Chemo costs

Ebarrera
Ebarrera Member Posts: 19

We meet with the oncologist tomorrow but I'm just curious what chemo and raditon cost. We do have insurance  through my work. I know everyone's costs are different, but a ball park.

 

Also, we are going to have to switch to the affordable health care insurance inAugust. Does anyone have insurance through them ? Is it good ? Any recommendations?

Comments

  • Butt
    Butt Member Posts: 352

    You call your cancer center and they will tell you a cost of certain chemo, most likely with your insurance taking into consideration.

  • Trubrit
    Trubrit Member Posts: 5,643 Member
    Depending on the cocktail

    I was on FOLFOX & 5FU

    I remember ONE bag of Oxaliplatin cost over $10,000 when I was having chemo.  I had it memorized once. I think it was $10,472.40  That was just the Oxi, none of the other stuff. 

    I was told NOT to look at the statements that came, while I was doing chemo. It was terribly depressing. 

    Tru

     

  • SandiaBuddy
    SandiaBuddy Member Posts: 1,273 Member
    "Out of pocket maximum"

    From my perspective, the most important thing to look at is the "out of pocket maximum" on your insurance policy.  If you are in the U.S., after you reach that point, the insurer will pay 100% of the costs (for almost all policies).  In my case, I hit the OOPM the first week of chemo, and did not need to worry for the balance of the year.  If I were shopping for new insurance, it would be important to me to understand the co-pays, out-of-pocket maximums, and if they cover the facility and doctors I prefer.

  • Annabelle41415
    Annabelle41415 Member Posts: 6,715 Member
    edited May 2019 #5
    Deductibles

    Everyone's insurance is different.  Your deductible is what your out-of-pocket cost is so if you aren't sure, call your insurance carrier and ask them.  Also, if you have a high deductible (something you can't afford upfront), ask your cancer center to put you on a monthly installment plan.  My deductible went to $10,000 so after calling my hospital they worked with me so that I'd be able to make payments throughout the year. 

    Kim

  • Ebarrera
    Ebarrera Member Posts: 19

    "Out of pocket maximum"

    From my perspective, the most important thing to look at is the "out of pocket maximum" on your insurance policy.  If you are in the U.S., after you reach that point, the insurer will pay 100% of the costs (for almost all policies).  In my case, I hit the OOPM the first week of chemo, and did not need to worry for the balance of the year.  If I were shopping for new insurance, it would be important to me to understand the co-pays, out-of-pocket maximums, and if they cover the facility and doctors I prefer.

    We are very close to meeting

    We are very close to meeting our oop. But so chemo drugs fall under rx? 

  • Steelkiwi686
    Steelkiwi686 Member Posts: 73 Member
    Out of pocket

     

    Can I say a think goodness and a hallelujah for out of  pocket limits?!!!!

    Like many others, mine was met on Jan 3 for this year. 

    I have deductible of $2500 and max out of pocket of $6000 so I know I’ll pay 6,000 and be done. This includes all treatments and prescriptions on my particular plan. 

    I‘d also like to give a shout out to the no lifetime limits in coverage costs as the amount the hospital has charged has to be close to (or beyond) the million dollar mark already. I believe this is the present law and for all of us I sure hope it stays that way

    I understand the specifics of each policy is different but I believe all or most of them have max out of pocket limits. 

     

  • myAZmountain
    myAZmountain Member Posts: 417 Member
    Trubrit said:

    Depending on the cocktail

    I was on FOLFOX & 5FU

    I remember ONE bag of Oxaliplatin cost over $10,000 when I was having chemo.  I had it memorized once. I think it was $10,472.40  That was just the Oxi, none of the other stuff. 

    I was told NOT to look at the statements that came, while I was doing chemo. It was terribly depressing. 

    Tru

     

    FOLFOX/5FU?Avastin

    Each infusion was almost 50K --mind boggling. Each port insertion was 25K.  I had a 6 day inpatient stay at a hospital in Fairfax, Va. that included hemi-colectomy, lung biopsy, colonoscopy, CT scans, MRI of brain, round the clock meds, nursing care and the total bill was only 57K. Kind of makes you wonder.

