The Cost of Getting Better

Nobody warned you this would happen to your finances.

Not when you were diagnosed. Not during treatment. And certainly not at the end of treatment, when whatever conversation there was focused on your body and what came next clinically. Nobody sat down with you and said: by the way, the financial impact of what you have been through is likely to be significant, it will arrive in forms you didn't anticipate, it may outlast the active treatment by months or years, and there is a specific set of things you can do about it.

And here is the thing most people don't know, because it seems almost absurd when you say it out loud: cancer causes a financial crisis for a large and predictable proportion of everyone who goes through treatment. Macmillan's research found that four in five people with cancer are on average £891 a month worse off as a direct result of their diagnosis. That is not a statistical anomaly. It is what happens when income drops and costs rise simultaneously, for months or years, and the financial system provides no clear pathway through the gap.

If you are reading this and your finances are under pressure — if the savings have shrunk further than you expected, if the bills are accumulating, if you are lying awake about money as well as everything else — you are not unusual. You are not bad with money. You are in the company of hundreds of thousands of people across the UK who are navigating an experience that was never properly explained to them and that the system does not make easy.

This chapter is the explanation. Not a vague acknowledgment that cancer is expensive, followed by a list of helplines. The actual information, in plain language: what you are entitled to, what has recently changed, what to do if you are in genuine difficulty, and how to access help that most people with cancer never know exists.

How cancer causes a financial crisis — even when it seems like it shouldn't

It is worth spelling this out, because the invisibility of the financial impact is part of what makes it so difficult. People don't see it coming. And then they look up and the damage has been done.

The mechanism is not complicated. Cancer treatment reduces your income. Often significantly. Sometimes to nothing beyond sick pay. Simultaneously, it increases your costs. Not dramatically at first. Gradually, invisibly, in forms that feel small and manageable until suddenly they don't.

Travel and parking arrive most consistently and most relentlessly. If you have been attending a specialist cancer centre — which may not be your nearest hospital — the cumulative cost of getting there, parking, and returning is significant over months of treatment. Macmillan has documented this running to hundreds of pounds a month for people with frequent appointments. This is money leaving your household at the exact point when your income has also reduced.

Heating and energy bills go up. People in treatment are often colder, more vulnerable to infection, and spending more time at home. Nobody adjusts your income to reflect this.

Food. Some treatments require specific dietary approaches. Appetite and tolerance change. The food that works during treatment is not always the cheapest food.

Clothing and practical items. Treatment changes your body in ways that have costs attached — weight changes, hot flushes, lymphoedema, prosthetics, specialist footwear for neuropathy.

The informal care that never appears on any budget. A partner who reduces their hours or leaves work to be present during treatment. An adult child who takes time off. These income losses are real and they are almost never counted because nobody is invoicing them. They affect household finances just as directly as anything else.

And underneath all of this: the income reduction itself. Some employers provide full or partial sick pay for a significant period. Some provide statutory minimum only. Some people are self-employed, in which case no one provides anything. The duration of treatment, the nature of recovery, the physical and cognitive late effects that affect the ability to return to work — all of these extend the period during which income is reduced beyond what most people anticipate.

None of this arrives as a single shock. It accumulates, quietly, while you are managing everything else. And the shame that surrounds money — particularly the specific shame of financial difficulty that feels like personal failure — means that people carry it in complete silence, often for months. People who survived cancer are downsizing their homes, exhausting their savings, and quietly making choices between heating and food because the financial consequences of being ill arrived incrementally and no one named them until it was already a crisis.

The most important thing in this chapter

Before anything else: call a Macmillan money adviser.

Not because the information below isn't useful — it is. But because benefit entitlements interact with each other in ways that are not obvious, and the decisions you make about which to claim and in what order can significantly affect what you receive. A Macmillan money adviser is a specialist, they are free, they are completely confidential, and they will do a full benefits check with you — looking at your entire financial picture and identifying every entitlement you may not have claimed.

In 2024 alone, Macmillan secured £310 million in financial gains for 84,000 people with cancer through this service. That is a very large amount of money that was sitting unclaimed in a system that does not come looking for you.

The number is 0808 808 00 00. Money advisers are available Monday to Friday, 8am to 6pm. The call is free. You do not need to have the answers to their questions before you call. You can say: I've had cancer, my finances are under pressure, and I don't know what I'm entitled to. That is a sufficient starting point.

