We explored how sociodemographics and health insurance literacy (HIL) are associated with financial toxicity (FT) among adolescent and young adult (AYA) cancer patients using linear regression. Participants (N = 86; ages: 18–39) diagnosed with cancer in the past year completed baseline surveys of an intervention trial assessing HIL (range: 4–36, lower scores = worse literacy) and the COmprehensive Score for financial Toxicity (COST; range: 0–44, lower scores = higher toxicity). Policyholders had higher FT (β = −5.24, p = 0.02). Among AYAs aged 26–39, each one-point HIL increase correlated with a 0.55 increase in COST score (p = 0.05). Improving HIL could address FT among AYAs aged 26–39, suggesting a potential target for intervention.
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