Always follow the advice of your care team.
Financial Preparations
Understanding your health insurance coverage and benefits for your stem cell transplant is the most important financial first step to take before moving forward with your stem cell transplant. It is important to understand your:
Questions to Ask Your Insurance Company (PDF)
Your Dana-Farber Financial Counselor
Our transplant financial counselors are experienced in transplant insurance benefits and will work closely with your insurance company, as appropriate, to ensure access to appropriate insurance benefits.
Your financial counselor will send you a letter with a brief summary of your insurance benefits and their contact information.
As part of your care team, your financial counselor will be the link between you and
your insurance company. They will:
Approval may be required at multiple stages during your care. In most cases, the major stages of authorization are: evaluation, donor search (if needed for allogeneic transplant), family typing, and prior to your transplant procedure. Insurance authorization for one stage does not guarantee authorization for others. Typically, an insurance plan assigns a case manager who will review and approve your coverage.
Your financial counselor will tell you when your transplant-related services have been approved or denied. If your insurance provider denies coverage, your financial counselor can help with the appeal process.
If you do not have insurance coverage, your financial counselor will prepare an itemized estimate of charges. Half of the estimate must be paid prior to starting any stem cell transplant-related services. Your financial counselor will explain the timing of payments.
IMPORTANT: Speak with your financial counselor before making changes to your health insurance or PCP. Making changes during the transplant process may cause delays.
Expenses During Transplant
There are many costs related to your stem cell transplant. Planning may help reduce stress during transplant, allowing you to focus on recovery and healing.
Stem cell transplant costs and other related expenses: Some costs will be based on your insurance coverage including:
After your transplant, additional costs may come from co-pays and deductibles related to follow-up services and post-transplant medications.
Pharmacy benefit coverage for medications: It is important to know what is and is not covered by your current pharmaceutical policy. This will help you understand and plan for potential out-of-pocket costs (such as copays, co-insurance, and deductibles).
Coverage for research protocols/clinical trials: You may have the opportunity to participate in a clinical trial as part of your stem cell transplant. Taking part in clinical trials may lead to added costs for you or your insurance company.
Planning for Disability or Medical Leave from Work
If you are applying for a leave of absence from work because of your transplant, you will need to complete paperwork for a Short- or Long-Term Disability claim from your insurance provider, or for the Family Medical Leave Act (FMLA). At Dana-Farber, a Disability/FMLA Coordinator in the Health Information Services (HIS) department can support these requests. For more information about the process and requirements, go to
dana-farber.org/medicalleave.
Financial Resources
The organizations listed here often require direct communication with the patient. Dana-Farber is not allowed to serve as an intermediary. Therefore, we encourage patients to connect with the grant-funding organization to provide all supporting information and to follow- up in advance of the deadline to make sure that all documents have been received.
We make every reasonable effort to locate helpful information for patients and families and have included a list of the resources that we know best. We encourage you to seek out other opportunities that may be appropriate. Our staff is available to help you evaluate new resources or additional information you may find.
Cancer Support Community
888-793-9355
www.cancersupportcommunity.org/managing-cost-cancer-treatment
Offers an overview of how to approach the total cost of cancer care, including key issues around health insurance, employment, disability, and prescription medications. A glossary of terms is included.
Dana-Farber Patient Financial Assistance Program
Dana-Farber's Patient Financial Assistance program helps patients who don’t have the ability to pay for their health care. Learn more at www.dana-farber.org/PFA or call a financial counselor at 617-632-9802.
Massachusetts Medicaid
If you are a Massachusetts resident, do not have health insurance, and you meet certain financial eligibility criteria, you will be encouraged to apply for Massachusetts Medicaid. Patients that do not meet the criteria to qualify will be given the option to purchase insurance through the Massachusetts Health Connector. If you do not meet the criteria to purchase insurance, you will be responsible for the cost of transplant. Your transplant financial counselor will work with you on the deposit requirements and payment arrangements. Massachusetts Medicaid covers inpatient hospitalization (at BWH or Dana-Farber’s Inpatient Hospital, located within BWH) and outpatient services at Dana-Farber. Massachusetts Medicaid does not include the cost of post-hospital skilled nursing facilities or home infusion and IV therapy. You can apply for Massachusetts state funded programs at any health-care facility in Massachusetts and that approval will be honored at both BWH and Dana-Farber. You can apply for Massachusetts Medicaid at BWH or Dana-Farber.
Leukemia & Lymphoma Society (LLS)
Call 800-955-4572or visit www.lls.org/support/financial-support to learn more about financial support available through the Leukemia & Lymphoma Society.
- Health care benefits
- Stem cell transplant benefits
- Transplant evaluation
- Donor and family typing coverage, if applicable
- Transplant conditioning and treatment
- Dental benefits
- Retail pharmacy coverage
- Transportation and lodging/housing benefits
Questions to Ask Your Insurance Company (PDF)
Your Dana-Farber Financial Counselor
Our transplant financial counselors are experienced in transplant insurance benefits and will work closely with your insurance company, as appropriate, to ensure access to appropriate insurance benefits.
Your financial counselor will send you a letter with a brief summary of your insurance benefits and their contact information.
As part of your care team, your financial counselor will be the link between you and
your insurance company. They will:
- Verify your insurance benefits and identify any patient financial responsibilities (such as co-pay amounts, deductibles, co-insurance, and coverage “caps”).