If you would rather not phone first, the Macmillan benefits calculator at macmillan.org.uk/benefits-calculator covers England, Scotland and Wales, takes about twenty minutes, and gives you an estimate of what you may be entitled to before any conversation.

If you don't have internet access at home, your local library offers free computer access. Or ask a GP surgery receptionist, CNS, or pharmacist to help you access the calculator or make the call on your behalf. Citizens Advice have local offices across the UK where advisers can access this information for you in person, without an appointment, for free.

Free prescriptions — the thing most people miss until it's too late

In England, if you have cancer or are receiving treatment for the effects of cancer or its treatment, you are entitled to free NHS prescriptions for everything. Not just cancer-related medicines. Every prescription item, for any condition.

The prescription charge in England is currently £9.90 per item. If you are on several regular medications, the savings over the months and years of treatment and follow-up are substantial.

You need a medical exemption certificate. Ask your GP, CNS, or hospital doctor for a form called FP92A. They complete their part, you send it off, and your certificate arrives within ten working days. It is valid for five years. Keep a note of the expiry date and ask your GP to renew it before it lapses — if it expires without renewal you can receive a penalty charge.

If you have been paying for prescriptions since your cancer diagnosis without knowing you were entitled to a certificate, you can claim back charges paid in the previous twelve months. Contact your GP or the NHS Business Services Authority.

If you need a prescription before your certificate arrives and have to pay, ask the pharmacy at the time of payment for an FP57 receipt. This allows you to claim a refund once the certificate arrives. You cannot get the receipt after the fact — it must be at the moment of payment.

If you are in Scotland, Wales, or Northern Ireland, all prescriptions are already free and you do not need a certificate.

Statutory Sick Pay — what it is now and what changed in April 2026

If you are an employee, you are entitled to Statutory Sick Pay from your employer. Two significant changes came into force in April 2026 under the Employment Rights Act 2025 that are important to know.

The rate from April 2026 is £123.25 per week — or 80 per cent of your average weekly earnings if that is lower. The waiting days are gone: SSP is now payable from the first full day of sickness absence, not the fourth. And the lower earnings limit has been abolished, meaning all employees now qualify regardless of how much they earn, including part-time workers and those on zero-hours contracts.

SSP is paid by your employer for up to 28 weeks. Many employers have occupational sick pay schemes that provide significantly more — check your employment contract or speak to HR.

SSP runs out after 28 weeks. If you are still unable to work at that point, you need to transition to other support. The key is to act before it stops: you can apply for Employment and Support Allowance up to three months before your SSP ends. Your employer should give you an SSP1 form when your SSP is ending — you will need this for the ESA application. Do not wait for SSP to run out before starting this process.

If you are self-employed, SSP does not apply to you. The self-employed section later in this chapter covers a different picture.

Benefits during and after cancer — the landscape in 2026

Benefit rules change and they interact with each other in ways that are not obvious. Nothing here replaces personal advice for your individual situation — call Macmillan's money advisers before making any claim. That said, here is what currently exists and what has recently changed.

**Personal Independence Payment (PIP)**

PIP is a benefit for people of working age — under 66 — who have a disability or long-term health condition that affects their daily life. It has two components: a daily living component and a mobility component. It is not means-tested. Cancer — including the ongoing effects of treatment such as fatigue, peripheral neuropathy, lymphoedema, cognitive change, pain, and mobility difficulties — can qualify for PIP, even after active treatment has ended.

There is something urgent about PIP that you need to know. The government passed the Universal Credit Act 2025 which introduces a new eligibility rule for PIP's daily living component: from November 2026, new PIP claimants will need to score at least four points on a single daily living activity to qualify. Currently, points can be spread across multiple activities. From November 2026, that route closes for new claims. Existing PIP claimants are not affected.

What this means if you have not yet claimed PIP: if the daily life impact of your cancer or its treatment is significant, claim now — before November 2026. Do not wait. The DWP impact assessment estimated that 430,000 people who would have qualified under current rules will be refused under the new rule. Call the DWP PIP helpline on 0800 121 4433. Be specific about your worst days, not your best ones.

