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Slightly OT, but have you noticed

jcortney's picture
jcortney
Posts: 426
Joined: Sep 2012

I was watching TV tonight and over a period of about 2 hours I saw at least four commercials for cancer treatment.  Is it just me being oblivious or has the competition for cancer patients gotten kicked into high gear.  I haven't gotten a firm handle on what my treatment has cost (bunch of EOB's not in yet) but I'm pretty sure it's going to be well over 100K (and that's with no surgery).  Big business, huh?

J.

phrannie51's picture
phrannie51
Posts: 3845
Joined: Mar 2012

....and I imagine if you actually added up your EOB's you'd find they are well over the $100K mark.  I remember seeing the cost of the Amifostine shot I got EVERY day before radiation, I almost passed out.  Between the shot and the hydration on a daily basis it was running $2300 a day...gulp.  Then add rads and chemo on.....a few transfusions, procrit injections, neupogen injections....all I can say is WOW, I'm glad I have good insurance!!

Skiffin16's picture
Skiffin16
Posts: 8103
Joined: Sep 2009

Just as an idea...

Dx Jan2009 STGIII SCC HPV+, tonsils out, power port installed, sixteen weeks of four types of chemos (16 doses), 3 neulasta injections, 33 amifostine injections, 35 daily rads, Tx (chemo and rads) ended Jun2009, two PETS, two CT's..., many hydrations, many scopes and MD visits...

Total 2009 billed before insurance, over $275, 000, after contracted pricing through United Health Care, billed at $97, 000... My total out of pocket, $3, 750...

JG

longtermsurvivor's picture
longtermsurvivor
Posts: 1835
Joined: Mar 2010

I had high quality health insurance when I got my first cancer in 1998.  One year later that company went bankrupt, so I lost my coverage.  Since then no one will underwrite me, of course.  I eventually qualified for SSD and got on Medicare, which leaves a big gap in coverage, as you know.  Fast forward two more cancers, a heart attack with interventions, and a recent occular stroke  with interventions.  I have never had the courage  to add up the bills that i have paid out of pocket.  The treatment options for cancer have expanded rapidly, kind of like those options expanded for heart disease 20 years ago.   With that, the  treatrment philosophies have changed.  We now live in a "full court press" environment for cancer care.  The sky is the limit for treatments. Therefore the sky is the limit for costs.  The future of this health care expansion is fiscally pretty scarey.

 

Pat

jtl's picture
jtl
Posts: 422
Joined: Sep 2011

Time magazine decicated almost an entire issue to the problem of healthcare costs a few weeks ago.  It was an amazing story with very good research.  I always thought the insurance companies had the upper hand when it came to negoitiating prices with the providers, apparently not any longer.  The providers are consolidating and are becoming so large that they are in control of prices.  Medicare still has the ultimate upper hand and is able to negoitiate prices that are lower than the private insurers, sometimes a lot lower.  I have always been surprised at how much the cost of medical services vary from one location to another.  I was just looking at my cost for RT (TomoTherapy), the provider billed $1360, Medicare approved $507 and paid $406.  The difference was the co-pay which is covered by my Medigap policy.  As a guess I bet my total bills paid by Medicare and my supplemental policy have not exceeded $35K, maybe not even $30K.  Aside from a couple of $4 copays for drugs I have not paid anything out of pocket.  I know this discussion has come up in the past and as I recall John paid a lot more for RT and we do not live very far from one another.  I know Medicare adjusts rates based on location and I suppose private insurance does so as well.

cureitall66's picture
cureitall66
Posts: 879
Joined: Aug 2012
donfoo's picture
donfoo
Posts: 1323
Joined: Dec 2012

>> Big business, huh?<< 

I have no idea now close to truth this is but it was mentioned during an infusion session that those big bags of Cisplatin, taxotere, etc. can run upwards of 10 grand a bag. If anywhere near that, I'm thinking how many new cars not sitting in my driveway. LOL

Skiffin16's picture
Skiffin16
Posts: 8103
Joined: Sep 2009

Those Emend pills P an I speak of, were something in the range of $150 each pill... Neulasta injections, in the range of $2,000 each.

jtl's picture
jtl
Posts: 422
Joined: Sep 2011

I was told that Cisplatin was only a few hundred at the clinic that I went to.  Much cheaper than Erbitux which was still only about $1200.  What is charged vs the real cost is a joke and no one with insurance pays anything close to "retail".  Prices are grossly overstated so if you don't have insurance or Medicare the provider has a high point to negoitiate from when they settle.  It was all in the Time magazine article.

robswife87's picture
robswife87
Posts: 182
Joined: Mar 2013

Was shocked to see $19,000 and treatment hasn't even started. Without insurance we pay the full cost. Insurance companies have negotiated rates but people without get the full cost. How does this make sense. 

