From the category archives:

Medical Bills

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When do you buy a car without inquiring about cost? Probably never. Chances are you carefully research different brands of cars, repair records, gas mileage, safety records, dealer cost (so you know how low you can negotiate)  or you read used car ads for a good deal until your eyes bleed.

When it comes to your health, shopping for the best deal usually does not enter into your equation. If you are told that six weeks of radiation is mandatory following a lumpectomy, you just say: When do I start and where? You don’t say: how much would that be? Usually you pick the facility closest to you and one that is covered by insurance. You do not call around and ask how much others may charge. (They probably won’t even tell you.) Also, you’d like to think that  you chose a radiation oncologist on his skills and a facility based on its equipment, not on price. Most people go to the radiologist recommended by  their oncologist.

The reality is that even with good insurance, you will end up paying between 10-20 percent of the bills yourself. And here is the reality check: My bill for one month of radiation comes to $44,681.00.

This amount does not include the whole six weeks. It does not include the bill for radiation set up, initial consultation with the radiation oncologist nor does it include the cost of a CAT scan.

Of course the total amount of $44,681 is what people pay who don’t have insurance. I will pay a percentage of the adjusted rate negotiated by my insurance company.  If I did not have insurance, could I have asked for “an adjusted rate?’ Probably not. I would have been stuck paying the whole thing.

When your life is in the balance, the price becomes irrelevant. Yet when I write the checks, a few thousand dollars at a time, for my part of the bills, I cannot help but think of people who simply do not have it. I think of people who have to put it on a credit card and pile up high interest rates. I think of people who don’t even have the ability to put it on a credit card because they don’t have them or their available credit would  not cover their medical  bills. Combine this reality with the fact that a woman with breast cancer usually sees her income go down by an average 26 percent. In my case it already looks like my income for the year will be down by close to 40 percent. For one reason I work a lot fewer hours, and when I am at work I am distracted. And I have not even had to have chemo therapy, a major stumbling block in anyone’s work schedule.

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The post man sprinkles me with bills. How many have I managed to accumulate, considering I have not yet had my MRI or surgery? Did their computerized billing system over heat? Reluctantly, I open the first white envelope.

“This is not a bill” it reads. Then what is it?

It is a letter from the insurance company informing me that a claim has been filed. The three next envelopes have the same date, June 19th, but all are for different amounts. What is going on? Ah, one is from the doctor for his time, one is for the laboratory for analyzing my cells, and the third  is for the  use their equipment.

In small print, all the bills confirm claims have been filed with my insurance company. Then in large bold letters, all three bills say: It is your responsibility to pay.

I realize: this is just the beginning of bill-o-mania.

Without as much as a glance at the content, I empty an old ring binder. Voila, a fresh storage facility for my medical bills. I take a yellow marker and high light the date, the “service provider,” the description and the code of what was done, as well as the amount.

This is going to take organizational skills I don’t possess. After all, some days I feel I already have the famous “chemo brain.” Should I need chemo therapy, my mental stamina will hardly improve.

I place my “new” medical ring binder in the book shelf and notice one more white envelope on my desk. It is from the Cobra Services Administration:

We are changing from Blue Cross Blue Shield to Guardian. If you do not respond to us with a check in the amount of $849.23 within ten days from the above date, we assume you do not want continued coverage.

Are they @*&%# kidding me? Why would they assume I don’t want health coverage just as I face my biggest expenses since paying for a university education and buying a house?

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