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avastin & insurance bill

nancy591's picture
nancy591
Posts: 1059
Joined: Sep 2009

I just recv'd a statement from my cancer center. They bill my insurance $10,891 for a single infusion. WOW.

Mwee's picture
Mwee
Posts: 1316
Joined: Nov 2009

and double WOW........ here's hoping it kicks butt.
(((HUGS))) Maria

jloe's picture
jloe
Posts: 175
Joined: Sep 2010

Mine billed 15k per treatment and it was covered.

Hissy_Fitz's picture
Hissy_Fitz
Posts: 1869
Joined: Sep 2009

I'm not surprised. The series of Taxol maintenance I just finished - 12 infusions - cost $55,000, and that's not full "retail", just what my insurance paid.

Taxol isn't even a new drug. My doctor cited cost as one reason for not doing longer (more than one year) maintenance treatments.

Lisa13Q's picture
Lisa13Q
Posts: 683
Joined: Jul 2009

When it works, you won't even blink!!!

Lisa13Q's picture
Lisa13Q
Posts: 683
Joined: Jul 2009

When it works, you won't even blink!!!

anicca's picture
anicca
Posts: 324
Joined: Dec 2010

All of us who have enjoyed good health for many years prior to our diagnoses, and all of those still enjoying good health have already footed that bill through our years upon years of insurance premiums. Thank goodness your insurance will pay for it!

pattysoo's picture
pattysoo
Posts: 173
Joined: Oct 2010

Yep, that's what it costs. And even the "Adjusted" cost for insurance is in the thousands. I can't even wrap my brain around that. Each of my treatment bills was something like $17000. Thank goodness for insurance - even crummy insurance.

clamryn's picture
clamryn
Posts: 508
Joined: Jun 2010

Oh my. I knew it was high but I had no idea. I haven't seen my bill from my first infusion. Now you have me curious as to what mine will be. My COBRA cost me $594 a month but I gladly pay it to be covered.

Mum2bellaandwilliam's picture
Mum2bellaandwilliam
Posts: 414
Joined: Oct 2010

I can't believe the cost of your insurance premiums, they are so expensive , but worth it granted.
In the uk it is all free, well ok we pay high taxes, but you just walk in a get treated, doesn't matter if you are a junkie or a high flying executive , we are lucky in that respect, although I do believe you get better treatment, as it is the insurance company that foots the bill , not the government!

clamryn's picture
clamryn
Posts: 508
Joined: Jun 2010

Yes it is high. COBRA is what they offer you when you leave your place of employment. You have the option of continuing the coverage just as if you were still employed but you have to pay for the coverage as the employer would and they also tag on 102% for doing the paperwork. However, you only get to have it for 18 months after termination. I received an extra 11 months (extension due to going on disability). This will take me to the point where I will then be covered by Medicare. It was a very good thing when they changed COBRA and added the 11 months on to carry a person through so that there would be no lapse in coverage.
I feel so sorry for the people that lost their jobs during this recession and can't afford to pay for their healthcare. So many people are suffering.

lindaprocopio's picture
lindaprocopio
Posts: 2022
Joined: Oct 2008

I have my own business and private insurance, so there is no volume bargaining like when you are a part of a group policy. I also live in a low income/elderly population region where there are many uninsured and many others on medical assistance programs. So the hospitals have to "get it where you can" to subsidize the charity care, etc. My oncologiust said their policy is to mark up drugs 300% to private insurers. "Yield management" is the business term, kind of like the airlines or hotels where each unit is sold at whatever the market will bear.

Soooo: they billed my insurance $30,200 for EACH Doxil infusion I had (with my insurance getting them down to only $24,000@). For EACH Nuepogen shot they bill my insurance $1700 (with my insurance paying $1200 each). My insurance pays $22,000 for the PET/CT scans I get every 3 months. I have had 2 Avastin infusions and haven't seen the bill yet, but I was warned that it would be in the $100,000 range per month.

