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My sister-in-law has cancer.
Last week, a biopsy revealed that Stephanie has a cancerous lump on her thyroid. She’ll likely have her thyroid removed, meaning she’ll need to take medication for the rest of her life. (She’s 37 years old.) She’ll also probably need a handful of radioactive iodine chemotherapy treatments.
Prognosis positive
Jeff and Stephanie have both settled down a bit after the initial scare. They’ve heard from many sources, including Steph’s grandmother, that this form (and location) of cancer is easy to eliminate, and has a low chance of spreading or recurring. Steph’s grandmother had her thyroid removed years ago (due to a growth on it), and she is now 77 years old.
Still, this is cancer, which no member of my family takes lightly. My father died from cancer ten days before his fiftieth birthday. Last summer, cancer killed a cousin at age 47. Other family members have died from the disease as well.
A lucky mistake
A situation like this has enormous personal finance implications. Steph’s case is especially interesting because it demonstrates that sometimes the “right choice” isn’t.
Before the birth of their daughter in February 2006, Stephanie obtained a supplemental hospital/short-term disability insurance policy because she knew she would need a C-section. After Emily was born, Steph tried to cancel the policy, but the agent talked her into switching to a cheaper cancer/accident policy instead.
Inspired in part by Get Rich Slowly, Jeff and Steph have been taking control of their personal finances. This past May, when it came time for her office to renew policies, Stephanie asked to have her cancer/accident policy canceled because she wanted to save the $70 recurring monthly expense.
After the cancer diagnosis came through, Jeff and Stephanie were kicking themselves for having canceled the policy — it would have offset some of their upcoming costs. Then Steph remembered that both of her June paycheck stubs still had the deductions listed. She called her agent to see if her policies were still in force. Sure enough, the official cancel date was July 1st, so the agent was able to revoke the cancelation.
“I don’t know if it will pay out enough to compensate for all the premiums we’ve paid in the last two years,” Jeff writes, “but at this point I don’t care. If it helps with the medical bills that are bound to accrue, that’s all that matters.”
A calculated risk
Stephanie’s situation highlights just how difficult it can be to know how much (and what kind of) insurance to carry. It seemed unlikely that she’d need the cancer policy, so she canceled it. From a Big Picture perspective, this was probably the right decision. But in her individual circumstance, it turned out to be the wrong move.
Last fall, in his brief introduction to insurance, Aaron Pinkston wrote that “insurance is the cheapest and most immediate way for a person to displace risks that are too great to assume individually”. That is, insurance allows groups to pool their money to offset unexpected large individual costs.
But how can you decide how much insurance you need? And what types? Later today, I’ll share a guest post about making informed insurance choices.
Meanwhile, friends and family are ready to help Jeff and Stephanie through this crisis. And although they have bigger things to worry about, it gives them a degree of comfort to know they have a little insurance to help with the financial challenges that loom ahead.



July 1st, 2008 at 5:24 am
I think this is a real crap shoot. No one, NO ONE, knows what life will bring tomorrow. Did I expect to develop Type 1 diabetes at the age of 38? No. Shit happens. I did not get Type 1 diabetes because of lifestyle choices and I have no family history of it. My autoimmune system just went amuck.
Get as much insurance as you can afford, penny pinch where you can, and hope for the best.
July 1st, 2008 at 5:30 am
First of all, I hope Stephanie gets better.
I bought life insurance, which covers surgeries and medicine. We don’t know what is waiting for us around the corner so insurance can be a waste of money, but it can also be a life saver.
July 1st, 2008 at 5:46 am
best of luck to your sister-in-law. i hope she has a speedy recovery and a complete elimination of the cancer.
we never could have expected the medical crises that hit us over the past 2 years either- in fact, i am currently spending time in the waiting room while husband has yet another procedure done to the tune of another several thousand dollars.
we remain thankful for our (admittedly subpar) medical insurance, but *really* wish we had fought the long term disability insurance denial.
friends and family are vastly important when reacting to a medical crisis- a supportive network means so much. all of my superficial local friends failed me as i waited for my diagnosis, and the only thing that kept me going was literally hours on the phone with my sisters and friends from home.
