation

If you’ve been recently diagnosed or if you’ve been dealing with a cancer diagnosis, now might be the time to take a few steps to evaluate whether some resources can help you straighten out your finances, help you avoid bad credit as well as foreclosure.

Step 1: Do an income and insurance evaluation.

Understand how you can manage your job and how your employer can help during a cancer diagnosis. According to cancerandcareers.org, it’s a great idea to do the following:

Know everything you can about your insurance policy. Understand what your insurance covers, and what it doesn’t. If you have your health insurance with your employer, don’t let your health insurance lapse, and always pay premiums on time. Know the details of your plan, including whether a provider is in-network or out-of-network. If you don’t have health insurance through your employer, ask yourself if you need Medicare, Medicaid or a private insurance company. Do your research so you understand the most minute details.

Know your rights under the Family and Medical Leave Act. The Family and Medical Leave Act (FMLA) is a federal law that guarantees certain employees up to 12 weeks of unpaid leave each year with no job loss threat. Employers are also required to maintain health benefits for FMLA-eligible workers.

Learn about your company’s disability plan. Understand both short and long-term disability policies. If there comes a time when you will not be able to work, you can apply for disability benefits.

Step 2: Know the costs of your treatment.

It’s best to ask questions about the expenses you’ll incur during your cancer treatment. The list of expenses from American Cancer Society can include:

Provider visits
Lab tests
Clinic visits for treatments
Procedures
Imaging tests
Radiation treatments
Drug costs
Hospital stays
Surgery
Home health care

Health insurance won’t cover everything, so ask your doctor and insurance company about cancer costs. It’s also possible to be proactive and ask about alternatives. For example, instead of an expensive chemo pill, your oncologist may be able to prescribe a generic drug that is just as effective.

Step 3: Calculate your monthly expenses.

Use a monthly expense calculator to analyze how your cancer care expenses will fit into the context of your overall budget. After you’ve completed these steps, you might find that you’re short on money and your home could be in jeopardy.

If you’re not sure where look for support, there are a number of programs that can help you find the right path. Kathy Conley, stakeholder engagement specialist for GreenPath Financial Wellness, offers support and guidance for people who seek to buy and keep their homes. “It’s a people-centered, holistic approach. We help people with financial wellness. We look at the whole picture as well. If you’ve got increased medical expenses, we put that into the context of the client’s whole financial picture,” says Conley.

Manage housing costs

Mortgage payments are likely one of your biggest living expenses and it can be an enormous challenge to keep up payments while fighting cancer. It’s important to work with your lender or servicer upon diagnosis. Learn about your options, which could include a short-term repayment plan, forbearance agreement, loan modification and more.

Conley says that once GreenPath gets in contact with a client, specialists do a snapshot of the financial challenges a client is facing, how long it’s been going on, what their current financial situation is and also take a look at their goals. Conley says one option could be to do a loan modification or re-amortization. More specifically, you could change the terms of your mortgage, which involves extending your mortgage term. An example could be turning a 30-year loan into a 40-year loan.

There are several ways you can shrink your mortgage payments:

Recalculate your escrow payment. Have your mortgage company check how much you’re putting away for taxes each month. If your homeowner’s insurance or property taxes are lower, your escrow amount could be lowered and your overall payment can be lowered, too.
Drop PMI. If you have private mortgage insurance (PMI), which is required when you put less than a 20 percent down payment on your home, find out from your lender how it would be possible to eliminate it.
Appeal your home’s assessed value. Talk to your county officials and get your home’s assessed value lowered by checking that the county has all the information correct about your home, particularly if you think your taxes are too high.
Look for a cheaper homeowners insurance policy. Your payments will be reduced if you lower your homeowner’s insurance rate.
Refinance. Refinancing does cost more initially because of application fees, the cost of an appraisal, origination fees, document processing fee, underwriting fee, credit report charge, title research and insurance, recording fees, tax transfer fees, etc. but refinancing offers a long-term solution to more affordable payments. Try using a Mortgage Refinance Calculator to see how much you’ll save over the long term.

