Winter rads 2014-2015
Comments
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farmerma, you have to figure out what your copay is for treatments, along with what your deductible and out-of-pocket maximum is for your insurance policy. I also have a BC/BS policy, and I believe my copays per each radiation treatment (I just had #8 of 19 today) is $120, which, if I do the math, will add up to at least $2,280 just for that. I have a deductible of about $2100, which I'd met probably even before my lumpectomy, just with all the mammograms and biopsy and doctor visits and so forth. But after you pay the deductible, the company can still charge you co-insurance for just about everything (I know, this all stinks). So until I reach by out-of-pocket magic number, which is about $6,300 (by the way, think I'm there by now, already), I will still get probably one or two or more big bills for rads. But after that $6,300, everything is covered 100%. It probably works that way for you, too. Obviously, if I'd expected to have BC, I might have chosen a policy with lower deductibles and o.o.p. levels, but then my premium (which is already $527 for just me), would have been considerably higher. Insurance companies win, no matter what.
Dig out your policy and look for those numbers, and then look carefully at your EOB to see what the charge actually is for each of your rads treatments. When I started piling up all these bills, early on, I took advantage of setting up an online account with BC/BS. That makes it a lot easier to keep on top of the money, and I can access it whenever I want. It's amazing how fast the charges come in. Having cancer, besides sucking, is very expensive.
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Farmerma. I would definitely talk to your center to see if they can help sort it out. Very discouraging for sure.
I saw my RO today for a follow-up. I wanted to clarify something I posted earlier about coughing. My cough was just from a cold. She said if you get a cough a couple of months after treatment with no cold symptoms, that would be from radiation hitting the lung. Then you would report that and be treated for that SE. Zingers, swelling and heat from fluid inflammation, and darkened skin could all take 6 months to go away completely. I am pleased that my skin has recovered. Shaving, deodorant, regular bras here I come!
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Farmerma, I would call your doctor and make sure they entered the correct codes etc. Then call your insurance company. Sometimes mistakes are made and often fees are negotiable. Doesn't hurt to ask. Love, Jean
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I didn't say in my earlier response, farmerma, but $2967 for just the sim and 1 week of treatments does seem high. I would definitely check with RO people and your insurance to make sure there isn't a mistake, in addition to checking on your deductible/out-of-pocket if you haven't. I hope you find out it's not quite that bad!
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So here is the question: Does a dx of breast cancer 6 mos. ago along with surgery, rads and daily meds put one at high risk for cancer in the other breast? Going for a 6 month mammog/ultrasound on the good breast next week and am freaking out scared.
Any advice or info is appreciated.
Thank. -
Do you have a deductible that you have to fulfill? I know I have a $3,000 deductible before the insurance kicks in, then everything is covered at 100%. If you aren't covered 100% do you have a co-insurance %? That could be it as well? Insurance stinks..
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My deductible is $350 individual--I have easily hit that. So, my coinsurance is 20%. I guess the good news is, we have "Catastophic Protection", so once we hit $6,000 out of pocket, everything will be covered 100%. So, looks like we're only about $1,500 away from that this year. Woohoo! Guess I won't be giving up that second job THIS year!
I mentioned to the tech today that I had gotten the EOB and she just agreed how expensive things are. She did mention that the setup can be VERY expensive since it covers the whole planning process, the review by several different people, etc. I guess I'll see when I get their detailed bill exactly what cost so much.
It is what it is. 15 regular treatments down, 13 regular to go, then 5 boosts. Saw the RO today and she said other than being redder than last week, my skin looks good and she doesn't think I'll peel. Not sure how she can tell that, but I sure hope she's right.
Hope everyone had a great, treatment-free weekend! (And for those of you who are all done--I'M SO JEALOUS!!!)
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Beachlady28. We all know how you feel, and your anxiety is understandable. My doctors tell me that the radiation is designed to get any cancer cells remaining after the lumpectomy and the Arimidex/Anastrozole is designed to protect the other breast. There are no guarantees of course on the cancer journey. Focus on all you have done to treat your cancer. I try to tell myself "don't borrow trouble." My post treatment imaging is set for August so I will enjoy being a NEDDIE (no evidence of disease) until then. That doesn't mean I won't have a few terrified moments between now and then. You know they say to set aside a certain amount of time for worrying and then let it go for the rest of the day.