July 1st, 2008 at 5:47 am
I lost my grandmother to leukemia, and my wife lost both her grandparents at a relatively young age to cancer. My mom is a cancer survivor, and we hold our breath any time she has a check up. My wife had a scare which turned out to be benign.
I’m not sure what to think about cancer insurance. On the one hand it seems awfully expensive, but on the other hand, if you have a family history of cancer it may make sense to carry it to hedge against major medical costs associated with treatment and recovery.
July 1st, 2008 at 6:16 am
Yikes! At least it’s in a spot that is way more often than not easy to treat and totally eliminate. That stuff does just pop in when you least expect it. My wife and I went through it 2 years ago. She had been battling bad stage 4 endometriosis for quite some time. We finally found a doctor who was willing to take the necessary steps to cure it (full hysterectomy)even though her age had been an issuse (she was 25). The surgery went great until we got the biopsy results. “Uhh Mrs. Miller, we found cervical cancer in the tissues we tested. When you you come back for another exam?”
Everything went fine though, and they were able to get it all. Tell Jeff and Stephanie to keep their heads up, and everthing will be fine.
July 1st, 2008 at 6:27 am
Keep your heads up. With today’s medical technology, they’re diagnosing cancer earlier and able to treat it faster. My Aunt was diagnosed with breast cancer just last year, and thanks to new medical technology and treatments, she has made it through.
Stay positive!
July 1st, 2008 at 6:50 am
I had my thryoid removed a year ago - you can see the photos on my site using the link. If she and her doctor are smart, they will take the whole thyroid and not leave part of it in (likelihood of having to back for a second operation at a later date are high). Meds all your life? It’s one pill a day - no big deal and the cost is very, very minimal (I pay $10 for 90 day prescription.) You hear the word cancer and its terrifying, but the upside is, this is a very small hump to get over, given its the thyroid. Easy surgery, quick recovery - I was riding bike two weeks after. Just get on the exercize, so weight troubles can be headed-off. Good luck to her!
July 1st, 2008 at 6:51 am
Good luck to all who are dealing with cancer!! It is never easy, but I certainly found that the love and support of my then partner now husband was the most helpful aspect of my cancer year (2005).
My health insurance had a significant deductable (more than a $1000) and a co-pay for some of the rest, but in the end, thanks to a good emergency fund, we didn’t go into debt.
I’ve seen several articles that say cancer insurance often costs more than it pays out; for most people a good general health insurance plan and savings can pull you through. Also, being really open with your doctor — I think even oncologists can provide sample drugs and have some leeway on other billing.
July 1st, 2008 at 7:02 am
Hi! I’m writing from Italy and here the situation is quite different. We don’t have to subscribe medical insurances and surgery in hospital and recurrent medicines at home are almost free for every citizen.
This post really upsetted me because I’m 36 and I’m waiting to do further medical exams, a biopsy, for my thyroid. I took one small pills a day for years and I really hope to simply continue doing so.
Good luck to Stephanie.
July 1st, 2008 at 7:03 am
First and foremost, I wish Jeff and Stephanie the best. I keep trying to imagine what it would be like if this were Kris who was diagnosed with cancer. Or me. My brother and his wife must be going through the wringer right now, and I want to do what I can to help. (Which is very little, probably. What can I do? Blog about it?)
Second, I’m so torn about insurance. Fundamentally, insurance is a game rigged against consumers. That’s fine. I understand that. We, as a whole, pay more into the system than we get out. However, there are individuals who do withdraw more than they put in. This isn’t necessarily like winning a jackpot, however. Nobody wants to win the insurance lottery.
So, again, how much do you spend on insurance and what types should you buy? It’s such a tough call.
For myself, I’ve come to the conclusion that I should self-insure as much as possible. I should raise my deductibles, and I should alter my coverage so that I pay for many things out of my own emergency savings. This will reduce my premiums and, theoretically, save me money in the long run, even if I do have to pay out of my own pocket.
I think that was what Jeff and Steph were going for when they cancelled their policy, and I don’t think it was a bad decision under normal circumstances.
July 1st, 2008 at 7:06 am
I work in healthcare and am bombarded daily with bad case scenerios that suddenly overtake a formerly healthy person’s life. It makes me a bit paranoid BUT the upside - I’m prepared for such occurances somewhat.