I pay $1500 month for my insurance premiums for my husband and me; and have a $7,500 annual deductible that I pay before my insurance kicks in that I have paid now in January of 2008, 2009, 2010, & 2011. Thank God I am able to afford this, although I'd sure rather have a swanky new car and an in-ground pool! But my insurance has always paid and never turned me down for anything my oncologist suggested except the Clinical Trial. I have had to scan and email my bills to prove these charges to friends because they are so UNBELIEVABLE. But true.

So there is plenty of blame to go around in the healthcare debate. The hospitals and clinics gouge when they can; the insurance companies up their rates when they can. And in spite of it all, somehow we get excellent healthcare.

Mwee's picture
Mwee
Posts: 1316
Joined: Nov 2009

we do get excellent healthcare. It's amazing the difference in chemo costs from one area of the country to another. My doxil treatments were billed at about $4000 an infusion and my gemzar/carbos are about the same and now done in the hospital for my doctor no longer has a contract with my insurance company. I have no idea if my insurance company will spring for Avastin, if I need to try that.
Maria

anicca's picture
anicca
Posts: 324
Joined: Dec 2010

Linda, you ended your post with "So there is plenty of blame to go around in the healthcare debate. The hospitals and clinics gouge when they can; the insurance companies up their rates when they can. And in spite of it all, somehow we get excellent healthcare."

I do agree with that, except it is not true for those who cannot pay for their health insurance and do not have employer supplied insurance. I had a friend who died recently of leukemia almost certainly contracted by her volunteer health care work at the site on 9/11. She was self-employed, and had no insurance. There were unconscionable delays in her treatment due to the lack of private insurance. What really made me angry, was that she had an identical twin, and so had a perfect match for a stem cell transplant, but the process got started so late that her health declined to the point where the transplant could not be done.

I have one word for profit making insurance companies, clinics, and hospitals - bloodsuckers. I have no problem with doctors, nurses, and other direct health care providers making money, but corporations that supply health care and insurance should be non-profit. Drug companies, I think, are a more complicated issue, but I am sure that the problems with drug costs and availability could be dealt with humanely, if we (the US as a nation) had a strong desire to do so. One other word on making money from health care - I believe the best practitioners, researchers, and inventors are not basically motivated by profit. If I were to find out that my doctor had gone to med school primarily because he/she wanted to be assured of a high income, I would find another doctor pronto.

Hissy_Fitz's picture
Hissy_Fitz
Posts: 1869
Joined: Sep 2009

Health care should NOT a privilege, reserved to those who have either the means to pay for private insurance, or employer provided benefits. People on organ transplant lists get booted off the list if they lose their insurance (unless they can pay a $100K cash deposit). How can anyone make a case for that? Obviously, if you are so sick that you need an organ transplant, you will become too sick to work, at some point. Unless you have been on disability long enough to qualify for Medicare (2 years), or have a spouse whose employer provides coverage, you are pretty much screwed. Same thing goes for cancer.

Not everyone is out to suck the last drop of blood from their patients, though. My neighbor was recently diagnosed with OVCA. She had Secure Horizons (an alternative to Medicare) and the doctor she was referred to (my gyn/oncologist in Texas) was not in their network. He agreed to treat her anyway. Many hospitals - some by law and some by choice - provide indigent care to patients who cannot pay.

Medicine in general, and cancer in particular, is big business. I would urge anyone who does not have spousal insurance coverage to be pro-active and look ahead to what will happen if you lose your job through cut-backs, bankruptcy, buy-out, etc , have to give up your job due to poor health, or other possible scenarios. SS Disability is a given if you are Stage III or IV, but you have to be disabled for 2 years in order to qualify for Medicare, and in many states you have to be disabled to receive Medicaid. If I did not have Disability/Medicare now, I would apply for it ASAP, because I am in remission and my medical expenses are not so high that they would bankrupt me.