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Thank you, dacre, for the encouragement. I don't feel so overwhelmed by the diagnosis and subsequent necessary treatment, but by the overwhelming (had to use the word again) compassion, interaction and kindness wherever I look! I just can't believe it.
I'm staying at an American Cancer Society Hope Lodge during the week and of course all of us are in the same boat although with many variations but I think this is the perfect place for me. Patients from so many backgrounds, cultures, customs--a wonderful buffet for the mind.
I came home from the treatment center after my session this morning, then slept, cooked dinner and visited with my son and I'm now happily at work (I have a night job on the weekends[Fri-Sat-Sun]. For the duration of radiation therapy I am taking Sundays off because the treatment center is so far away. My room at the center is lovely and the Ronald McDonald house is across the street from my window. This Sunday I'm going to take back with me some cuttings from the plants I brought inside for the winter and place each cutting in a little glass on the windowsill. I know they'll have rooted by the time my treatment is done and those plants will have shared some growing with me. I know just where I'll put them when I get home.
Reading each writer's story touches the soul and grounds me. Insofar as the physical treatment goes--it does just that--goes, and I float with it. Akin to being consciously born once more (and I don't mean this in any religious sense) with struggle and pain and knowing the body is doing what it must to achieve birth.
Well, back to work and sweet dreams to everyone. Goodnight.
Cheers,
Hygeia
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Farmerma, My bills are piling up, and I don't care so much. I worked out a plan for the collection agency to combine all of the accounts together, and I pay them $50 per month. That's it and no more. That is really what I can afford. I am 58, live alone, and no job thanks to BC. So I take care of my credit account, rent, car payment etc., and it will just have to be good enough. Or like I tell them I have Stage IV cancer, would zero be better?? They always take what I can pay. I really hate to be like that, but I don't have many options at this point. I owe over $12,000 just to the Cleveland Clinic and the others. I can be depressed about it, or do the best I can.
My rads are healing up pretty good, lots of Aquaphor, RadiaGels, and soft pads to keep it from rubbing. Hopefully this will be a bad memory soon.
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Farmerma, my initial sims was right around $3,000, the treatment plan was another $8,500 and the treatment itself is running around $8,000 per week. Thank goodness for insurance. We've got a high deductible plan where we pay the first $4,000 and then it's 80/20 until we reach $8,000 out of pocket which, between my last chemo in January, an ultrasound, and radiation, I've already met. I can't imagine going through all this without insurance.
I'm down to 5 more boosts. One week to go
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Yeah, 7 of 30 done today! Who Hoo! My husbands marks the calendar before I can even get home to do it. Met with heart surgeon Wednesday, mitral valve has to be repaired as soon as rads are done. So we are looking at open heart surgery late May or early June. Stupid chemo!
Congratulations to all who finished rads today, hope your skin heals quickly!
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Gosh, I was only away from the computer yesterday and today! So much has been added!
First ~ Beachbum - Congrats to you. The smiley will go up on the list immediately!
Farmerma ~ During a conversation with RO staff, I learned that insurance coverage can be challenging for radiation treatments. Be sure to talk with the people in the office about what is going on with your insurance. They may be able to help in a variety of ways.
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This is our list of Winter Warriors as of March 16, 2015 - We are coming 'round the bend. Hooray! Spring is in sight!