THis is a good post. Thank you for the reminder. We all need to hear it time to time.
btw - I’ve had thyroid cancer. It is very treatable if caught early (but still scary). There is no reason to believe I will be affectd by this again as my life continues. May I ask how they found it? (Mine was found because I had another tyroid disease, so my thyroid was checked every three mns. THis way, tumors were found v. quickly - which resulted in a good outcome).
You can also tie this post into how important it is to receive rountine medical care and to not delay when something is amiss. (Because the sicker one is, the more likely it can be more expensive to treat).
Best wishes to your SIL and family
July 1st, 2008 at 7:10 am
As a person who was diagnosed with Thyroid cancer in 2005 (at 29), I know what your sister-in-law is going through. As my surgeon said, if there’s any kind of cancer that’s the “good” cancer, this is it. I’ve had 2 recurrences since being diagnosed, and to be honest, it’s been good. My thyroid replacement cost me $2 for a 90 day supply with generics. The only thing that she has to be careful of is, health insurance. I can’t change jobs unless the health insurance starts immediately, since I can’t be uninsured. She won’t need an oncologist, just an endocrinologist, who will prescribe her thyroid replacement. My endo gives me samples if I ask nicely.
I know that she’ll pull through this. Especially with a family such as yours.
July 1st, 2008 at 7:14 am
Boy you just never know what life throws at you. I hope and pray for a speedy recovery.
Our family was caught in a health crisis when we had young kids. I canceled a policy and before we could get on another policy we had a health challenge. We were fortunate to be able to get help.
Our goal is to give back.
July 1st, 2008 at 7:17 am
Thyroid cancer is one of the most treatable cancers. My 2 year cancer free anniversary will be in September. Scary to be 27 and now have “cancer survivor” next to my name, but I am lucky at the same time to have had good health insurance.
JD - as for what can you do, just be there. Don’t let the elephant loom in the room. Ask questions, bring over fancy chocolate desserts. (the #1 cure for any stresser) Do what you normally do, but offer a few more hugs and phone calls. It was amazing for me… my sister told her BIL, pretty soon his entire prayer chain was praying for me and I was getting hand crocheted prayer angels mailed to me from strangers.
It is very frightening to me to see people who are going without health insurance. I was happy to pay my monthly premiums after I saw the totals from my treatment add up. (I think ~$30-35k was the total billed) One thing you can do is have a couple posts on the different types of health insurance, benefits/downfalls of each, and even guest posts about what works or doesn’t work for them.
My best to you and your SIL and family. Keep us updated on how she’s doing.
July 1st, 2008 at 7:26 am
Thyroid cancer is very beatable. My husband is an endocrinologist and sees it frequently - most all are curable cases. But its scary nonetheless. And as for the pill, its no big deal. I have an underactive thyroid (which may eventually stop making hormone, much like if I had no thyroid). Its just a little pill and its quite possible that pill is cheaper than your co-pay.
As for the insurance, I’m currently reading a book titled High Wire. I’m only about 40 pages in but I am quickly getting the gist of what the book is about - insurance, lack of protection in spite of having a policy, and personal finances. In other words lots of well to do people are having trouble making ends meet because of policies they had that they thought covered things such as MS and other disabilities. You might pick up a copy and see.
July 1st, 2008 at 7:30 am
My friend’s dad had this a few months ago but is now clear of cancer and back at work. I hope it goes as smoothly for Stephanie.
July 1st, 2008 at 7:39 am
Oh dear. My very best wishes, JD!
July 1st, 2008 at 7:47 am
Scary stuff.
With a family history of cancer I have been looking into some natural preventatives (the most frugal way to compensate the costs of sickness is to not get sick - if that’s possible). I have recently found out about Doug Kaufmann and his friends in the medical field who are finding that a lot of diseases(cancer included) could be caused by fungus and could be treated without all the chemotherapy. He has a site http://www.knowthecause.com Not trying to give him a plug or anything, just hope this helps you and your family.
July 1st, 2008 at 7:58 am
JD, I’m sorry to hear this and my thoughts go out to your family.