There was a time when people could save up enough money to pay for their own medical costs. The hospital bill when I was born was $50 (and they kept my mom and I for 10 days). No one can do that now. No matter how responsible you are, unless you are very, very wealthy (as in millions of dollars in savings), some corporate or government entity will have to contribute if you need treatment for cancer, or an organ transplant, or other catastrophic illness. Otherwise, you won't get it. Plain and simple. And you will die. Americans should not die for lack of affordable health care. It is unconscionable. We are the richest country in the world, and we should be ashamed of ourselves for not taking better care of our most vulnerable citizens: our sick, our elderly, and our children.

Carlene... (climbing down off her soapbox now)

anicca's picture
anicca
Posts: 324
Joined: Dec 2010

"There was a time when people could save up enough money to pay for their own medical costs."

My mother died of breast cancer in 1951. She was ill for 14 months before she succumbed. Even with the help of my aunt, who was an RN, my dad was ruined financially. When he remarried a few years later (small children need a mom,) my new mother had serious chronic asthma. My father owned his own small business, and he really never got out from under. If it weren't (eventually) for Medicare, my parents would have lived pretty much at the poverty line. As it was, Social Security was their only retirement income.

My husband worries that if he loses his job (works for NY State, so that's always a possibility,) I'll be without insurance. For that reason, I'm looking into the possibility of Canadian citizenship. My mom had emigrated from Poland to Canada and was a citizen when she met my dad. It's going to cost a bit, but I think it would give my husband some peace of mind re my future health care.

DB

nancy591's picture
nancy591
Posts: 1059
Joined: Sep 2009

How old were you when your Mom died? I have a GREAT interest in children who grew up without a Mom. I need validation the kids will be alright!! :(

Hissy_Fitz's picture
Hissy_Fitz
Posts: 1869
Joined: Sep 2009

Nancy... my mother lived to see me grown, but my stepmother's mom died when she was a small child, and her dad never remarried. She grew up to be a wonderful mom, a good Christian woman, and an amazing cook. There were two girls, only a couple of years apart in age. Her sister and she remained unusually close throughout their lives. Her sister's nickname was "Happy", because she was always such a happy child.

When I was growing up, there was a boy named Jon in my neighborhood whose mom had died before I met him, so he was under the age of 10 when his mom died. If his dad ever remarried, it was after we graduated from high school. Jon was the envy of every kid in the neighborhood. His dad doted on him. Jon's first car was a Corvette (not a new one, but still.....a CORVETTE.) Jon was an only child, but he was allowed to have friends sleep over on school nights. He wasn't obnoxious, though. His dad was pretty strict about manners and rules and stuff. I never heard of Jon getting into any kind of trouble. I can't remember if he went to college or not, but he made decent grades in high school - not honor roll grades, but decent ones.

And finally, I have a good friend, whom I met in a support group for widowed persons about 12 years ago. At the time he had a 5 year old (boy) and a 10 year old (girl). His wife went in for a routine gall bladder removal, had a stroke on the table, and died after several days (and many strokes later). She was 35 years old. Those kids are doing great. The daughter graduated from college last Spring and the boy is in high school and has his heart set on a military or law enforcement career. Their dad never remarried, either. There was another couple in the group who got married and combined families totaling 5 kids. The youngest was under two when his mom died. I don't keep in touch with them, but a mutual friend (whose wife died and left him to raise two boys) does, and he told me not long ago that he had heard from Pam, and they were all doing fine.

My good friend Rob (the mutual friend in the preceeding paragraph) remarried when his sons were older - around 17 and 20. Prior to that, it was just the three guys. It was a bit odd to visit them at first, because they never changed the mom's color scheme (lots of mauve), and her collection of those little angel figurines (I forget the name of them) was everywhere, even years after she died (of gastric cancer). They liked it that way, though. Rob told me that all the milestones were bittersweet: the boys' graduations, their weddings, and the birth recently of his first grandchild. At both their weddings, when the bride handed her mom a rose, she also placed one on a seat that had been left empty, in memory of the boys' mother.

