The Plan for me.....

Skiffin16

phrannie51 said:

LOL...I did have the name in the post....
Gawd...I told ya my concentration and focus are out the window...ha! I'm going to check with the Dr.'s office tho, and make sure the insurance company pays for the Filgrastim...it would be just my luck they'd be saying no to that, but yes to the other.

p

Insurance...
I'm pretty sure they'll pay for it, it's standard for treatment to get one of the two mentioned above if you have the heavy doses of cycled chemo.

Costs are huge on everything...

If I remember total billed was in the $275,000 range, contract price was around $97,000 and my total out of pocket was $3,750..that was for 2009 on me.

JG

phrannie51

Skiffin16 said:

Insurance...
I'm pretty sure they'll pay for it, it's standard for treatment to get one of the two mentioned above if you have the heavy doses of cycled chemo.

Costs are huge on everything...

If I remember total billed was in the $275,000 range, contract price was around $97,000 and my total out of pocket was $3,750..that was for 2009 on me.

JG

So that means...
I had no idea it cost nearly $300K. I wonder what a chemo infusion costs. I'm stunned.

I was mistaken on the Emend...I thought there were 4 pills in that packet...there are two...that means they are $200 a pill...somebody's getting rich on that one. Glad I don't have to pay for it.

p

Skiffin16

phrannie51 said:

So that means...
I had no idea it cost nearly $300K. I wonder what a chemo infusion costs. I'm stunned.

I was mistaken on the Emend...I thought there were 4 pills in that packet...there are two...that means they are $200 a pill...somebody's getting rich on that one. Glad I don't have to pay for it.

p

Costs
My costs were pretty equal between the nine weeks of cycled chemo, and the seven weeks of concurrent chemo/rads.

Now of course that was total costs for me, which included a lot of CT's a few PET scans, several follow-ups, extra hydration, etc....

My first year post treatment (Jul - Dec), was mainly follow-ups every six weeks, CT scans, PET scan, blood work, port flushing, etc....

But anyways, the nine weeks and the seven weeks were somewhere around $125,000 each part.

Oh, and that seven week portion included the 32+ Amifostine injections each day. They were somewhere arounf $150 each also.

JG

phrannie51

osmotar said:

neulasta
I looked at my EOB and the injection was around $5k insurance paid $3k I didn't have to pay anything probably like you I had to have 3 of those injections. My accountant told me to keep a log of all mileage to every appointment/treatment and all receipts. WOW was I amazedat just the miles alone.

$5K per shot....holy moly!!
Gold is cheaper...it is!! If I didn't have insurance, I can't imagine what I'd do...we'd be living in our car down by the river, or in the Walmart parking lot....and still wouldn't be able to pay the bills.

p

Mikemetz

phrannie51 said:

$5K per shot....holy moly!!
Gold is cheaper...it is!! If I didn't have insurance, I can't imagine what I'd do...we'd be living in our car down by the river, or in the Walmart parking lot....and still wouldn't be able to pay the bills.

p

Costs are outrageous
Somehow the discussion came to this topic, so here's what I've learned. From my dx in early 2009 until a few months ago, my insurance company has paid about $850,000 in claims for me! I have not tallied my out of pocket expenses, so can't comment on that. Now, my claims have included some very expensive stays in ICU from reactions to chemo ($71K per night!!!! at one stretch) and HBO treatments (40 @ $2,200 each)--but let's get real. There is NO way that those billings reflect the actual cost of my treatments--but yet the system allows that. So, those who are fortunate enough to have insurance pay more for coverage, and those who don't have insurance face some very difficult decisions over what they can afford for treatments and how they can ever pay if they get treated.

I'm looking at a debridement in 8 days, followed by 10 more HBOs,so my tally is going way up again soon.

I don't know the solution, but I do know that this system is grossly unfair and badly broken.

Mike

osmotar

phrannie51 said:

$5K per shot....holy moly!!
Gold is cheaper...it is!! If I didn't have insurance, I can't imagine what I'd do...we'd be living in our car down by the river, or in the Walmart parking lot....and still wouldn't be able to pay the bills.

p

Costs
Thank goodness I ahve great insurance from the start of this in april 2011 to Dec 3oth 2011 my insurance has paid out just over $200,000 out of pocket to date for me $1200.

phrannie51

osmotar said:

Costs
Thank goodness I ahve great insurance from the start of this in april 2011 to Dec 3oth 2011 my insurance has paid out just over $200,000 out of pocket to date for me $1200.

I'm hoping, that my insurance is like yours, Linda...
I've never had the opportunity to use it in the past, so I don't know. Just hoping that when it says $500 deductable and $1000 out of pocket, that they stick by that.

p

tommyodavey

phrannie51 said:

I'm hoping, that my insurance is like yours, Linda...
I've never had the opportunity to use it in the past, so I don't know. Just hoping that when it says $500 deductable and $1000 out of pocket, that they stick by that.

p

Insurance
Hi P51,

What saved us from financial doom was having insurance. I have not tallied up how much they've shelled out but I'm sure it is up there.

