Editor’s note: This is the second installment Kathy Bussell’s story. The first focused on her re-occurring battle with breast cancer; the second on how to pay for treatment.

TRAVERSE CITY — Kathy Bussell quit her second job earlier this year.

She relied on it for extra income but trying to rid her body of the invasive ductal carcinoma —including undergoing a double mastectomy — takes a toll.

“I have 25 radiation treatments, Monday through Friday for five consecutive weeks,” said Bussell.

“You are like a sloth.”

Luckily her full-time employer has worked with her to allow treatments, which isn’t always the case, she said.

Once treatment begins the bills start rolling in. Treatments can cost $100,000, multiple times, to cure the disease. Many people have insurance, but there are still deductibles and coinsurances to meet, while facing challenges in the workplace.

“It’s expected when you get a treatment you can’t work or can’t work as much,” said Scott Legleitner, Oncology Financial Navigator for Cowell Family Cancer Center.

Legleitner works to ease the burden of people fighting the disease. Usually, when patients are at Bussell’s stage of treatment they meet with a financial counselor who figures out what type of assistance they can qualify for.

Meeting with a counselor was on her list of hospital visits before undergoing radiation treatment, where she hopes some of the weight of the financial obligation will be lifted.

“Ideally we will catch patients early on before all this [treatments] happen to reduce the out-of-pocket costs,” said Christine Meek, Service Line Business Manager for the Cowell Family Cancer Center.

Financial counselors say fewer patients are filing for bankruptcy after meeting with them and following through on steps to get aid.

The cost causes some patients to change the course of their care according to Meek. Michigan is one of seven states that does not have an oral oncology parity law.

This means drugs in pill form are not covered the same as intravenous treatments under insurance and can be much more costly per treatment.

An IV treatment may cost $100, while a pill could be thousands of dollars. Patients may choose to either skip the pill treatment or choose a different treatment if that’s an option because of finances, said Meek.

“Occasionally patients skip treatment due to finances. At first, they are very concerned about leaving their family with lots of bills, but that changes after they meet with the finance people,” Meek said.

Patients are referred to Legleitner at Cowell Cancer Center. He says even the patients with good insurance can fall behind on household bills, but there are programs available to help those people make ends meet.

The Medicaid Spend-down program is for people who don’t qualify for traditional Medicaid.

It picks up bills after patients have spent a significant amount of their income on medical bills, leaving a fraction to live on for each month.

While it may be a good program, Meek says sometimes patients are left to cover costs they hoped were subsidized. Pharmaceutical companies sometimes offer grants to qualifying patients. The Munson Cancer Patients Needs Fund allows donors to direct their gifts to patients dealing with a certain type of cancer — like the breast cancer Bussell contends with.

That money helps patients pay for everyday expenses they may fall behind on.

“Your focus is on getting better and then you have these bills. You have to figure out how to keep the lights on and pay your mortgage. I have radiology, pathology, hospital, surgeon, plastic surgeon, oncologist, anesthesiologist, medications and specialist visits,” Bussell said. “I get my financial notices on my bills. I just don’t want to look at it.”

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