If you are in Scotland, PIP is being replaced by Adult Disability Payment, administered by Social Security Scotland. New claimants in Scotland apply for ADP. Call Social Security Scotland on 0800 182 2222.

**Universal Credit and the health element**

For people who cannot work because of illness, Universal Credit includes a health element — the Limited Capability for Work and Work-Related Activity payment. For people making a new Universal Credit claim from 6 April 2026, this health element is paid at a new lower rate of £217.26 per month — roughly half the previous rate of £429.80, which is protected for existing claimants.

This means: if you have not yet claimed Universal Credit and are unable to work because of cancer, claim now and report your health condition at the point of claim. The date you report your health condition is the date that determines which rate you receive. Do not delay.

If you are already on other benefits — particularly Housing Benefit — get advice before applying for Universal Credit. Moving to Universal Credit ends those other benefits, and some people end up worse off.

**New Style Employment and Support Allowance**

New Style ESA is available to people who cannot work because of illness or disability and who have paid sufficient National Insurance contributions. It is not means-tested and can be claimed alongside Universal Credit in many circumstances. The assessment rate from April 2026 is £95.55 per week for those aged 25 and over. After assessment, if you are placed in the support group, the rate rises to £145.90 per week. You need a fit note from your GP.

**Attendance Allowance**

If you are over State Pension age — currently 66 — and cancer or its treatment means you need help with personal care or supervision, Attendance Allowance may be available. It is not means-tested. The lower rate from April 2026 is £76.70 per week. The higher rate is £114.60 per week. Receiving Attendance Allowance can also increase your entitlement to Pension Credit, Housing Benefit, and Council Tax Reduction — so if you are awarded it, contact the Pension Service to have your Pension Credit recalculated. Many people miss this step and miss out on additional payments as a result.

The Macmillan grant — what it is and what it isn't

This needs to be said plainly because outdated information about the Macmillan grant is still circulating widely and causing real harm — people searching for help, finding references to a national grant that no longer exists, and giving up.

The national Macmillan grant — once available to people with cancer across the UK as a general entitlement — no longer exists. It was closed to new national applications.

Local Macmillan grants currently exist in specific areas only. As of May 2026, they are available in: certain areas of Northern Ireland (Derry City and Strabane, Newry Mourne and Down, Causeway Coast and Glens, Fermanagh and Omagh); parts of England (the North East, Knowsley, Liverpool, Kingston upon Hull); parts of Scotland (Glasgow City, Inverclyde, Dundee City, North Ayrshire); and parts of Wales (Newport, Merthyr Tydfil, Cardiff, Rhondda Cynon Taf).

If you do not live in one of those areas, a Macmillan grant is not currently available to you directly. What is still available is the broader landscape of charitable grants. Turn2us — at turn2us.org.uk or by calling 0808 802 2000 — runs a free grants search that identifies charities and trusts providing financial help to people in your situation. Local authority emergency grants also exist in most areas — Local Welfare Assistance schemes providing help with food, fuel, and essential household items for people in crisis. Contact your local council directly to ask what is available.

Travel, parking, and the Blue Badge

If you cannot travel to medical appointments without assistance because of your condition, NHS patient transport may be available through your hospital trust. Ask your CNS or the hospital's patient services team. This is not widely advertised and many people who qualify never know to ask.

If you have been paying for travel to NHS appointments and you receive certain benefits or are on a low income, the Healthcare Travel Costs Scheme covers reasonable travel costs. Claim it at the hospital appointment itself — ask at the reception or cashier when you arrive. You cannot claim it retrospectively in most cases, so ask each time.

The Blue Badge scheme allows you to park in disabled bays and closer to your destination. Cancer can qualify, including the effects of treatment such as severe fatigue, neuropathy affecting walking, or post-surgical mobility difficulties. It is not means-tested. Apply through your local council. Ask your GP or CNS to support your application with a letter.

Insurance — life cover, critical illness, and travel

If you had life insurance or critical illness cover before your diagnosis and your policy was in force at diagnosis, check it now. Critical illness cover is typically a lump-sum payment on diagnosis of specified conditions including most cancers. If you have not yet claimed and your diagnosis falls within the policy terms, claim now. There are time limits. Do not assume the policy doesn't apply without checking.

