While some research studies will pay participants for their time and effort, cancer clinical trials do not pay people or offer any financial incentives to participate.
Federal law requires most insurance companies to cover “routine patient care costs” if they are on an approved clinical trial. These costs cover things like routine blood and radiology tests that you may have had as part of your cancer care even if you weren’t on the trial. Your insurance company does not have to cover tests that are done specifically for the trial and are not part of standard care. For example, if the pharmaceutical company is worried about liver damage caused by the study medication, they may want extra blood tests or scans. These do not have to be covered by insurance, but will often be paid for by the pharmaceutical company or study sponsor.
If your healthcare plan does not include out-of-network doctors or hospitals, your plan does not need to cover the costs of trials that are done at an out-of-network practice or facility.
Medicare has been covering clinical trial costs since 2000. The study nurse or coordinator should review any out-of-pocket costs with you. You should also talk with a representative at your insurance company to learn more about your coverage.
Most trials do not cover out-of-pocket expenses. These include costs related to traveling to the trial site, housing, transportation, parking, and meals. The study coordinator or oncology social worker can talk with you about local resources and referrals.
National Cancer Institute Clinical Trials Information Section
American Society of Clinical Oncology Health Insurance Coverage of Clinical Trials
Lazarex Foundation - Non-profit dedicated to supporting patients in accessing clinical trials. Also provides some financial assistance for clinical trials participation.
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