October / November Start
MeneK – Oct 24
.................... MagicalBean - Oct 28
......... Mmtagirl - Nov 3 MarieBernice6234 - Nov 4
... Hope50 - Nov 5 .................. dennyvol - Nov 5 CAS4 - Nov 6
........................ Beachbaby65 - Nov 4 .......... CoyoteNV - Nov 10 Lush61 - Nov 13
.................... Rosa54 - Nov 13 ................. Beachlady28 – Nov 17 Nomatterwhat - Nov 17
......... LMVerma Nov 18 ................ katieC12 – Nov 18 Lorrilynne - Nov 18
.............. Gongshow18 - Nov 20 .........Yikes1 - Nov 20 Birdgirl11 - Nov 23
............. Perfectlyimperfect39 - Nov 23 Singsing1020 -December Start
Pita119 - Dec 1
.................. SandyLovesLucy - Dec 1......... AnasNana - Dec 1 HockeyCat - Dec 3
......... . CanuckMom Dec 4 ................ MeanMomto3 - Dec 4 JustJean - Dec 5
............... runningcello - Dec 9 ............... carynbrit - Dec 10 ForHisGlory - Dec 10
........ Davida58 - Dec 10 ....................SCMom - Dec 11 eileenpg - Dec 16
.............. Linzer – Dec 16 ....................... WndrWoman - Dec 16 sweetbanker - Dec 16
........ labelle - Dec 17 ....................... Slavrich - Dec 27InGodshands - Dec 18
....... Catie57 - Dec 18 ........................ lilactulip - Dec 18 PoppyK - Dec 29
.............. kpmacmill - Dec 29 .................... Jlynn13 - Dec 29 gretchy - Dec 29
...............Bellegirl - Dec 30 January Start
reader425 - Jan 2
................ILCMom - Jan 2 ....................... Purrrrana99 - Jan 5 Cath57 - Jan 5
.................. Professor50 - Jan 5 ....................fossf - Jan 7Lulubelle1 - Jan 8
............. lescover - Jan 8 ....................... Nancy6540 - Jan 12 .Saltygirl - Jan 12
...............aj103014 - Jan 12 .................... Fionascottie - Jan 13 Magdalene51 - Jan 15
...... quiggy - Jan 19 ....................... Annie88 - Jan 19 chtease - Jan 19
................ Bippy625 - Jan 20 ......................Dacre - Jan 20 feelingoverwhelmed - Jan 20 ....KYBLUEEYES - Jan 20 ....................Beachbum1023 - Jan 22
Cavalier - Jan 22
................ mqt64 - jan 26 ........................... Sjacobs146 - Jan 26 Windgirl - Jan 28 ....................... Hotdrodmommy - Jan 29
February Start
JeniferE - Feb 1 ....................... LARock - Feb 2 ............................ Chrissie29 - Feb 2
gemmafromlondon - Feb 2
.keri71 - Feb 6?............................. ladyb1234 - Feb 9Mm68 - Feb 10 .......................... CassieCat - Feb 12 ..................... Texas94 - Feb 16
Leslie58 - Feb 16
.............. farmerma - Feb 23 ....................... Dotwithkitties - Feb 23SunnySydeUp - Feb 23 ............ Allmodestyisgone - Feb 24 ............ brandyrose - Feb 26
Scubawoman - Feb 26
February Start Dates Not Known
intothewoods - Feb ?..................... MaggieCat - Feb ? ..................... ThinkingPositive - Feb ?
March Start
gtlucky - Mar 2 ............................. sybilskelton - Mar 2..................... Kayfry - Mar 4
WheelyGirl - March 5 ................... Booklady1 - Mar 9 .................... Hygeia - Mar 13
zjrosenthal Mar 16 ........................Redhead01 - Mar ? ................... cbooklvr - Mar ?
Shelleym1 - Mar ?
Special Sister Warriors and Warriors who stopped for a visit, but for various reasons didn't stick around. No start date determined. We wish them well.
Minnielee; surrrana99; Coloradocancermom; Shuf; bjeaneg, knittingPT, Shayne36, KGotThis, ckr1956, funthing42
Mary59G
- No Rads needed !!= Reported Complete = Should be Complete by now. -
Thank you so much for your imput on best topical solutions for rads. Miaderm is sounding good with calendula. Been lurking since may 2014 and was trolling the July chemo (me too) and November surgery. Unbeknownst to mags51 and nv coyote...you are "old friends" to me! Can't thank you enough
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oops meant coyotenv and magdalene51 properly.
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You all have given me a new appreciation for my insurance coverage and my employer for providing it. I am blessed to have a $1000 out of pocket maximum which I did not even come close to last year even with the surgery, chemo, and ER visit. I haven't paid one penny for rads. I'm afraid to change jobs now because I don't know if I will get that same coverage elsewhere
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Hygeia. I just love to think of your plant cuttings and you being reborn. Such a positive way to mark the time. I will look at my new skin where the old peeled and now think that I am like a shedding snake or a creature expanding its shell.
National universal health coverage would be a good thing IMO. There is no fairness or humanity in the way America deals with health needs. Sorry if I offend with a political point of view.