My sister in law is also battling cancer. It is the third recurrence. She’s 30. You truly, as those above have already said, don’t know what’s coming. One other thing is the toll on the “healthy” spouse. It is really difficult to get up and go to work every day with such an illness part of your life, and being financially secure can help a great deal with choices you may make with that.
July 1st, 2008 at 8:01 am
I had thyroid cancer last fall!
Honestly, the experience is really not like having cancer at all. The impact on my life was approximately the same as getting the flu really badly twice in one semester- not pleasant, but certainly not the end of the world. I’m 27.
My total medical costs on my grad student insurance were only $2500 for the entire thing including two separate surgeries and one night in the hospital. I now pay $5 copay per month for the replacement hormone.
This is a wonderful site: http://www.thyca.org/
You should download the free PDF cookbook and make her some low iodine meals, and freeze them in tupperwares. The low iodine diet (before radioactive iodine) is quite difficult to follow, and I would have been eating plain white rice for a month if my mother hadn’t come and cooked me 20+ meals to have in the freezer.
July 1st, 2008 at 8:06 am
Oh yeah- also, radioactive iodine is actually just radiation (not chemotherapy.) It doesn’t even make most people feel nauseous, and of course your hair doesn’t fall out or anything like that. And most people need only 1 treatment, or else 2.
Can you tell us the type of the cancer (papillary, follicular, other?)
July 1st, 2008 at 8:19 am
Good luck, I know she can do it.
I have been reading a blog by a girl who has incurable cancer, and it should offer some inspiration. I saw her on Oprah and have been following her posts about how she’s conquering it.
Her site is here: http://www.crazysexycancer.com/
Blog here: http://crazysexycancer.blogspot.com/
July 1st, 2008 at 8:19 am
Oh no! that is sooooo scary, i can’t even imagine it - i’ll def. say a prayer for sure.
Having the right type of insurance is no joke, I’ll agree it’s definitely key to check your policy every now and then to make sure it aligns properly.
July 1st, 2008 at 8:21 am
My mom has her last chemo treatment tomorrow. They caught it pretty early so we are hoping for the best.
Hope all goes well with your sister-in-law.
July 1st, 2008 at 8:22 am
JD - I wish her the best luck fighting cancer off. Fortunately, thyroid cancer tends to be very treatable when caught early. I too have lost too many family members from cancer.
It’s interesting you would say in your comment that insurance is like a “lottery”. While reading your post, I was thinking that the cancer policy was probably ‘a bad decision with good consequences’. That’s a phrase statisticians use for lottery winners.
Cancer policies and other “supplemental” insurances tend not to have the best return for the premium. This is partly because the people most likely to sign up for dental insurance, for instance, have a broken grill. We call the phenomenon of people buying insurance with the intent to use it adverse selection, which raises rates for all applicants.
In the end, I’m glad they have the policy to help out, regardless of what they should have done. My wife and I racked up over $50000 worth of neurological services so far at UNC, but we’ll only pay a few thousand of that. It feels great to have insurance when you need it.
July 1st, 2008 at 9:08 am
Health insurance covers cancer — other forms of specific insurance, like cancer insurance, are a scam on paranoid Americans.
July 1st, 2008 at 9:42 am
JD, your sister-in-law and family are in my thoughts and prayers.
As for insurance, I have similar feelings as you. I know the game is rigged against the consumer, but again, the piece of mind is well worth it. I also have no clue how much my wife and I should have…
July 1st, 2008 at 10:04 am
JD- I’ll keep your family in my daily thoughts.
I’m struggling with the same thoughts re: life insurance. I know we need it, but I’d love to not have to pay that monthly fee.
July 1st, 2008 at 10:16 am
Steph told me last night that she has gotten over the initial shock of the diagnosis, and she is encouraged in knowing that this is such a treatable form of cancer. I think we are now at the stage where we just want to get it taken care of and move on… and deal with whatever comes after it has been removed.
Regarding FranticWoman’s comment (#11), Steph went in for a yearly exam, and the Dr. felt a lump on her thyroid, and suggested further tests.
Regarding Kristina (#26) and cancer insurance… this is supplemental insurance, and it pays above and beyond what our standard health insurance covers. Besides that, our regular health insurance does not cover everything — we can expect hospital and prescription bills in excess of $500 per stay. Couple that with time lost from work, and the costs can add up pretty quickly.