I work in the medical field and feel for people like us without insurance. 

debbiejeanne's picture
debbiejeanne
Posts: 2590
Joined: Jan 2010

a lot of hospitals have funding for people w/o insurance.  ask where you go and apply for financial assistance.  it shouldn't be too big of a deal.  just a thot.  i wish you the best.

God bless,

debbiejeanne

katenorwood
Posts: 1860
Joined: May 2012

This is a good subject....and one that hits us all very close to the pocketbook but most importantly the heart.  I navigated through the billing system for my parents during my Mother's cancer journey.  Dad and Mom needed just to concentrate on getting Mom tx's.  Mom of coarse had medicare part A and B.  But no supplements.  And once they heard the C-word, the premiums were out of site for any extra insurance.  She qualified for extra help through our state of Mn., but my parents were very proud and at the time didn't want to hear it.  It meant that at the time, that 1/2 of what they owned if Mom passed would go to the state to pay back anything Mn. paid towards Mom's care.  I talked with workers til I was blue in the face, and of coarse my parents.  We finally got everything nailed out, and my parents agreed Moms care was worth more than the house they owned.  The bills were already outrages.....but the way I looked at it was Mom was worth every penny.  Dad ended up losing the house, and still owing monies 2 yrs later after Mom's passing.  Now fast forward to my dx being found.  At least I had a leg up on how the system worked.  I have been very blessed w/the insurance I had, and they paid 100% after I had met my deductible of $6000.  The premiums were very high, and I *****ed about it for 12 yrs at work.  But thank god I kept it in force.  Now I no longer can work, and was on medicaid for 1 yr., and in July qualify for medicare.  The hospitals and clinics have also worked with me on writing off some of the bills.  It's insane, but a neccessity to be informed and stay on top of it.  I pray that everyone has someone to walk beside them to help navigate through all of this.  And re-check billings as I have found tons of errors on some billings.  (double billed for meds., or meds I didn't receive)  Good luck, and god bless !   Katie

hwt's picture
hwt
Posts: 2002
Joined: Jun 2012

Fortunate to have some. Last years billed set UHC back more than $250,000 with a 19 hour surgery, chemo and rads. YTD, I am almost at $40,000, now with BCBS because my husband's retirement plan opted for a change.  The 1st place I went (Mercy) to set up HBOT, the doctor told me they were $2500 a session. I ended up at St Lukes Hospital for tx and looks like they billed $433 a session...quite a diff. I thought maybe I misunderstood the Doc at Mercy but maybe not because he said w/o insurance you won't get these tx unless you are Bill Gates.  What gets me is the out-of-pocket max of $1250....but that doesn't include deductible or all of the co-pays and of course not perscriptions. I shouldn't complain as I am lucky to have coverage. Who ever thought there would be a reason to look forward to getting to 65!

jcortney's picture
jcortney
Posts: 426
Joined: Sep 2012

I originally started this thread about all the ads I've seen on TV lately from hospitals trying to get cancer business (I was watching golf today and saw two ads for Cancer Centers of America and one for UT Southwesten).  Now it's kind of morphed into an insurance topic and I'm really glad as I've learned a bit(or relearned what I forgot).  I got a pretty substantial bill from MD Anderson this week for when I went down there for my second opinion in October of last year.  I called them and asked what it was all about and to make a long story short, it looks like I owed them the money.  I told them I just couldn't afford to pay as I'm just out of treatment and not working and again, making the story short, got them to knock off 40%.  I was really trying for the discount they gave UHC, which was way over 40% but just couldn't get there (or just got tired of trying).

Anyway, it's interesting to see how much they bill and how much they actually get.

J.

meinken's picture
meinken
Posts: 38
Joined: Jan 2010

Just to add to the discussion.   Beginning of last year(2012) I had open flap surgery(15 hrs in the OR)  for my right side maxillary sinus cancer, and eye orbit reconstruction on the same side.  I then had chemo and rads at mid year for a lymph node and a tumor near the rt. eye near the temple.   The hospital and all the doctor visits billed 589 thouand.  I paid around 5000 with out of pocket max of 1500 and the other 3500 was copays charged for each rad treatment as a doctors visit and all the misc doc visits for ent's and med oncologists and my reg fam doc etc.   Plus another thou or so for perscription copays.

For the surgery and room stay (10 days, 4 in icu and 6 private) in the hospital....no doctors, just or, anestesia(but not anestesiologist), room, labs, meds, some phys therapy, bad meals, etc..... Billed 167 thou, and the ins co. Paid 125 thou.  I had no out of pocket for that, though.

Lots of out of pocket money, but with no insurance, I'd be in bankrupcy right now.

 

 

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