  • SandiaBuddy
    SandiaBuddy Member Posts: 1,273 Member
    Ebarrera said:

    We are very close to meeting

    We are very close to meeting our oop. But so chemo drugs fall under rx? 

    RX

    For me, they did.

  • SandiaBuddy
    SandiaBuddy Member Posts: 1,273 Member
    edited May 2019 #10

    Out of pocket

     

    Can I say a think goodness and a hallelujah for out of  pocket limits?!!!!

    Like many others, mine was met on Jan 3 for this year. 

    I have deductible of $2500 and max out of pocket of $6000 so I know I’ll pay 6,000 and be done. This includes all treatments and prescriptions on my particular plan. 

    I‘d also like to give a shout out to the no lifetime limits in coverage costs as the amount the hospital has charged has to be close to (or beyond) the million dollar mark already. I believe this is the present law and for all of us I sure hope it stays that way

    I understand the specifics of each policy is different but I believe all or most of them have max out of pocket limits. 

     

    OOPM

    To the best of my knowledge, the OOPM application and unlimited coverage were requirements of the Affordable Care Act.  I can't imagine what will happen to people with cancer if the campaign to eliminate the Affordable Care Act is ultimately successful.

  • Ebarrera
    Ebarrera Member Posts: 19
    Trubrit said:

    Depending on the cocktail

    I was on FOLFOX & 5FU

    I remember ONE bag of Oxaliplatin cost over $10,000 when I was having chemo.  I had it memorized once. I think it was $10,472.40  That was just the Oxi, none of the other stuff. 

    I was told NOT to look at the statements that came, while I was doing chemo. It was terribly depressing. 

    Tru

     

    Is this the one given through

    Is this the one given through the port? So your oop was $10,000? Wow

  • Ebarrera
    Ebarrera Member Posts: 19

    FOLFOX/5FU?Avastin

    Each infusion was almost 50K --mind boggling. Each port insertion was 25K.  I had a 6 day inpatient stay at a hospital in Fairfax, Va. that included hemi-colectomy, lung biopsy, colonoscopy, CT scans, MRI of brain, round the clock meds, nursing care and the total bill was only 57K. Kind of makes you wonder.

    When you say port insertion

    When you say port insertion was 25k, was that your portion

  • myAZmountain
    myAZmountain Member Posts: 417 Member
    Ebarrera said:

    Is this the one given through

    Is this the one given through the port? So your oop was $10,000? Wow

    Deductible was only OOP cost.

    Fortunate to have good insurance through my spouses employer--I just read all of the paperwork the insurance company sends and was blown away by the amount of the charges--thats how I saw they were biling 25K for port insertion. The radiologists charge a small fee on top of insurance company for some reason too-at the small hospital where I got my chemo the Interventional Radiologists rule the roost. 

  • Ebarrera
    Ebarrera Member Posts: 19

    Deductible was only OOP cost.

    Fortunate to have good insurance through my spouses employer--I just read all of the paperwork the insurance company sends and was blown away by the amount of the charges--thats how I saw they were biling 25K for port insertion. The radiologists charge a small fee on top of insurance company for some reason too-at the small hospital where I got my chemo the Interventional Radiologists rule the roost. 

    Oh ok

    I am praying well just have to pay the deductible and max out of pocket. Cancer is scary enough without having to worry about going bankrupt to save your loved ones life. Thank you for the info.

  • beaumontdave
    beaumontdave Member Posts: 1,223 Member
    edited June 2019 #15
    Trubrit said:

    Depending on the cocktail

    I was on FOLFOX & 5FU

    I remember ONE bag of Oxaliplatin cost over $10,000 when I was having chemo.  I had it memorized once. I think it was $10,472.40  That was just the Oxi, none of the other stuff. 

    I was told NOT to look at the statements that came, while I was doing chemo. It was terribly depressing. 

