Rising Healthcare Costs: What Aetna Employees Need to Know About Managing Financial Strain in Retirement

Healthcare Provider Update: Healthcare Provider Information for Aetna Aetna, part of the CVS Health family, has been a key player in the Affordable Care Act (ACA) marketplace, providing health insurance plans to individuals and families. However, significant changes are on the horizon for 2026, as Aetna will exit the ACA marketplace in 17 states, impacting approximately 1 million members. This withdrawal is attributed to the company's challenges in maintaining competitiveness and providing value in a rapidly evolving healthcare landscape. Potential Healthcare Cost Increases in 2026 As the healthcare landscape shifts, substantial premium hikes are anticipated for those enrolled in ACA marketplace plans, with projections of up to 75% increases in out-of-pocket costs due to the potential loss of enhanced federal subsidies. In some states, insurers have filed for rate increases exceeding 60%, driven by surging medical costs and the expiration of premium tax credits established under the American Rescue Plan. For Aetna's former members, this change further complicates their healthcare landscape as they seek new insurance options amid heightened financial pressures. Click here to learn more

As Patrick Ray, a representative of The Retirement Group, a division of Wealth Enhancement Group, points out, 'It is crucial for all employees, especially those in the Aetna sector, to proactively plan their finances to avoid the unexpected costs of health crises.

According to Michael Corgiat of The Retirement Group, a division of Wealth Enhancement Group, 'It is important for Aetna employees to understand the bigger economic implications of health issues as reported in this article to have robust financial plans to manage the risks of healthcare adverse events.

In this article, we will discuss:

1. The Economic Impact of Cancer: Examining the direct and indirect financial challenges faced by patients, including increased medical costs and loss of income.

2. Personal Stories of Financial Struggle: Highlighting individual cases, such as Gwendolyn Jackson, to illustrate the broader financial implications of a cancer diagnosis.

3. Solutions and Support Systems: Exploring available resources and potential strategies to alleviate the financial burdens on patients and their families.

When one is diagnosed with cancer, it is not only a life-threatening disease that affects the patient’s health but also their finances.  Many patients are faced with the financial challenges of higher out-of-pocket costs, reduced income and higher cost of drugs. This article looks at the huge financial impact that cancer has on Americans and Aetna employees, using cases, numbers and the overall trend of this new epidemic.

The Story of Gwendolyn Jackson and the Personal Toll of Cancer Gwendolyn Jackson had no problems paying her bills before being diagnosed with cervical cancer. She owned her house, had insurance and had a job. But when she was 53 years old, her life changed drastically when she was told she had cervical cancer.  Jackson lost her work as a housing coordinator due to the physical toll of chemotherapy and a subsequent stroke, and she is already facing tens of thousands of dollars in medical debt.

Her vehicle was repossessed, and she received an eviction notice.  Jackson recalls, 'I woke up one morning, and I was a top case manager. Then I was losing everything.' Increasing Prices and Economic Difficulties Cancer is becoming an increasingly expensive disease in the United States due to the rising prices of drugs and medical care.  Iqvia’s Institute for Human Data Science predicts that 55% of cancer medications launched between 2019 and 2023 will cost more than $200,000 a year.

Those of working age, like those at Aetna, have several difficulties and are more likely to report financial hardship after diagnosis.  Sixty percent of cancer survivors of working age have money problems, according to the study. Many struggle to pay for medical care, and this often results in debt accumulation — payday loans, credit card debt, and so on. About 40 percent of medical GoFundMe campaigns are for cancer.  Radiation oncologist Dr. Reshma Jagsi of Emory University School of Medicine and the Winship Cancer Institute says, “We do not want to believe that people with cancer in this country have to cut back on medications, doctor visits, lose their home, or cut back on food.” The Financial Toxicity Concept Financial toxicity is the term used to describe the financial burden of cancer and its treatment.  It is not just the cost of treatment and the expensive drugs but there are many other costs as well.

Patients who receive chemotherapy and other treatments may not have enough energy to work, thus, losing their employer-sponsored health insurance and income.  The financial consequences may last for many years. It is always a shock. As Aetna Employees planning for these unexpected expenses is crucial. Dr. Fumiko Chino, a radiation oncologist at Memorial Sloan Kettering Cancer Center adds, “It can cause this wealth shock that can ripple on.” Her husband died of cancer more than 10 years ago and she still gets phone calls from debt collectors about his debts.  She faced the financial burden personally.

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The Growing Price of Anticancer Drugs The chief problem facing Aetna employees is the rising cost of healthcare and cancer medications. These costs are either rising at the rate of inflation or have very high initial prices.  The prices of common cancer medications can be as high as six digits. For example, Medicare beneficiaries will have to pay $5,247 out-of-pocket for the leukemia therapy Imbruvica in 2022, which is more than $213,000 per year. Tagrisso lung cancer medication is approximately $208,000 per year.

Some employer-based plans have patients pay a portion of the drug costs, shifting the burden of rising healthcare costs to patients. Cancer patients of working age with private insurance had out-of-pocket expenses rise 15% between 2009 and 2016. Many patients have to pay for parking, hotel, child care, and transportation, among other costs.  The Broader Effect on Earnings Besides the cost of treatment, cancer has a major negative impact on the financial well-being of the affected individuals. It is still a serious matter that makes many have to leave their workplaces or even quit their jobs altogether.  Chemotherapy patients are four times more likely to quit than patients who do not receive the treatment within the first four years.