Even my friend whose mom took her own life turned out alright, though she had a harder time dealing with it emotionally. Maybe because she was older (middle school), or maybe because of the circumstances.

Carlene

nancy591's picture
nancy591
Posts: 1059
Joined: Sep 2009

thank you, Carlene. Sincerely. Your post brought tears to my eyes I just wish it would bring comfort to my heart. Well, it does give me some comfort yes. I realize kids live through tragic events and are resilient as long as they have love and guidance. I have no doubt my husband will do his best to raise them into fine young men. I will never stop wishing I were the one raising them. I will never willingly give up fighting.

clamryn's picture
clamryn
Posts: 508
Joined: Jun 2010

Nancy, I just got my bill for one Avastin treatment. It was $15,211. It is just amazing to me that the cost for all of us is so different. And Linda... I think that is terrible that they charge so much for your treatment. It is just not right.

nancy591's picture
nancy591
Posts: 1059
Joined: Sep 2009

Linda, that sure would be a financial hardship for most people.

My husband works for NYS so he has excellent insurance. I'm not sure what his cost for the insurance is. It started out quite expensive but drops 10% every year of employment. After completing 10years of service it is free for the family. His healthcare contracts with well known cancer centers. If you use these cancer centers there are NO out of pocket expense for any services you receive there. I even get reimbursed for mileage, tolls, parking, food and lodging. Mileage is .27 cents per mile, tolls, parking and food are paid for by saved receipts. I haven't had to use lodging. If I chose to fly to one of their contracted cancer centers in another state they would pay airfare as well as ground transportation. If you don't use one of their 'centers of excellence' you have the standard out of pocket expenses.

Luckly, prior to being diagnosed, we purchased cancer insurance through my husbands employer as well. I get reimbursed from them each time I receive chemo, mileage and hospital stays. I think I get $250 each time I get chemo, $300 night for hospital stays (thank God I've had no stays in the last 2yrs) and I think I get .50 cents a mile travel.

Having this coverage has allowed me to quit my job and spend whatever time I have left with my family. My kids were ages 3 and 5 at time of diagnosis.

Rookerbird's picture
Rookerbird
Posts: 100
Joined: Feb 2011

Nancy, was the cancer insurance that you mentioned at the bottom of your post through AFLAC?

I have a friend whose wife died of cancer a few years ago, and she had similar benefits through an AFLAC policy. Of course, you can only obtain it when well, but I'm going to start recommending supplemental cancer insurance to healthy friends.

WHAT a blessing you don't have the financial element playing into your decisions with such young children! Being a mother is a full-time job. Fighting cancer is a full-time job. Glad you and your husband planned ahead, so you don't have to contend with a job-job.

I'm like Linda P...private insurance, steep out-of-pocket. In 2009, I paid $8,974 toward my medical bills, and BCBS covered the rest. In 2010, I paid $7,095 and BCBS covered the rest. Coverage varies based on the type of treatment, and my policy caps certain treatments such as physical therapy.

No COBRA option, so I must work to pay for medical insurance, or go on disability and hope Medicare kicks in. I'm 51, and live in Texas. Every state's Medicare rules differ AND state Medicare rules are in flux now due to budget crises. I'll stick with BCBS as long as possible. Those of you with excellent insurance...rejoice!

nancy591's picture
nancy591
Posts: 1059
Joined: Sep 2009

Yes, it is AFLAC Cancer platinum plan. I forget what it costs weekly but it is worth it. We bought it after my brother in law died of oral cancer at the age of 45. They had a 6month old baby when he was diagnosed. After his death we also bought additional life insurance policies. You truly never know how what life will throw at you.

BTW, I did read the blog you posted. Your sons friend who died. It brought me to tears. Such a shame.

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