Treating cancer is not cheap, and navigating the complex world of health insurance and financial assistance can be incredibly daunting for patients facing cancer diagnoses. By assisting patients in optimizing their insurance coverage and finding external assistance programs, financial navigators can help to alleviate the financial burden of treatment; as a result, they have undoubtedly become a central component to the delivery of quality cancer care. At the 2023 Academy of Oncology Nurse & Patient Navigators Midyear Conference in Orlando, FL, Clara Lambert, CPH, BBA, OPN-CG, Director, Financial Navigation, TailorMed, Chicago, IL, and Jason Zimmerman, RN, OCN, Clinical Financial Facilitator, Trinity Health Saint Mary’s, Grand Rapids, MI, discussed some of the many hats worn by these crucial members of the care team.
The Financial Navigator’s Role
The financial navigator’s role is multifaceted and requires a comprehensive knowledge of all things financial assistance, including a broad spectrum of health insurance policies, government safety net plans, and external assistance programs that cover things like co-pays, medications, and funds for utilities, rent, or mortgage. According to Ms Lambert, insurance optimization should always be explored first, followed by external assistance programs (ie, manufacturer patient assistance, co-pay assistance, premium assistance, and patient financial support programs).
“A financial navigator needs to know everything they can about the different types of health insurance policies, whether it’s a government or commercial plan, as well as the different rules surrounding them,” she said.
But it does not stop there; beyond financial assistance and insurance optimization, financial navigators should also be well-versed on disease processes and cancer treatment options for a variety of malignancies. For example, financial assistance for a patient with stage IV disease will differ from that of an earlier-stage patient, not only when it comes to paying for treatment but also considering other factors like how long that person might be out of work. According to Ms Lambert, knowing how a disease might progress enables navigators to anticipate the patient’s needs and proactively offer assistance.