Health insurance coverage and clinical trials

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Strategies to help you optimize your coverage

To minimize your own out-of-pocket costs, some research may be necessary to ensure you have optimal access to new prescription medications.

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Drug coverage and drugs provided through cancer care centres can vary from province to province.

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Meet with your employer, your Human Resources department, or your union representative to help you better understand your benefits.

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If your employee health plan does not cover a certain drug, ask your employer if the company can make an exception in your case or waive the cap on your drug coverage.

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Ask your doctor what drugs you may need in the future and check to see if your plan covers them.

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Some private insurance plans require that you pay up front and then apply for reimbursement. You may ask your insurance company to allow your pharmacy to send the bill directly to them.

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Find someone to work with you to advocate for the drug coverage when you cannot.

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If you are refused coverage of a medication you need, appeal the decision. Sometimes the refusal may be the result of nothing more than faulty paperwork.

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Some pharmaceutical companies have free services that will help you search for coverage of specific drugs. Sometimes a compassionate use program is offered to patients requiring the drug. Talk to your cancer care team.

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See, at a glance, the drugs that are available and covered in each province and territory with the Myeloma Drug Access Navigator.

Advocacy Handbook

Everyone has rights that need to be respected and a voice that deserves to be heard. In our society, advocacy is essential in ensuring that your voice is not muted and that your rights are not dismissed.

Learn about advocating for yourself, advocating for others, and advocating for change in the Myeloma Canada Advocacy Handbook.

Questions to ask your healthcare team

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Will I have to pay for any part of the trial, such as tests or the study drug? If so, what will the charges likely be?

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Will there be any travel costs that I need to consider while I am in the trial?

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What will my health insurance likely cover?

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Who can help answer any questions from the insurance company?

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Myeloma Canada has many resources to help you navigate the financial implications of living with myeloma.