I would not quite call these policies scams, as it is possible to use them to your advantage. With the hospital / short term disability policy Steph had when our daughter was born, we received more than we paid into it (by a factor of at least 3:1) — but we canceled the policy before the premiums outpaced the payout. Now we have a situation where we will actually make good on the premiums we’ve paid into her cancer policy, so I wouldn’t really call this one a scam either. It’s just a different option for a different financial situation.
It is true that if we had followed sound personal finance philosophy early on in our marriage, we would have been in a better position to handle this, and we could have just dipped into some [interest bearing] account and paid all the bills without much strain on our finances. But that is not where we are now, so we have to look at different options.
If you do not have any need for these kinds of specific insurances, then I commend you on your good health, and on your financial success.
July 1st, 2008 at 10:25 am
I hope all the best for your sister-in-law. My grandmother was diagnosed with thyroid cancer, and yes, it was a scare, but it’s very treatable.
Your post brings up an interesting issue for me though: I didn’t realize there were supplemental insurance policies for different things (like cancer). I signed up through my employer for health insurance and made the choice on the basis of in-network vs. out-of-network and which doctors (and how many) were available to me. I’m wondering whether I should look over everything when it comes time to re-enroll this fall?
July 1st, 2008 at 10:29 am
Health insurance doesn’t cover cancer, it covers direct medical expenses from hospitals for surgeries, treatments, follow ups, etc.
Supplemental insurance is intended to cover indirect expenses, such as that $1,000-$5000 deductable, 10-20% co-pays on surgeries and hospitalization, traveling expenses for those who must commute to receive treatment, and finally, lost income.
Everyone’s situation is different, and for some people supplemental insurance doesn’t make sense. However, there are many others who benefit greatly from the financial assistance these policies provide.
Best wishes to your family.
July 1st, 2008 at 10:36 am
sorry to hear JD.. i’ll keep your family in my prayers
July 1st, 2008 at 10:36 am
“Regarding FranticWoman’s comment (#11), Steph went in for a yearly exam, and the Dr. felt a lump on her thyroid, and suggested further tests.”
Thank goodness the doc did a regular check. I’ve been hearing in the med community that it is not such a common thing to automatically do anymore. She is blessed to be “lucky”.
I never would have known had I not been “lucky” enough to already have a thyroid disease.
I hope that so many of us having positive outcomes with the disease puts your wife and family minds at rest.
Best wishes.
July 1st, 2008 at 11:35 am
I was diagnosed w/thyroid cancer at 34. The relevant observation for GRQ is that I could have opted into my employer’s supplemental life insurance very cheaply before my diagnois, while I cannot get it any more due to the diagnosis being fairly recent. I would recommend that folks opt-into as much supplemental life as they can get (discounted) via their employer. It is cheaper that way that individually, and folks should opt in as soon as the opt into things like a 401K
July 1st, 2008 at 12:35 pm
First of all: best wishes to Stephanie
Second: I somewhat share your position on insurance, however, be careful of “non-buyer remorse”. There are plenty of stories in the media of people who decided to go with a lower coverage (some for good, some for not-so-good reasons), however, when disaster struck, an extremely large percentage changed their mind about how much insurance they wanted or could afford. Then the nightmare stories started.
So, should we, as a society, allow people to go naked (as far as health insurance is concerned)? Self-insurance is fantastic for people with self-discipline (a lot of us, here). But for the rest? Poor health has a social cost, as well as an emotional one.
Try the following comparison…would you be disturbed if we allowed any driver to decline third-party car insurance?
Should we force people to buy health insurance, even if the game is rigged? Do we trust the government to administer it? If no, does it mean that people without insurance are just a fact of life, and we stop caring about it?
Somewhere, in the middle of the road, is an imperfect solution. Not sure what it is, though…
July 1st, 2008 at 3:48 pm
I’m sorry your sister-in-law has been diagnosed with cancer and wish her a speedy recovery.
Like her I tossed up cancelling/reducing our insurance. About 3 months later I was diagnosed with leukaemia. Thank goodness I didn’t reduce the policy!
