Copays for Rads?

RunswithScissors

Are copays customary for daily rad therapy?

econmom

My insurance (MVP) did require a copay for each treatment, and I had  28 treatments, so $560 for radiation.  It was not a big deal for my household, financially, but it made me aware that even with good health insurance, cancer can really be a financial drag on a family.

rreynolds1

On my first rads appt. the tech asked me if I had prescription insurance to help pay my treatments.  I was shocked that it was looked at as a prescription.  This did not present a huge problem for me but I know some of us have difficulty paying all these expenses.  If you can't afford the copays, talk to the clinic/hospital and they will work things out for you.

Roseann

bluedasher

I don't know that there is anything "customary". I suspect every insurance plan does its own thing. In my coverage, radiation treatment is fully covered. I had a co-pay for the consultation visit with the rads onc where we discussed what treatment I should have. I didn't have any copays for radiation. Once a week during rads, I had a brief visit with the rads onc after treatment so he could check how things were going but where I go that is included as part of the rads treatment so there isn't a copay for that.

We switched our insurance during open enrollement to be double covered by my husband's coverage and mine just in case the economic downturn affected my employment so my copays went to zero. If we hadn't done that, I would have had either 2 or 3 $10 copays: one for the initial consutation, maybe one for the pre-mapping meeting with the onc and one for the follow-up visit 3 months after rads. I probably also spent about $50 on over the counter lotions and such.

unklezwifeonty

Bluedasher is right. Every insurance is different. Mine covers radiation @ 100% except for the radiation oncologist's visits once a week during therapy.

Tamara67646

Radiation was the most expensive part of my treatment - it was covered like a hospital stay - 80% paid by insurance and 20% paid by me.  I did hit my annual "out of pocket maximum" and the coverage went to100% but my treatment crossed over into a new year - so I had to re-pay annual deductible and start up with the 20% co-pays for my last 10 tx. 

KQuigley

Hello. I'm new to all of this...I had my 4th radiation treatment today.  My insurance company charges each treatment as an office visit, which comes with a $35 co-pay per visit.  I was told that in my area (Albany, NY), there is only one insurance company that pays for rads in full.

RunswithScissors

Tamara, it looks like that same thing  will happen to me, too - 

Geez it's hard to pay so much for something you don't want in the first place!  

concernedsis

Sis has Empire - we asked and thankfully she only pays a copay for the doc visit - didnt have a copay for chemo and now not for rads. Ladies you might want to call your carrier and ask specifically about daily rads - sometimes how something is coded by the carrier can change the response so cant hurt to ask

 Best of luck to all

cherneski

I sure hope mine is charged each time!  My copay for a specialist is $50.00 x 25 rads.  Yeah it will take me a few years to pay all these freaking bills.

Rose_wood

My rad doctor told me up front that there was only one co-pay that everything after that would all go under insurance.  A package deal I guess.  The onc doctor, on the other hand, charges me a co-pay each time I see him in addition to what he charges the insurance company.  Funny thing  though is that his office is in the cancer center of the hospital, and the hospital also charges the insurance company for something I can never figure out.  On another note, a friend was receiving chemo, and she was charged a co-pay each time.  We had same insurance and same doctors.  I would look into a hardship clause if necessary.  There must be some organization that would help.

cmb35

Yet another thing I can't remember (thanks chemo brain!) but I don't think I paid a copay. Or maybe just for the initial consult and then follow-up consult when rads were finished?

RunswithScissors

Well I have an update.  I checked at the facility - and they said yes, daily copays. Then I called insurance company, and they said, "no daily copays."

I finally have it straightened out - no dailys! Hooray.  Thanks for the advice to check into it concernedsis. 

The error made me question my chemo copays - which I do each time, same facility. Unfortunately, tho chemo does not have a copay, the fact that I get blood pressure, temp and weight checked before tx means it can be called a "low level office visit with nurse practitioner" ... so I have to pay it for that. At least that is only once a week, and just 2 more!