Editor’s Note: A serious diagnosis takes a heavy toll on patients, medically and financially. Proactive financial navigation can make a huge difference in patients’ lives by connecting them with the resources they need to afford care. In the latest installment of our “Patient Stories” series, learn how navigator Jen Burgess from our TailorMed Complete team helped a patient with lymphoma avoid medical debt.
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Financial navigator: Jennifer Burgess
Diagnosis: Hodgkin lymphoma
Type of healthcare organization: Cancer center
Medication: Opdivo
Assistance program: Leukemia & Lymphoma Society grant
Costs covered: $4,000
Patient financial responsibility without assistance: $1,645 per treatment until patient meets annual out-of-pocket maximum
Patient financial responsibility with assistance: $0
Financial navigator Jen Burgess provided essential support to a patient with Hodgkin lymphoma. The patient relied on Social Security Disability income of $1,500 per month. She was insured with a Medicare Advantage plan, leaving her with a high out-of-pocket responsibility. After beginning treatment in the final months of 2024, she reached her annual out-of-pocket maximum (OOP). However, once the new year began, her OOP reset to $0, meaning she was suddenly required to pay the full cost of her treatment. Given the significant expense of the patient’s immunotherapy medication, Opdivo, her bills could have become unmanageable.
Thankfully, Jen found an open grant through the Leukemia & Lymphoma Society (LLS). She swiftly enrolled the patient and submitted claims for the treatments the patient had received up to that point. While the patient will quickly exhaust the $4,000 grant, Jen will continue to monitor for additional resources utilizing the TailorMed platform.
Throughout the process, Jen provided hands-on financial care to the patient and her sister who serves as the patient’s caregiver. “Managing this new diagnosis–along with the appointments, transportation, paperwork, and emotional energy–has been a lot for all involved,” Jen said. “I was able to explain how these grants work and how they could truly lessen the financial burden.”
The patient and her sister, who were previously unaware of the various assistance programs available, expressed gratitude for Jen’s support. “Without help, treatment costs would have saddled this family with medical debt,” she said. “I could hear the relief in the sister’s voice throughout our conversation.”
Interested in partnering with our TailorMed Complete team to optimize financial assistance for your patients? Contact us to learn more.