Of course there is a huge difference in how much a hospital or doctor charges to what the insurance company will pay. I have BCBS and they cut the bill down by over half. One radiation treatment is billed at $1300 and BCBS pays $59 + my $35 co-pay. That is one example of how far down they were able to negotiate the price. Wow!

The biggest and best part of my insurance is the catastrophic clause. My family out of pocket per year is $5,000. So once we reach that, no more co-pays for the rest of the year. That hasn't happened yet but it may this year. In 2011 it ended up being $4,300. I got sick in Oct so we may luck out this year starting out early.

It might be a good idea to look into what and how much your insurance company pays. I've had to call mine several times for clarification of coverage.

You are in for quite an experience Phrannie. I just finished and you are just starting. Best wishes that you don't get too beat down by the process.


Tommy

Mikemetz

tommyodavey said:

Insurance
Hi P51,

What saved us from financial doom was having insurance. I have not tallied up how much they've shelled out but I'm sure it is up there.

Of course there is a huge difference in how much a hospital or doctor charges to what the insurance company will pay. I have BCBS and they cut the bill down by over half. One radiation treatment is billed at $1300 and BCBS pays $59 + my $35 co-pay. That is one example of how far down they were able to negotiate the price. Wow!

The biggest and best part of my insurance is the catastrophic clause. My family out of pocket per year is $5,000. So once we reach that, no more co-pays for the rest of the year. That hasn't happened yet but it may this year. In 2011 it ended up being $4,300. I got sick in Oct so we may luck out this year starting out early.

It might be a good idea to look into what and how much your insurance company pays. I've had to call mine several times for clarification of coverage.

You are in for quite an experience Phrannie. I just finished and you are just starting. Best wishes that you don't get too beat down by the process.


Tommy

Non political statement
This is not meant to start a political thread, but one key feature of President Obama's health care plan (and already in effect) is the elimination of limits on claims over one's lifetime. Before that change, my BC/BS coverage had a lifetime paid claim limit of $1 million. Whod'a thunk that I would ever need to worry about that? But, as my paid claims for cancer treatments since 2009 are already $850K (with more big claims looming),there is no doubt that I'll be over $1 mil before I qualify for Medicare in about 6 years. This will be even more helpful for those who get a cancer diagnosis at a younger age and face more years of even more expensive treatments than those in my age bracket.

Mike

Mikemetz

phrannie51 said:

I'm hoping, that my insurance is like yours, Linda...
I've never had the opportunity to use it in the past, so I don't know. Just hoping that when it says $500 deductable and $1000 out of pocket, that they stick by that.

p

Just keep monitoring things
From now until your treatments are over, things will be happening fast and furious, insurance-wise. The key is to stay on top of it on a daily basis, and if your condition won't allow, have someone do that for you. For me that someone was my wife who took time every day to take a close look at any new EOBs, invoices, and kept track of deductibles, etc. In cases that involve a lot and expensive treatments, some insurance companies will assign you to a [don't know what they are called], who knows your case history, treatment plan, list of involved doctors, expected billings, etc.. The insurance company does it to protect their own interests, but this is one time that this also protects a patient.

The key is to stay on top of things, read things carefully, ask questions, and get answers before you make any out of pocket payments. By the way, all good reasons why my wife handled this for us--let's just say that those things are not 'prominent in my skill set.'

In the end, you need to stay focused on your treatment plan and save your energy for fighting the beast. Even though you can't escape the need to manage this financially, try to reduce the stress that those things can bring.

mike

phrannie51

Mikemetz said:

Non political statement
This is not meant to start a political thread, but one key feature of President Obama's health care plan (and already in effect) is the elimination of limits on claims over one's lifetime. Before that change, my BC/BS coverage had a lifetime paid claim limit of $1 million. Whod'a thunk that I would ever need to worry about that? But, as my paid claims for cancer treatments since 2009 are already $850K (with more big claims looming),there is no doubt that I'll be over $1 mil before I qualify for Medicare in about 6 years. This will be even more helpful for those who get a cancer diagnosis at a younger age and face more years of even more expensive treatments than those in my age bracket.

Mike

Today when hubby came up here...
He told me our Pharmacy had called to say we had a $38.00 credit there. Seems that my Oncologist had called the insurance company and gotten them to pay for the one anti-nausea drug they had formerly denied payment on. I don't even know how the Dr. knew that I'd paid for it out of pocket. It was just a pleasant surprise, after already bumping heads with the insurance company three times in only 2 months.

p