This burden usually affects families as a whole since relatives may have to take care of the patient or financially support the family.  The hardship faced by Erica Olenski is illustrative. Olenski’s young son August was diagnosed with brain cancer in 2019. She cut back drastically on her working hours, spending time traveling back and forth between McKinney, Texas, and Dallas for August’s treatments, which entailed weekly hospital stays.

The family’s income was lowered even though Medicaid paid for the medical expenses. “It was the transport, gas, tolls, food at the hospital because you can’t buy groceries like you would at home,” says Olenski. “There’s a pragmatic reality of living that lifestyle that carries an enormous cost.” Financial Repercussions and Insolvency Financial strain may have serious implications for Aetna employees and may include bankruptcy.  Olenski had to liquidate most of her 401(k) to pay off the debts. She later got divorced and lost $20,000 during the divorce process. In 2023, August’s illness returned, and she had to use her credit cards to pay for things like car and mortgage.  She finally filed for bankruptcy, and was over $100,000 in debt.

Cancer’s Wider Financial Effects Dr. Scott Ramsey, the director of the Hutchinson Institute for Cancer Outcomes Research at Fred Hutchinson Cancer Center, and his team found that cancer patients have more credit card late payments, mortgage defaults, and other financial issues than non-cancer patients.  According to Ramsey, patients who incur more out-of-pocket expenses are more likely to delay starting their prescriptions or stop taking them altogether.

According to his research, cancer patients who file for bankruptcy have an 80 percent higher chance of dying than those who do not.  “It was actually kind of bad for the survival,” he said. Gwendolyn Jackson’s Persistent Battle When Jackson’s father was diagnosed with lung cancer 10 years ago, she saw for herself how cancer affects people’s finances. Inspired by families who had to sell their jewelry and savings to pay for treatment, she started a charity organization to help cancer patients and their families.  She is currently in a comparable situation. Her diagnosis has greatly impacted Jackson’s life. She has gone from a social person who used to jog daily to a person with a very busy schedule of doctor’s appointments.

Her 83-year-old mother had to pay $800 a month for her health insurance until it became unaffordable after she quit her job in 2022.  Jackson then chose a less expensive insurance plan, but the costs for tests, chemotherapy, and physical therapy kept on rising. While waiting for long-term disability, she used her credit cards and received money from friends and relatives. She moved in with her daughter and shared a room with her grandson after losing her house and car.  “It broke me,” Jackson claims. Looking for Guidance and Assistance Despite substantial holes in the safety net, campaigners and doctors are looking for patchwork solutions to the increasing problems.

More cancer facilities are now able to help patients who have financial problems and other needs like food and transportation.  The problem is that there is not much funding and not many people are aware of these options. Only a few patients who turn to crowdfunding platforms like GoFundMe can raise the needed amount through the platform. Cancer Care Kansas had not considered Jackson for aid because she earned too much money.

She was able to avoid using cash from her nonprofit because she had to. She could not manage the demands and her efforts to work remotely were in vain. Jackson is now on disability, so she helps pay for groceries, gas, utilities, and prescription drugs.  She has just been informed that she would be eligible for Medicare in a few months’ time, but this will leave her with around $38,000 of medical debt that she has no way of paying after monthly expenses are covered.

Jackson’s cancer has not responded to chemotherapy, so she is still undergoing treatment through a clinical trial. Despite the fact that she has less than 18 months to live, debt collectors are still after her for the medical bills. “They’ll give you calls and letters,” she continues.  “But I can’t pay for what I don’t have.” In Summary Cancer impacts the lives of American households in a real and significant way. The costs of prescription drugs, the out-of-pocket costs, and the lower incomes are a financial burden that many patients and their families cannot bear.

The stories of people like Gwendolyn Jackson and Erica Olenski show that there is a need for better financial support and ways to help people cope with the economic impact of cancer. This is becoming more important as the cost of cancer treatment rises, so patients can focus on their health without worrying about the financial impact.  It is important for Aetna employees to always be prepared for any unexpected medical expenses.

Medicare enrollees paid $5,460 on average out-of-pocket for healthcare in 2021, according to a recent Kaiser Family Foundation report released in May 2023. Healthcare costs were substantially higher for people with serious diseases like cancer.  Such costs can strip retirement funds quickly, and it is crucial to understand and prepare for healthcare expenses in later years. Older retirees may struggle with financial issues that threaten their financial well-being and quality of life as healthcare costs rise (KFF, 2023).  Disclosure: This information is not intended as recommendation. The opinions are subject to change at any time and no forecasts can be guaranteed.  Investing involves risk, including possible loss of principal.

Sources:

1. 'Financial Hardship.' American Cancer Society. www.cancer.org. The following is a reference from the American Cancer Society on financial difficulties encountered by cancer patients and the need for support and resources.

2. 'The Economic Burden of Cancer.' The Cancer Atlas. canceratlas.cancer.org. This article presents the costs of cancer in the US and EU and shows that the costs are high.

3. 'The Financial Impact of Cancer: How to Manage the Costs.' Cancer Survivors Network.  csn.cancer.org. This narrative focuses on financial assistance and community resources for cancer patients with a focus on long-term financial planning.

4. 'CRFT Brings Distress, Bankruptcy, and Mortality.' Family Reach. www.familyreach.org. This article explores the financial devastation that cancer can cause and the consequences of heightened chances of bankruptcy and death.

5. 'Legal & Financial Impacts of Cancer.' MD Anderson Cancer Center. www.mdanderson.org. This source provides information on the legal and financial challenges of cancer patients, including information on managing health insurance and healthcare costs.