    Tru

     

    I always looked up at my bags

    I always looked up at my bags of clear liquids, as they dripped into my port, and thought: There goes a late-model Harley, and high-end sand toy, or a really good vacation/trip. The whole thing was depressing as h*ll............................Dave

  • beaumontdave
    beaumontdave Member Posts: 1,223 Member

    Out of pocket

     

    Can I say a think goodness and a hallelujah for out of  pocket limits?!!!!

    Like many others, mine was met on Jan 3 for this year. 

    I have deductible of $2500 and max out of pocket of $6000 so I know I’ll pay 6,000 and be done. This includes all treatments and prescriptions on my particular plan. 

    I‘d also like to give a shout out to the no lifetime limits in coverage costs as the amount the hospital has charged has to be close to (or beyond) the million dollar mark already. I believe this is the present law and for all of us I sure hope it stays that way

    I understand the specifics of each policy is different but I believe all or most of them have max out of pocket limits. 

     

    When my cash was running out,

    When my cash was running out, and the MediCal OOP was $5000 each month, I found Cali's High Risk Insurance Program, it's limits were $75000 per year, $750k lifetime. The second half of the twelve Folfox treatments and two subsequent liver surgeries had to bump up close to the yearly limit. The hernia surgery fix cost just under $120k in Dec. of 2018. my wife had an easy million in brain cancer treatment from Dec. 2008 to April 2015.  Had the ACA not shown up when it did. I'd be a guy in a small apartment, collecting Disability instead of running a business with my son and living in my own home. I don't know if you're in NZ or what you know of America's health mess, but when any rant about how lousy Obamacare was/is, I make a point of telling my tale. Wrecking peoples lives for lack of some kind of safety net, makes no sense........................................Dave

  • SandiaBuddy
    SandiaBuddy Member Posts: 1,273 Member

    When my cash was running out,

    When my cash was running out, and the MediCal OOP was $5000 each month, I found Cali's High Risk Insurance Program, it's limits were $75000 per year, $750k lifetime. The second half of the twelve Folfox treatments and two subsequent liver surgeries had to bump up close to the yearly limit. The hernia surgery fix cost just under $120k in Dec. of 2018. my wife had an easy million in brain cancer treatment from Dec. 2008 to April 2015.  Had the ACA not shown up when it did. I'd be a guy in a small apartment, collecting Disability instead of running a business with my son and living in my own home. I don't know if you're in NZ or what you know of America's health mess, but when any rant about how lousy Obamacare was/is, I make a point of telling my tale. Wrecking peoples lives for lack of some kind of safety net, makes no sense........................................Dave

    Ditto

    The Affordable Care Act (aka Obamacare) saved me from travelling to the edge of bankruptcy.  I do not think that many people know its coverage requirements also extend to most private insurance policies as well.

  • Ebarrera
    Ebarrera Member Posts: 19

    Ditto

    The Affordable Care Act (aka Obamacare) saved me from travelling to the edge of bankruptcy.  I do not think that many people know its coverage requirements also extend to most private insurance policies as well.

    More detail

    Can you go into more detail. I current have insurance through my work.  But I may have to switch to the affordable health care in sept. 

  • annie4145
    annie4145 Member Posts: 218 Member
    Ebarrera said:

    More detail

    Can you go into more detail. I current have insurance through my work.  But I may have to switch to the affordable health care in sept. 

    I don't know your options,

    I don't know your options, but keep the best insurance that you can while you go through this.  My costs (that insurance paid) for chemo and radiation was at least 250,000, but we just had to pay out maximum out of pocket of 6,000.  Make sure that you have one that will allow you to get second opinions (if needed) and that don't fight you for scans in monitoring you in the following years.  We had  blue cross/blue shield, and I was able to get evaluated at Standord, and then transfer up to UCSF where I got a second opinion and actually did treatment.  Even blue cross though is (so far) denying my 6 month PET/CT scan after treatment.   In my opinion, although some people like them and they do give good treatment, don't go for an HMO..

  • SandiaBuddy
    SandiaBuddy Member Posts: 1,273 Member
    Ebarrera said:

    More detail

    Can you go into more detail. I current have insurance through my work.  But I may have to switch to the affordable health care in sept. 

    Insurance marketplace

    I think the "insurance marketplace" will have details about the policies and coverage in your state.