FAQ Finances

What Benefits are Available for Cancer Patients?

Find out what type of benefits cancer patients are entitled to, how to apply for them and some extra ways to cover your medical expenses.

What Benefits are Available for Cancer Patients?

Cancer treatment in the United States healthcare system can be extremely expensive. Depending on your treatment plan and the severity of your cancer, you may need to cut back hours at work and possibly take a brief leave of absence. In times like these, both the federal and state government offer financial assistance to help with your treatment. So what type of benefits are cancer patients entitled to?

Typically, patients who are diagnosed with cancer have access to one of the following government programs:

  • Social Security Disability Income (SSDI)
  • Supplemental Security Income (SSI)
  • Medicare
  • Medicaid

In this article, we will cover each program in depth including how to tell if you qualify, what will be covered, and how to apply. Additionally, we will provide you with resources if you need non-federal or non-state funds for your cancer treatment.

What is Social Security Disability Income (SSDI)?

SSDI is a social security program that will pay income to individuals who are unable to work due to a disability. In some instances, SSDI will also pay certain family members who are affected by the disability.

The program typically covers individuals who are unable to work as a result of a disability for a year or more. SSDI will also cover certain expenses and healthcare as you transition back to work.

How Do I Qualify for SSDI?

Unfortunately, SSDI has very stringent restrictions on who qualifies for financial aid. In order to qualify for SSDI you must:

  • Worked in a job covered by Social Security for “long enough”
  • Meet Social Security’s strict definition of disability

While to qualifications for SSDI provided by the Social Security Administration (SSA) may seem vague, they do provide detailed information of each qualifying factor on their website. However, to save you time we’ve summarized the requirements for the qualifications below.

How Much Work Do You Need to Qualify for SSDI?

The Social Security Administration determines if you’ve worked long enough to qualify for SSDI based on two factors:

  • Total yearly wages or self-employment income
  • Length of time working in a job covered by Social Security

The SSA assigns you credits based on how much you earn in a given year. They assign a value for one credit and you have the potential to earn up to four credits per year. 

The value of a credit varies yearly; however, in 2022 you need to make $1,510 for one credit and $6,040 for all four credits. 

Additionally, you generally need 40 credits to qualify for SSDI with at least 20 of those being earned in the last 10 years. However, there are sometimes exceptions for younger individuals.

If you are interested in learning more about how to earn credits you can look over the SSA’s guide on how to do so.

How Much Money Can I Expect to get on SSDI?

SSDI is paid on a monthly basis. As of 2021, the average monthly benefit was $1,128 and the maximum benefit was $3,148.

“I educate people about how insurance policies generally work and refer them to help them understand exactly what their plan will cover.”

Read more about how Lia A. helps cancer patients with their finances after being diagnosed.

What is Supplemental Security Income?

Social Security Income (SSI) provides basic financial assistant to older adults and those with disabilities who have very limited income. SSI is typically supplemented by state benefits, in addition to federal assistance.

How Do I Qualify for Social Security Income?

The two qualifying factors for SSI are:

  • Meeting the SSA’s strict definition of a disability or being over the age of 65
  • Having limited income and assets

You have to meet the SSA’s definition of having “limited” income and assets to qualify for SSI. Individuals have to have less than $2,000 in assets and couples must have less than $3,000.

Additionally, you have to be at or below the federal benefit rate (FBR) in terms of income. In 202, the FBR was $794 for individuals and $1,191 for couples. However, not all income counts when the SSA calculates your income.

What Counts as Income Under SSI?

Social Security has a large list of items that do not count towards your income when assessing if you qualify for SSI. The list of items can be found on their website along with more information on how they calculate your income.

How Much Money Can I Expect to Get on SSI?

The average monthly benefit under SSI is $577 per month. The maximum in 2021 was $791 for an individual and $1,191 for a married couple.

“I was able to apply for disability because acute leukemia is one of those conditions with compassionate allowances within social security, so I started getting money from that in month four or five.”

Read more about Christine’s experience with the SSA

How are Social Security Disability Income and Social Security Income Different?

SSDI and SSI differ in two major ways: the amount of money that is paid to the recipient monthly and the determination for receiving the benefits. 

SSDI pays recipients a lot more on a monthly basis than SSI. This is in part because SSI is supposed to be complemented by state benefits.

Additionally, the determination for receiving SSDI benefits is based on the length of time worked, while SSI is based on income and resources. Therefore, SSDI benefits those who have been in the workforce for an extended period of time, while SSI is meant to help low-income individuals.

However, unless you are over the age of 65, both benefits require you to meet the SSA’s definition of disability.

How Does Social Security Define Disability?

Social Security has a three-part definition for disability in its SSI and SSDI programs:

  • You are unable to work and engage in a substantial gainful activity because of your medical condition.
  • You cannot do work that you previously did or adjust to other work because of your medical condition.
  • Your condition has lasted or is expected to last longer than a year or result in death. 