If you are looking for new life insurance after cancer: it is generally possible, particularly once treatment has ended. Premiums will be higher, and the terms depend on cancer type, treatment, and time since completion. Full disclosure of your diagnosis and treatment is legally required — never omit anything, because a claim on an undisclosed pre-existing condition can be refused. A specialist broker who works with people who have pre-existing conditions will navigate this more effectively than a standard comparison site.

Travel insurance. Standard policies frequently exclude or restrict cover for cancer-related medical treatment abroad. This does not mean you cannot get travel insurance — it means you need a specialist policy that specifically covers your condition. Always disclose your full diagnosis and treatment history. Never minimise it. Travelling without cover that includes your cancer means potentially catastrophic uninsured medical bills abroad. Specialist providers include AllClear, Fit2Travel, and Insurancewith. The British Insurance Brokers' Association at biba.org.uk can help you find a specialist broker.

The self-employed reality — specifically and plainly

If you are self-employed, everything above applies with one fundamental difference: you cannot claim Statutory Sick Pay. SSP is paid by employers to employees. There is no equivalent for self-employed people. This is one of the starkest financial vulnerabilities in UK employment, and it becomes acutely real when a serious illness removes your ability to work.

New Style ESA is available if you have paid sufficient National Insurance contributions — specifically Class 2 NI over two of the last three tax years. If you have been registered as self-employed and paying Class 2 NI, you may well qualify. If you are not sure, your self-assessment records or a call to HMRC will tell you.

Universal Credit is available to self-employed people. Normally, Universal Credit applies a Minimum Income Floor — an assumption about your earnings based on minimum wage hours — which can produce a lower payment than your actual income loss warrants. Critically, this floor is suspended if you are sick and have provided a fit note from your GP. During a period of illness with supporting fit notes, you are treated more like an employee for Universal Credit purposes. Make sure you are providing fit notes continuously. A gap can trigger the floor's reapplication and reduce your payment dramatically without warning.

PIP is available to self-employed people on exactly the same terms as everyone else. Employment status is irrelevant to PIP.

If you are a director of your own limited company and pay yourself through PAYE, you may be eligible for SSP from your company — ask your accountant specifically.

When you call Macmillan's money advisers, tell them from the start that you are self-employed. The picture is different and they are equipped to work through it with you.

Practical help that works without digital access

Everything above assumes some capacity to make phone calls or use the internet. For people who have neither reliably, or who find both difficult right now:

Your local Citizens Advice office offers free, in-person, confidential advice on benefits, debt, and financial support. No appointment is required to walk in. Find your nearest office by asking at your GP surgery, library, or community centre. They can access the benefit calculators, make calls on your behalf, and help you complete forms.

Your GP surgery receptionist or practice manager can often signpost you to local welfare and financial support services, and some surgeries have a link worker or social prescriber who specifically helps with non-medical consequences of illness including financial difficulty.

Community centres, foodbanks, and local charities often have access to emergency hardship funds and can connect you with local welfare assistance. A referral from your GP or CNS is usually the fastest route.

You do not have to navigate any of this alone.

What to do this week

Benefit rules change, figures are updated annually, and entitlements interact in ways that are not always predictable. This chapter reflects the position as of May 2026 and has been checked against current government and Macmillan guidance. Always get personal advice from Macmillan's money advisers or Citizens Advice before making a claim or changing your benefit situation. The Macmillan money adviser service is free, confidential, and current.

• Macmillan money advisers (free, benefits check, Monday to Friday 8am–6pm): 0808 808 00 00
• Macmillan benefits calculator — macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/benefits-and-financial-support/benefits-calculator
• DWP PIP helpline (to start a PIP claim): 0800 121 4433
• Social Security Scotland (Adult Disability Payment, Scotland): 0800 182 2222 — socialsecurity.gov.scot
• Turn2us grants search (charitable grants for people in financial difficulty): 0808 802 2000 — turn2us.org.uk
• Healthcare Travel Costs Scheme: ask at the hospital reception
• Citizens Advice (free, in person, no appointment, benefits and debt) — citizensadvice.org.uk
• Citizens Advice debt helpline (England and Wales): 0800 144 8848
• National Debtline: 0808 808 4000 — nationaldebtline.org
• StepChange debt charity: 0800 138 1111 — stepchange.org
• Attendance Allowance helpline: 0800 731 0122