Will my insurance pay for treatment in a clinical trial?

18.Will my insurance pay for treatment
in a clinical trial?

It is a good idea to contact the insurance company
directly to determine whether the patient’s insurance
policy will cover therapy involved in clinical trials.
Some insurance companies will pay for all treatment
expenses, including any added costs associated with
clinical trials (if there are any). At the other extreme,
insurance companies may decline to pay for any treatment
considered “experimental” or therapy that is part
of a clinical trial.

Other policies are somewhere in
between; some states have enacted legislation mandating
that private insurance companies pay for treatment
involved in clinical trials (see the American Cancer
Society [ACS] Web site for details). However, a patient
may be responsible for the costs above and
beyond what would have accrued with standard
treatment. Medicare, for example, may have coverage
restrictions for treatments that are part of clinical trials.

Understand that the patient may be
responsible for the balance. If you do run into financial
roadblocks with entering a clinical trial, appeal to the
insurance company and/or seek assistance from your
doctor or social worker, as sometimes there is additional
funding for some protocols to assist people with
the added expenses.

Protocol = Description of a clinical trial; also used
more generally to refer to a plan of medical treatment.