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WndrWoman, one's perspective about health insurance and health care in general does change when faced with a serious illness. Several times during my treatment I wondered what it all cost. Two CT scans for rads planning? Custom made shield to shape the beam for boosts? Weekly visit with RO? Oh my
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WndrWoman, I don't consider it "political" to recognize the simple fact that national universal health coverage would be a good thing, as every other modern country around the world except ours has acknowledged and implemented. Any kind of serious health problem can become a crisis, and in some cases even a life-or-death issue, without affordable health coverage, and all of us here are living proof of how unsustainable the costs can be for one of the most common diseases that affects large numbers of women in the U.S. and worldwide. Just among this handful of us who have posted our own insurance situations, we can see how much disparity there is. I agree that this is both unfair and inhumane. (And now I'll step back off my soapbox, sorry!)
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I agree kayfry, I don't know how, when or why something like healthcare became a political hot button issue, but apparently it is. I have decent coverage through my employer, not great but good enough. The numbers have been staggering and I can't imagine what one would do without coverage. That's not politics, it's criminal.
During the enrollment period at work last fall when folks were whining about increasing premiums and deductibles (which were miniscule BTW) I just said I'd happily pay whatever it costs. I am so far ahead of the insurance company at this point they'll never recoup from me all they've paid out. Ha!
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Wino ~ Well it's nice to meet you! I hope you are doing well with all you have been through - which, if you have been with us since July Chemo, has been considerable!
Re: Insurance. There certainly are differences in how each of our insurances have dealt with the costs of these treatments. What amazes me, is how much control these programs have over what treatments we get by controlling what they will and will not pay for. Whether they are public or private entities, they hand cuff our doctors in so many ways. They determine what is and is not good treatment based on their ideas of cost effectiveness. There in is my fear of "national universal health coverage". Nice idea, but who gets to decide? Our insurance has pretty much covered it all, but we have paid well over $10,000 a year for two of us for a long time because "stuff happens." From what I am hearing about insurance costs lately, that might be a bargain. From our current perspective, it seems like it was.
BTW: This surprised me - Medicare does not decrease your insurance costs, it adds a new one. The secondary insurance premium doesn't decrease in cost just because Medicare becomes the primary carrier. Medicare - a version of a national universal health program - does not cover it all. You must carry another insurance also or your "share", in a situation like we all have experienced, will eat you alive financially.
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I too have been given a new appreciation for my insurance coverage and my employer for providing it. I switched jobs 9 months before dx. My old companies insurance plan was abysmal. My current employer covers everything, I only have to pay a small co-pay for face-to-face Dr. appts. All other treatment I did not pay a dime. I met a lady at the same center that has paid thousands. We were comparing our insurance coverage. It is night and day. I did run across a lady without health coverage and it took 4 months to begin her treatment. Wow! She was terrified and I would be in her position.
Well I have 1 more treatment on Monday. Yes, I have open areas that hurt like the dickens. Using silvidene (sp?) and medihoney for the bad area. And step up the number of times I slather on aquaphor and aloe Vera each day. I have also stepped up the pain meds. Can I yell ouchie. Silver lining -- one more step to the finished line! Yay!
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Good afternoon ladies. The insurance discussion is very interesting.
Farmerma, you might want to also check to see if there is local help too. There is a group here set up to help women with breast cancer with no/ inadequate insurance with the bills. Your mo/ro's office should have info on that.
Beachbum, I love your attitude! It truly is what it is.
As far as the national healthcare discussion goes, healthcare has been rationed for years! Right now insurance companies are making money hand over fist from people's suffering as are for profit hospitals. Having been a provider fighting to get things covered I have seen people die as a result. So I don't think rationing is the issue. I think it's a matter of will and basic human decency and fairness. OK, I'll get off my soapbox too. Hope everyone has a good Sunday !
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I still believe that the better the insurance you have, the better treatment you get. I have terrific insurance and feel I have gotten better care than a lady I work with that has gone through colon cancer with lesser insurance. I still see my BS, MO and RO at least every two months. I had 4 TC treatments and two of those were 100% paid for as well as all my rads. I am a life-time member of my insurance company, even when my husband retires. Although the premiums will go to above $200 a month for us.
The thought of a "universal" health care plan definitely scares me.
