Your cost of participating in a clinical trial

Health plans are not required to cover the research costs of a clinical trial. Examples of these costs include extra blood tests or scans that are done purely for research purposes. Often, the trial sponsor will cover such costs.

Plans are also not required to cover the costs of out-of-network doctors or hospitals, if the plan does not usually do so. But if your plan does cover out-of-network doctors or hospitals, they are required to cover these costs if you take part in a clinical trial.

Grandfathered health plans are not required to cover routine patient care costs in clinical trials. These are health plans that existed in March 2010, when the Affordable Care Act became law. But, once such a plan changes in certain ways, such as reducing its benefits or raising its costs, it will no longer be a grandfathered plan. Then, it will be required to follow the federal law.

Federal law also does not require states to cover routine patient care costs in clinical trials through their Medicaid plans.
https://www.cancer.gov/about-cancer/treatment/clinical-trials/paying/insurance

Try to negotiate costs with the P.I. of the site offering you enrollment in a clinical trial.

Calculate in cost for transportation and hotel accommodations. Often times the institution will cover all or some of the cost, or the pharmaceutical company producing the drug may be of help.

In any case, don’t hesitate from speaking up. You may want to get into this particular study, but remember that you also bring value to the investigator and ultimately the pharmaceutical company.

Good luck and please share your experience with us.

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Marion