Seek additional mortgage help

You can also check to see if you qualify for mortgage assistance through Fannie Mae or Freddie Mac.

The Federal National Mortgage Association (FNMA), or Fannie Mae, and the Federal Home Loan Mortgage Corporation (FHLMC), or Freddie Mac, are government-sponsored enterprises which back many mortgages in the United States. If you have a loan through Fannie Mae or Freddie Mac, the Fannie Mae and Freddie Mac Flex Modification Program can reduce your mortgage payments through a few different options:

You can add your past due amount to your unpaid loan balance and recalculate your monthly payments over the new loan term.
Adjust your interest rate.
Forbear some of the principal balance, which means a temporary payment suspension or loan modification.

To explore your eligibility, check out Fannie Mae’s loan lookup tool or Freddie Mac’s loan lookup tool.

The Hardest Hit Fund could also be a resource; it offers mortgage payment assistance if you’re unemployed or underemployed, advocates for principal reduction for more affordable mortgages, offers help when transitioning out of your home and into more affordable living.

Paying for home modifications

It may be necessary to make certain physical changes to your home during and after cancer treatment, including:

Easy-to-reach safety rails
Ramps instead of stairs
Shower seats
Hospital beds
Over-bed tables
Patient lifts and slings
Trapeze bars
Lift chairs
Safety rails
Lift chairs
Elevated toilet seats
Handheld showers
Grab bars

Centers for Independent Living (CIL) are nonprofit agencies run by people with disabilities within local communities. CILs are free and they provide information, peer support, skills training and can also utilize assistive technology programs that can also evaluate changes to your home to help meet your needs. They generally do not sell products or charge a fee for their services.

Loans, home improvement grants and other assistance programs may be just the ticket to help you fund your modifications. Check out these websites for more information:

Rebuilding Together
U.S. Department of Agriculture single-family housing repair loans and grants (for very low-income individuals)
U.S. Department of Health and Human Services
Housing and Urban Development

Bill and utility assistance

Manes acknowledges the widespread help among government agencies and nonprofit organizations, and the Angel Foundation provided nearly 2,000 emergency financial assistance grants in 2018. “We refer to our services as the bridge that gets you to the next point,” Manes says. “A family will list out what they need help with, whether it’s mortgage or utilities, and that includes gas, water, electricity,” Manes says. “The check is cut directly to the bank or the landlord. We never give the cash or check directly to the patient. We want to make sure the money is going to the correct places.”

Similar to the Angel Foundation, utility companies often have funds to assist individuals and families. Homeowners, renters and subsidized housing tenants may be eligible for government programs and local programs in your area, and resources include:

If you need to downsize

If it’s necessary to downsize in order to manage your monthly payments, a short sale or deed in lieu could be an option to avoid foreclosure. In a short sale, also known as a pre-foreclosure sale, you sell your home for less than the balance remaining on your mortgage. If your mortgage company agrees to a short sale, you can sell your home and pay off all (or a portion of) your mortgage balance with the proceeds.

A deed-in-lieu occurs when you transfer the ownership of your property to the owner of your mortgage in exchange for a release from your mortgage loan and payments. There are some options to help you leave the home immediately, to stay in the home for up to three months without paying rent or lease the home (at market rates) for up to one year.

Other resources

Many financial aid programs and cancer organizations can help you determine the best course of action and some may also help with specific mortgage and utilities-related expenses. Do your research to find programs that fit the needs of your financial situation:

The bottom line

Ultimately, if you’re struggling with a cancer diagnosis, don’t feel as if you have to fend for yourself.

Manes says she sees people who have to make hard choices and sacrifices every day. “‘I’m sitting on $12,000 on medical bills. I’m going back to school. I have a car that broke down. I don’t think I can pay for a taxi,’” she says. “It doesn’t matter what type of cancer you have. People have to be able to get help and they need to get help now.”