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mqt64, I agree with everything you've said. Thank you for saying it. I know others may have different viewpoints.
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Nomatterwhat, I'm glad you're one of the lucky ones, that you have such excellent health insurance. I guess I have pretty good insurance now, and I don't feel that my care or choices have been dictated in any way by my insurance company—although there was a scary day right before I was scheduled for my simulation that at least 8 people at my BC/BS company insisted to my hospital that they were out of my network (not true) and not covered (not true). It took more than 3 hours for a very excellent and persistent person from my hospital to finally find someone who knew the right answer! But my premiums are costing me $527/month for just my coverage, and I will pay $6,300 out-of-pocket before everything is covered. (Thanks to BC, I'm there). When you add up my premiums and the o.o.p. expenses, that's a lot of money. It is not easy, and many folks are in worse shape than I am with regard to resources.
The worse problem is that some people have no insurance at all, and some have worse insurance than either of us has. Some just don't bother, but most probably haven't felt they could afford to buy insurance. But they still get sick, and still need treatment. I think that universal health care need not be a threat to those who already have insurance they like. That's the idea, that it's "universal."
I would love to hear from anyone here who has lived in a country that does provide health care to its citizens. How satisfied with your coverage and care have you been? Anyone?
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I'm from Turkey originally. There we have social security where if you go to any state hospital treatment is pretty much free. My two relatives who got cancer and got treated at these state hospitals did not pay a dime. They are also the larger hospitals so the standard of care is very good. However, if you have something less important, you will have to wait in line for a long while before the doctor will see you for this free service. That's why there are a ton of private hospitals who provide health services for higher fees, where the facilities are pretty and there's no waiting in line. They are expensive, although no where near the prices in the US. Private insurance, if purchased, covers the costs of these private hospitals. Healthcare is a mess in a lot of places...
Edited to say: since 2012 heathcare insurance was made mandatory by the government for people over 18 years of age. they determine the premiums based on your income level I believe.
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Living in the UK I am most interested in reading all your accounts regarding insurance as I of course, have paid not a cent for all my treatment BUT I have had virtually no say in whom I see or how often. I have, of course, paid my share of taxes to cover the NHS which is now creaking badly with all the extra people we have drawn in and an ageing population plus all the sophisticated scans etc. which were never envisaged when it was set up in 1948. By and large I think my treatment has been first class. I am aware, however that survival is better in the US and Canada than the UK but whether that is reflection on early diagnosis with the extra mammos you have I am not sure.
We tend to think here that all the visits you make are just as much a wallet lining exercise by the medical profession as made of necessity. Just what difference does it make if you see your RO every week or - as I did - not at all during treatment? (If there were problems of course she would have been available) We all know prescribing is well and truly oiled by the pharmaceuticals.. What happens to those who do not have insurance? Please tell me.
Hygeia - I love the sound of growing plants - it is such a positive thing to create new life. I gave a cancer suffering friend a plant in the autumn to let her know that I was sure (not at all actually) she would be around to see it bloom in the summer.
Just one other thing. WndrWoman you asked your RO about coughing . I am three weeks post rads and caught a cold last week. I have had a bad cough and my chest has been exceedingly painful all over and even down the back and I ached as much as just after surgery. It seems too to have knocked me out energywise so much so that I had a day in bed which must be the first for a cold. I was fine after rads but obviously less robust than I thought. The return to strength and wellness must be very fragile. So take care everyone.
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Hello ladies. I would have to say that BC makes you either appreciate your insurance or be frustrated with it. My coverage is somewhat in the middle. I pay $282 a month for my kids and I, as my hubby has VA benefits. We have a $300 individual deductible and the max out of pocket is $2000. I feel safe in preparing to pay at least $2000 out a year. The nice part is once you have paid that there are no co payments or fees. I had my surgery in Houston, which is in network, even though we live 7 hours from there.It seems that one really doesn't know the extent of their coverage until they need to use it. I do not feel that my insurance dictates the treatment I receive, but it does influence the amount I must pay for the treatment I choose😀. My father in law lives here in the states half of the year and in Greece the other half. Unfortunately years ago he had a boating accident when in Greece. They have public health in Greece, luckily his friend is a Dr over there and made sure that he received top care. He said that he is sure that he would have lost his arm had he not know someone in touch with the medical community.
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