I was a little anxious this morning to pull up my medical history for 2016. I watch the charges that come in regularly, the discounts that are given to insurance companies and what is actually paid. I am curious as to the different charges that each office bills and I want to make sure there aren’t any denials that sneak by me.
Let me first say that I am incredibly blessed to have insurance. Yes, I have an out-of-pocket expense but there is a cap on it each year. My medical insurance coverage is different than my prescription coverage. For some reason my prescription coverage is not available for me to pull today so I’ll do that another day and share it for sure.
All of the charges have not come in for 2016 and all of them have not yet been processed. But as of this morning, my insurance has been billed $896,584.71. This is the retail cost of every charge. If I did not have insurance, this would be the bill (although separate from each provider) that I would be asked to pay.
There was an insurance discount, which was $548,532.79. This is the discount amount contractually agreed upon between my insurance and the in-network providers.
The amount that my insurance company paid, which excludes my out-of-pocket costs, is $261,190.61. My deductible and coinsurance for 2016 was $3250 for medical expenses.
This number astounds me. Again, I am incredibly grateful for having coverage. Even with my out-of-pocket expense, it’s nowhere near what is billed to my insurance company.
Life with cancer is not easy. As I mentioned the other day, every headache, back pain or cough is cause of concern. Scans are frequent, I have regular follow ups with my oncologist and radiation oncologist and then I have another half dozen or so doctors that follow my care. And that doesn’t even include the oncologists at the different cancer centers that I have visited. Thankfully I can communicate with them via call or text for the most part now that we have established relationships. And then there’s the regular visits for wellness exams, physicals and colds.
Then there’s the day-to-day cost of this disease. Outside of prescriptions (which I will cover when the website has the information again), there’s the protocols that I follow, which are supplements that I take 3 times a day based on meetings with an alternative medicine doctor (the visit and the supplements aren’t covered by insurance). That retail cost is somewhere around $1500 every 8 weeks. I have been using Band-Aids, gauze and saline for this radiation burn since August. The radiation oncologist provides most of the gauze and the saline and I buy the Band-Aids to cover the wound. There’s stomach medicine that I take regularly. Sometimes its anti-nausea, sometimes Imodium but mostly Senokot. There’s the lotion that is needed for the areas of my body that have been radiated ($14 for 1.7 oz, mixed with organic Calendula oil which is $10 for 1 oz). Then there’s the lotion that is needed for my feet, especially with taking Xeloda previously ($27 for 4 oz). I use a diffuser filled with different essential oils that run anywhere from $10 to $100 per bottle. I have to use special toothpaste (biotene). In 2015, I bought wigs to help cover and keep my bald head warm. I also previously and more recently purchased bathing suits that can hold my prosthetic. Oh, then there’s the cost of driving around town to and from all of these appointments.
My diet is significantly different now too. I buy organic as much as possible and eat a lot of fruits and vegetables. Juicing and smoothies are wonderful but come at a cost. I feel better physically eating what I eat now and wish I had started it long ago.
Then there’s the travel to different centers. Though we try to make the most out of it by sight-seeing, the reality is that we are traveling in the hopes of finding a doctor or treatment that can help prolong my life. These visits come at a cost, emotionally, physically and financially.
It’s a full-time job in itself.
I am sharing this information because it is simply the reality of cancer. These are just the things that come to mind as I type and I am sure that there are many other costs that I’m not including. Are some of these things that I am doing to help me live a longer, stronger life? Yes. Are some of these things that I am hoping will help me outlive my prognosis? Of course. Are some of these things necessities? Absolutely.
What do people do that cannot afford these costs? Let’s say that the protocols and the organics and the lotions aren’t included and it is simply the cost of treatment…treatment that will hopefully work to save their life. What if they don’t have insurance? What if they can’t pay the cost of care? It scares me. Cancer is not something that any of us ask for or expect – especially at 31. But it’s here and we make the best out of it while we can. But what if that best isn’t an option because you can’t afford care? It terrifies me. I don’t know what people do.
What if people can’t work? I have been blessed with the ability to work throughout the last year and a half of treatments and surgeries. But I won’t lie, it takes its toll. There is continuously a question of whether or not you will work until your life ends…or until you simply can’t manage it anymore. Life is exhausting without cancer. Add in a family, a toddler, a life that you are trying to enjoy and top it off with cancer and you are bound to be in bed with your toddler at 8pm every night. But work is your insurance coverage and your paycheck is your ability to live the life that you want to live while you feel well enough to do just that. Is there really a choice?
I have been extremely blessed with financial gifts that helped to cover most of these expenses. There are so many people who care about us and want to help. For that, I am eternally grateful. I honestly don’t know what we would do without people like you.
This is the reality. I have debated on a post like this for months but thought it was important to share the realities that are breast cancer. And the reality that with metastatic breast cancer, those costs will never disappear. Each year, deductibles go up along with premiums and people like myself know they will reach their out-of-pocket expenses…likely in the first month. It’s not something that I can change and yet it causes a lump in my throat. I am SO GRATEFUL for another year of life and yet I can’t help but fear the restart of my out-of-pocket costs. The costs of cancer care is enough to break even the most financially-fit person. I bet with my prescription coverage and the other expenses that I mentioned, I did actually reach a million dollars this year.
This is metastatic breast cancer. This is Stage 4. This is our reality. But, we keep living. We make do with what we can and we don’t go without. And we choose to live. Despite the costs of treatment, of cancer and of side effects, we continue to enjoy this life that we are so blessed to have. And you all should to…enjoy each and every beautiful moment.
Here’s to 2017…and LIVING.