It’s important to note that SSDI does not cover partial or short-term disability.

What is a Qualifying Disability Under SSDI and SSI?

Even if you meet the definition for disability, you do not automatically qualify for SSDI or SSI. You need to have what the SSA refers to as a “qualifying disability.” 

To have to be considered a qualifying disability you must meet the following five criteria:

  • You cannot be working
  • Your condition must be considered severe
  • Your disability must be on the list of disabling medical conditions
  • You cannot be able to do the work that you previously did
  • You cannot do any other type of work

Which Forms of Cancer Qualify for SSDI and SSI?

The SSA does consider some forms of cancer to be a qualifying disability especially particularly disabling or hard-to-treat cancers. These include:

  • Any small-cell cancers
  • Brain cancer of all types
  • Esophageal cancer
  • Gallbladder cancer
  • Inflammatory types of breast cancer
  • Liver cancer
  • Pancreatic cancer
  • Salivary gland cancer
  • Sino-nasal cancer
  • Non-small-cell cancers that survive three months of chemo or spread to other organs

Even if your cancer is not on this list, the SSA may still consider it a qualifying disability.

How Do I Apply for SSDI and SSI?

You can apply for SSDI and SSI at a Social Security office or on the SSA’s website.

It’s important to note that several people don’t receive and approval for SSDI on their first application. If the rejection was due to a clerical error you have the opportunity to reapply. Alternatively, you can also submit an appeal if your application was denied for some other reason.

“It was a lot of internalized emotions and stress. To be away from there was just a relief. I felt better the day the doctor said you can be off work. I felt amazing that day, you know what I mean?”

Read more about how Maurissa was able to take time off from work because of her benefits.

How Can Medicare and Medicaid Help with My Medical Expenses?

While SSDI and SSI can help provide supplemental income if you end up needing to leave your job due to cancer you still have to find a way to cover your medical expenses. Medicare and Medicaid can help cover a large portion of those expenses if you end up losing your healthcare benefits from your employer.

What is the Difference Between Medicare and Medicaid?

Medicaid and Medicare are intended for different people just like SSDI and SSI.

Medicaid is for low-income individuals. It is primarily funded by the state, so requirements and benefits will vary from state to state. However, in most states, if you qualify for Medicaid the majority of your medical expenses will be covered.

To learn more about how Medicaid may be able to help you cover your medical expenses read our article about Medicaid coverage.

Most people associate Medicare with individuals over the age of 65. However, Medicare is also available to anyone who has a qualifying disability and is sponsored by the Federal Government. Medicare is fairly similar to your work insurance. You pay a monthly premium and pay for certain costs until you hit a deductible. After that, Medicare helps with the bill.

It’s important to note that Original Medicare (Part A & B) only covers the bare minimum and cancer patients will often need to purchase additional insurance. Government-approved private insurance companies offer Medicare Advantage (Part C), which will allow you to choose additional coverage that meets your needs. 

To learn more about how Medicare can help cover your medical expenses read out article on Medicare and cancer coverage.

How Do I Apply for Medicare and Medicaid?

You can apply for Medicare online here. You also have the option to visit a local SSA office or call Social Security at 1-800-772-1213.

The application process for Medicaid varies by state. Your state government should have a website dedicated to information about the application process.

How Do Identify the Different Type of Benefits for Cancer Patients?

While we have covered four of the most commonly used benefits for individuals with cancer, you may qualify for several other benefits based on a multitude of factors. 

The SSA has a questionnaire dedicated to helping you determine which benefits you qualify for. It asses your eligibility for over 1,000 federal and state-sponsored benefits.

What If I Don’t Qualify for Federal or State Benefits?

If you don’t qualify for state or local benefits to help cover the costs of your cancer treatment or cost of living don’t fret! Several organizations can assist you with your finances. Some of these include:

This only begins to scratch the surface of the organizations dedicated to helping assist cancer patients with the financial burden of cancer treatment. 

What if I Have Other Questions About Cancer and Finances?

A cancer diagnosis can be a scary and stressful time in anyone’s life. The last thing you want to stress about is the financial burden of the treatment and medications needed to help you fight the disease.

If you have more questions about cancer and finances or just cancer in general, visit our FAQ page.

2 replies on “What Benefits are Available for Cancer Patients?”

I’m 68 years old on social security
I have stage 4 cancer. Like to learn more about what help do I qualify for.

Is there any program that helps when a 57 year old man WAS self employed, diagnosed with metastatic pancreatic cancer. Private health insurance is canceling him after upgrading him and backdating the insurance to date of diagnosis. Has had this insurance over 15 years and is getting ready to have nothing. Has been referred to MD Anderson to see them in November but they do not accept Obamacare or Affordable Care Act.

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