- Provide the clinical information that your health insurance provider needs for prior authorization.
- Autologous Transplant Financial Counselor: 617-632-5877 or 617-582-7779
- Allogeneic Transplant Financial Counselor: 617-632-5338 or 617-632-5113
Approval may be required at multiple stages during your care. In most cases, the major stages of authorization are: evaluation, donor search (if needed for allogeneic transplant), family typing, and prior to your transplant procedure. Insurance authorization for one stage does not guarantee authorization for others. Typically, an insurance plan assigns a case manager who will review and approve your coverage.
Your financial counselor will tell you when your transplant-related services have been approved or denied. If your insurance provider denies coverage, your financial counselor can help with the appeal process.
If you do not have insurance coverage, your financial counselor will prepare an itemized estimate of charges. Half of the estimate must be paid prior to starting any stem cell transplant-related services. Your financial counselor will explain the timing of payments.
IMPORTANT: Speak with your financial counselor before making changes to your health insurance or PCP. Making changes during the transplant process may cause delays.
Expenses During Transplant
There are many costs related to your stem cell transplant. Planning may help reduce stress during transplant, allowing you to focus on recovery and healing.
Stem cell transplant costs and other related expenses: Some costs will be based on your insurance coverage including:
- Transplant outpatient care (physician services, labs, imaging)
- Inpatient care (as needed)
- Tests
- Prescriptions
- Donor-related costs (for allogeneic transplants)
After your transplant, additional costs may come from co-pays and deductibles related to follow-up services and post-transplant medications.
Pharmacy benefit coverage for medications: It is important to know what is and is not covered by your current pharmaceutical policy. This will help you understand and plan for potential out-of-pocket costs (such as copays, co-insurance, and deductibles).
- Remember that your pharmacy benefit provider may be different from your health insurance provider.
- Ask specifically about transplant medications and if there are any “caps,” coverage limitations, co-pay amounts, and/or deductibles.
- Your financial counselor can help you find out what medications are covered by your pharmacy insurance benefit.
- Sometimes, pharmaceutical companies can provide medications at low or no cost based on income or other factors.
Coverage for research protocols/clinical trials: You may have the opportunity to participate in a clinical trial as part of your stem cell transplant. Taking part in clinical trials may lead to added costs for you or your insurance company.
- Some insurance companies view these as experimental treatments and will cover the experimental aspects of the trial (i.e., those which differ from the standard of treatment). Others may provide coverage for certain costs only.
- Insurance coverage for medically-related services, as well as research protocols/clinical trials, varies by insurer.
- Some states have laws requiring insurance coverage for clinical trials, while others do not. Check your state laws to learn the details of clinical trial coverage available to you.
- If you are a Massachusetts resident, state law requires health plans to cover routine care costs for cancer-related clinical studies conducted by Massachusetts providers like Dana-Farber and Brigham and Women’s Hospital. For more information about clinical trials, go to dana-farber.org/clinicaltrials.
Planning for Disability or Medical Leave from Work
If you are applying for a leave of absence from work because of your transplant, you will need to complete paperwork for a Short- or Long-Term Disability claim from your insurance provider, or for the Family Medical Leave Act (FMLA). At Dana-Farber, a Disability/FMLA Coordinator in the Health Information Services (HIS) department can support these requests. For more information about the process and requirements, go to
dana-farber.org/medicalleave.
Financial Resources
The organizations listed here often require direct communication with the patient. Dana-Farber is not allowed to serve as an intermediary. Therefore, we encourage patients to connect with the grant-funding organization to provide all supporting information and to follow- up in advance of the deadline to make sure that all documents have been received.
We make every reasonable effort to locate helpful information for patients and families and have included a list of the resources that we know best. We encourage you to seek out other opportunities that may be appropriate. Our staff is available to help you evaluate new resources or additional information you may find.
Cancer Support Community
888-793-9355
www.cancersupportcommunity.org/managing-cost-cancer-treatment
Offers an overview of how to approach the total cost of cancer care, including key issues around health insurance, employment, disability, and prescription medications. A glossary of terms is included.
Dana-Farber Patient Financial Assistance Program
Dana-Farber's Patient Financial Assistance program helps patients who don’t have the ability to pay for their health care. Learn more at www.dana-farber.org/PFA or call a financial counselor at 617-632-9802.
Massachusetts Medicaid
If you are a Massachusetts resident, do not have health insurance, and you meet certain financial eligibility criteria, you will be encouraged to apply for Massachusetts Medicaid. Patients that do not meet the criteria to qualify will be given the option to purchase insurance through the Massachusetts Health Connector. If you do not meet the criteria to purchase insurance, you will be responsible for the cost of transplant. Your transplant financial counselor will work with you on the deposit requirements and payment arrangements. Massachusetts Medicaid covers inpatient hospitalization (at BWH or Dana-Farber’s Inpatient Hospital, located within BWH) and outpatient services at Dana-Farber. Massachusetts Medicaid does not include the cost of post-hospital skilled nursing facilities or home infusion and IV therapy. You can apply for Massachusetts state funded programs at any health-care facility in Massachusetts and that approval will be honored at both BWH and Dana-Farber. You can apply for Massachusetts Medicaid at BWH or Dana-Farber.
Leukemia & Lymphoma Society (LLS)
Call 800-955-4572or visit www.lls.org/support/financial-support to learn more about financial support available through the Leukemia & Lymphoma Society.