insurance and finances

It is a disgrace that we should have to be burdened with financial and insurance issues at a time when all we should have to be dealing with is getting well.  I really think there should be a forum added here regarding this issue.  I was diagnosed December '09 with DCIS and have not even decided on a treatment plan yet, but today I added up all of my incurred out of pocket expenses since diagnosis and it is over $6,000 and I do have insurance.  I find this mind boggling.

Finances are such a huge issue, count me in for discussion. I have insurance, but if it weren't for my mom's help I'd never have covered the deductibles without tapping into my 401k. And now I'm contemplating whether to do some reconstruction or at least fix up the lumpy areas, and I don't know what the financial burden will be. It's really tough. I have a friend who has it even worse, because she is stage III and does not have insurance. She worries about everything.

Amyob:

They are obligated to submit a claim for you or give you a bill with the diagnosis code, procedure code and amount charged.  I work in a doctor's office and most of our patients are self-pay and I give them a paid bill with the above information so that they can submit it to their insurance carrier.  Maybe a threat of reporting them to the local county medical society might light a fire under them.

It sure does stink when finances and insurance are added to our list of concerns besides fighting for our lives. I was diagnosed with breast cancer while unemployed which meant no insurance coverage. I applied and qualified for a medically needy program in my state of Florida but with a share of cost. This is when they decide on your income, or lack thereof, what they feel you can afford each month before they will cover the rest.

 In the beginning, I was so stressed about the entire process of billing and self pay. I would go to my chemotherapy sessions worrying about meeting my share of cost for the month. I distinctly remember drifting off to the benadryl drip, thinking about all the medical bills.

Hello Ladies, I thought I would let you all know a little about what I have learned.

I was laid off my job in November and was paying COBRA.  Well the company (my old job) closed, thus leaving no insurance policy no Cobra.  The scariest part of that is that I got the letter that my insurance had been canceled effective January 29, on February 17th.  Yes you read that right I got the notice 2 1/2 weeks after I no longer had insurance.  It is completely legal what they did.  

The notice from insurance has all sorts of information about HIPPA and to make sure I do not go 63 days with out coverage otherwise it will be considered a break in coverage.  What they dont tell you is if you go 31 days without coverage they are allowed to consider my pre-existing condition.  This is all NJ laws.  Each state is different.

My advice to EVERYONE is to call your state insurance commissioners office and get familiar with what the laws in your state are.  If you are on Cobra, I would call every 28 days to make sure the coverage is still effective, because they can cancel you retroactive and it will still be legal.

Luckily for me, I found out just in the nick of time.  I now have a private policy for just me $407.99 per month.  My kids and husband have nothing right now.  Kids will be able to get state insurance, but DH is beat, as we make too much money with us both collecting unemployment.  

Good luck to you all, Lord knows we need it.

PS my Drs get paid about 10-20 bucks a month, they are all very cool with that, they know I have bills to pay, and prescriptions to fill.  As long as I make an effort they are happy.  If I miss a co pay they dont give me greif.

Okay, here is/are my problems.

I had unilateral mastectomy in April 2009. I wanted bilateral. The day before surgery insurance company said no as the left side was "not diseased."  I was not about to stop removing the right side with disease the day before so I went ahead. It still drives me nuts that I have the left side. I will find out what happens soon if I happen to be BRCA + as my mom and aunt are being tested soon.

Next problem, I started about a month or so ago JUST looking into my reconstruction options. I have an HMO insurance and can ONLY see in-network doctors or they pay NOTHING. Okay, my in-network doctors only do implants. I have had radiation. I and most everyone else knows 50% of implants after rads can/do fail. I submitted a referral to the next biggest city closest to me for a doctor that does DIEP, SGAP, etc. They denied it saying I had in-network options. In other words, they are forcing me to have an implant if I want reconstruction at all. The doctor himself gave me a call about 2 weeks ago and said he was literally p*ssed and this was against the women's act and against the law. I have not heard back from him yet, so need to give him a call back. I think I have 6 month's to file a grievance and even though other things have come up right now that might delay my reconstruction, I think I need to file the grievance and go all the way that I can with this, as it angers me to no end that they can first deny me a bilteral, and now are telling me what kind of reconstruction I can have.

Also, Debi, thanks much for your info on the 30 days to get insurance in your state without them being able to use your pre-existing condition(s) against you. 

Hello everyone -

I live in California.  Last summer, Pacific Care advised me my new rate would be 2100/month

to cover my husband and myself.  We are both over 50 and my husband is diabetic.  Of course,

that was unaffordable so I terminated coverage.  I had already exhasted COBRA from my

last job.  The "insurance" we were able to afford is a kind of discount card that lowers the

cost of doctor visits and prescriptions but does not cover surgery of anykind, or any type

of testing.  I was diagnosed with cancer in January.  Luckily, it is very early and a very

small tumor.  My surgery, of course, is being delayed until some kind of coverage is

found.  Has anyone heard of "Every woman Counts" or "Saving our Sisters" in the state

of California ?  It appears this will be my only hope.  Now that I have cancer, I am sure

no one will cover me with a preexisting condition.  Thanks for letting me vent my

frustration.  Isn't it ironic that for the first time in my life that I don't have "real"

insurance, I need it the most.

Love to all,

Judy
  

    JudyAnnW for California go to cobrahealth.com/statehighriskpools.html. You should be able to get health insurance.