Accident and illness are so often things that we have absolutely no control over and cannot predict. My advice is to view your insurance as a mandatory expense. Pay for the most that you can afford - you never know when you may need it.
July 1st, 2008 at 8:24 pm
I know several folks who have had thyroid cancer and went on to live full lives with no issues other than having to take meds for the rest of their lives. So, I am hoping and praying for the same for your SIL, J.D., and your wife, Jethro.
Noting the number of other folks here citing thyroid issues, all types of cancer, endometriosis, etc., I do want to throw this info out there for folks to consider. I have gluten intolerance. (Gluten is wheat, rye, barley, and oats–the latter due to cross contamination in fields and processing.) I only found that out 5 years ago after a lifetime of issues including thyroid problems, ob/gyno issues including endometriosis (with hysterectomy before gluten intolerance diagnosis), gastrointestinal issues like diarrhea/constipation daily, and so much more. Gluten issues range from sensitivity to intolerance to celiac disease, but folks with these issues cannot tolerate gluten and their body runs amok. You may think there is no reason for your body to have these issues or certain diseases, but there may be. You can Google and find many sites, but no two list the same symptoms and no two individuals have exactly the same symptoms either. Folks who have problems with gluten and continue to eat it can even develop cancer as a result. 97% of folks with celiac disease remain undiagnosed and even more remain undiagnosed with intolerance and sensitivity. Gluten sensitivity can be tested through http://www.enterolab.com. My doctor had me tested via that route and the differences I have experienced in my health have been nothing less than amazing. No more GI issues, no more joint pain (I avoided stairs for years before), no more headaches, no more fatigue, no more canker sores … I can’t even remember all my old symptoms now. My doctor immediately ordered a bone density test and I was diagnosed with osteopenia (the precursor to osteoporosis). Even that disappeared after 3 years of eating gluten free. (I can’t tell you what a huge relief it is to have normal bones again.) Now I lead a support group and have seen others go through equally amazing transformations, like fibromyalgia disappearing, seizures stopping, anemia being resolved, arthritis disappearing, weight being normalized, etc. I am not saying it’s a miracle cure for all by any means, but it’s definitely something to check out.
July 2nd, 2008 at 6:39 pm
Just adding to the chorus–I am a thyroid cancer survivor too. Sounds like she’s got lots of good resources, but if your sister-in-law wants to talk to someone who’s been there, have her drop me a line or go and read the “thyroid” and “surgery” tags in my journal. I wish her the best!
July 3rd, 2008 at 6:01 am
Stories like this make me sad. I have a friend who was recently diagnosed with cancer. He had to quit his job so he could get government medical coverage. Now he’s struggling greatly to cover the extra $1000 a month in medical/living expenses even on a shoe string budget. He’s started a grass roots fundraiser to hopefully get help from friends and family while he recovers over the next 16-24 months.
I just dont understand with the technology and all the wasted money we spend in this country every day why anyone should have to deal with things like this on their own. Many people are dealt these terrible blows with no reason and have to suffer not only from their illness, but then the financial burden on top of it. This is just simply wrong and there must be a better way. I hope only being in my 20’s that I see something done about this in my life time.
July 3rd, 2008 at 9:04 pm
J.D. Sorry to hear about your sister-in-law. I wish her well. My best advice for the family is to take it day by day and think positive. I truly believe alot has to do with the mind. You have to believe you are going to beat it.
I know what it must be like for her. I was diagnosed with a rare form of cancer at 21. No cases were ever reported in Canada, therefore I had to go to the US for initial treatments. I wish there was such thing as some coverage. The bill was extradinary and my parents fought to reduce the bills. The doctors there worked with a team in canada so I could return and be under coverage. I have been blessed and thankful for the support of family and friends. I am cured.
Unfortunately, these events, we just can’t predict.
July 6th, 2008 at 2:00 pm
Just a word of encouragement to your family and Stephanie… I had the exact same thing happen to me 3 years ago.. when I was 21! It was all very successful, had my entire thyroid removed, radiation, and am on replacement meds. The initial “It’s Cancer” is scary, but like I was told, it’s the best kind of Cancer you can get, b/c it’s so treatable.
Hope she passes everything with flying colours.