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Chemotherapy: FOLFOX

Paying For FOLFOX Treatment

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4/29

As you review the following for the situation that applies to you, keep in mind that the Colon Cancer Alliance has the Blue Note fund which provides a one time cash payment to people in need.  For information, click here offsite link.  

If you have Medicare or Medicaid (Medi-Cal in California): Both insurance coverages cover FOLFOX treatment when medically necessary. Coverage includes the infusion set up and out-patient port placement . To learn more about:

  • Medicare and life changing health conditions, click here
  • Medicaid and life changing health conditions, click here

If You Have Health Insurance:  Health insurance policies vary, but generally cover:

  • Port placement.
  • FOLFOX treatment
  • The “set up,” meaning the medical device itself.
  • Cost of infusion at the treatment center, as well as repeat visits
  • Cleansing supplies
  • Medications such as anti-nausea drugs – though you may be limited to drugs on the company’s list of drugs they cover (formulary)  Co-pays may also vary depending on whether the drug is branded or generic. 

Even if you are covered by health insurance, you may be out of pocket for a deductibleco-insurance, co-pays  or uninsured drugs or treatments. These expenses can add up quickly. In addition to the extra expense, there may be a decrease in your income as a result of your treatment. There is a reason that over 75% of the people in the U.S. who went bankrupt due to health care costs had health insurance.  To learn how to maximize use of your insurance, and minimize your out-of-pocket expenses, click here. 

If you need help paying for co-pays, contact:

  • The HealthWell Foundation Copay Program, tel. 800.675.8416.
  • For help with co-pays for fluorouracil, contact  Diplomat’s co-pay assistance program at Tel.: 877.977.9118 xt. 89864
  • For assistance with all three parts of FOLFOX, check the Partnership For Prescription Assistance website at: www.pparx.org offsite link
  • Cancer Care at www.CancerCare.org offsite link, Tel. 800. 813.4673
  • Ask the treatment center if it has a program to pay co-pays or is willing to waive them. If you are working with a social worker, ask him or her about these possiblities.
  • For additional information, see:

If you are uninsured: You may be able to obtain the chemotherapy drugs for little or no cost.

  • Oxaliplatin is manufactured by several pharmaceutical companies. Each company has its own criteria. 
    • You can find a list of the various manufacturers, and a summary of their qualification criteria at: http://www.needymeds.org/generic_list.taf?_function=name&name=oxaliplatin offsite link 
    • If you do not qualify for a company’s program, it is worth a call to see if they will make an exception for you. (If you’re not good at speaking objectively about your needs, perhaps someone in your oncologist’s office or a close friend will make the call for you.)
  • For assistance with all three parts of FOLFOX, check the Partnership For Prescription Assistance website at: www.pparx.org offsite link
  • Ask the treatment center if it has a program to provide FOLFOX to people who are not insured. If not, does it provide a discount for people who are not insured? If you are working with a social worker, ask him or her.
  • Perhaps a clinical trial is testing a particular use of one of the FOLFOX variations. You can learn about clinical trials by clicking here. Or contact a company that connects patients with clinical trials such as Emerging Med by clicking here offsite link

For information about accessing care without insurance, click here.  

You can still obtain health insurance. To learn how, click here. If all else fails, you may be able to qualify for Medicaid. Learn how by clicking here.  

If money is a concern: We have a lot of practical information about dealing with a financial crunch, including such matters as how to prioritize debt, how to negotiate with creditors, how to find money in your assets without selling them, and when to think about bankruptcy. To learn more, click here

If money is not a problem, this is a good time to do financial planning to assure that you have the financial resources to get through treatment, to continue the lifestyle you’ve worked for, and to be prepared in case colorectal cancer continues or recurs. It may be time to adjust your investment strategy to take account of a potentially shortened life expectancy.  At the same time, plan in case you have a long life ahead of you. Financial planning does not have to take a lot of time. To learn more about financial planning, click here. About investments, click here.  


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