Fighting with insurance=Fighting to live

Honestly, as if the cancer patient doesn’t have enough to deal with.  As I progress further along in this journey, my insurance has become more and more reluctant to pay for needed treatments.  Recently I have been having an email battle regarding paying for my chemotherapy.  Something they decided to tell me was “experimental”.  Uhm…WHAT?

Here is where having a rare form of cancer bites you once again.  There is no set treatment protocol for Metaplastic Breast Cancer so naturally it requires an argument with the insurance company.  Meanwhile they are trying to tell me I am responsible for 13K of that ONE particular treatment.  Yes folks, $13,000 for one treatment.  That in a nutshell tells you what is wrong with our medical/insurance world.  I was charged $8 for two Tylenol recently.  Good thing I didn’t need the Morphine!  So argue with my insurance company I will because according to them my portion I am responsible stands at $55,000.  I will say UF Health is arguing with them as well, and they submitted prior authorization but its never a guarantee of payment.  I just finished telling UF yesterday as I spoke with a manager in the billing department that I have just lost my job and that I will be paying for COBRA to continue my treatment/surgery, so they better hope my insurance can pay them because how does that saying go…. you cant get blood from a stone.

Insurance is a touchy subject right now in the US.  All the ACA talk and trying to do away with it.  This is where I would reiterate that without insurance I would die.  The ACA is far from perfect and I hope that somehow intelligence and caring will prevail and a solution that is provided is one that both takes care of the people and reigns in HOW insurance works.  You wanna know why the hospital bills so much? Because when it comes right down to it, it doesn’t matter.  They sign contracts with all those many many insurance companies and in the end though they charge $8 for two Tylenol they receive nothing.  Not that its ok by any means to charge what they do- but we all know that chemo is  a medication and that my folks is Big Pharma.  Its all a big flipping mess.

I am one person, fighting to live.  I am one person out of too many fighting to live.  Where does money stop being a motivator in the care of HUMANS?  I know, its all a business the caring for patients…and that my folks is the crux of the problem, in my humble little opinion.

Luckily for me due to being in the medical field 25 years and being in billing/coding for quite a bit of that, I know what I am talking about when I argue with the insurance company CPT codes and diagnosis codes. Even with that knowledge they talk circles around me. I can only imagine what its like for the regular everyday person.

I see why so many file bankruptcy after something like this. Its astounding what I have already shelled out/made payment arrangements for.   I will fight and avoid that scenario as long as possible.

Now that I have a headache from all this and a low platelet count I am off.

As always,  #FuckCancer

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: