I've never been horribly sick, meaning so sick that I've had to depend on the medical industry in order to lead a normal life. I have however always had health insurance though, the lowest amount necessary to cover basic needs like breast exams, pap smears and flu shots. It actually wasn't until I was pregnant with twins that I even felt thankful to have health insurance, what with all the ultrasounds, check ups and c-section. Penelope was breach at 24 weeks so we knew then there would be no room to move around, no matter how many downward dogs or hand stands. We chose a date of 4/11, but as with everything else in life things don't always go according to plan.
I also attribute it to luck in life. Our twins were born healthy, at about five pounds each and breastfed immediately. But on the day we were to leave the hospital, Sophia was a little under weight, I was told by a couple of ounces. I heard stories of families that would have to leave one child in the hospital while having to take the other home. My heart sank. (I have dear friends who are coping with this issue at this very moment, and i cant imagine the turmoil.) I demanded a bottle of formula. Knowing that it was a mere two ounces, I was going to do everything I could to make sure we went home as a family. I fed Soph and she drank like a champ. I demanded they weigh her as soon as she had finished the last drop for fear she'd pee it out. And it worked. But as a new parent, you leave the hospital and become worried about any harm that may come to your child. And it wasn't until we had twins that I ever ended up in the ER (except when I drove a college friend when he almost got his foot mangled). Ellie broke her leg at two. I almost cut off my finger. Soph had complex febrile seizures. (We've started to think that it's really Graham with the luck.)
But I knew it. I knew the moment I felt that lump, nearly a year ago today, that I had the wrong insurance. None of us were ever sick. No asthma, no allergies, no chronic illness. We just needed the basics. But not with cancer. So the moment I felt the lump I knew the lack of insurance would kick my ass more than the cancer itself.
I started keeping my medical binder when I got my biopsy results. The one inch has turned into the two inch. And the confusion of co-pay, in network, out of network, deductibles and more have confused me beyond reason. There are times I go to a doctor and don't pay anything and there are times my co-pay can be either $10, $30 or $55. Now grant it, I've been seen by my general practitioner, gynecologist, breast surgeon, reconstruction surgeon, medical oncologist and radiation oncologist, not to mention the amount of times lab techs have taken blood samples, cat scans, MRIs, given radiation, physical exams and more. So when the thought of all the bills started flooding my head, I had to cease stressing about it. I was not going to ignore them, but I also was not going to let them bury me in debt and bankruptcy. Once again, I came up with a plan. I would pay all of the smaller bills, under $1000, immediately. The rest I would make monthly payments on and just take it one bill at a time.
I can see how people could just let it all pile up and live under a heap of denial, dreaming that it will all go away. But, like with cancer, that dream leads to nowhere. See, the hospital won't turn you over to a collection agency if you're showing that you have intent of paying, even it's a little every month, at least that's what I've read and have been told. So when the bills come in, at least two or three a day (once it was eight) I simply put them in a corner on the counter, in a sense letting them pile up. At the end of the month, I go through each one and enter them into a spreadsheet where I've listed each and every doctor's appointment, blood draw, chemo and radiation treatment. You see, over time I've figured out the medical industry's problem. The different departments even at the same hospital don't communicate to one another. I get a bill for a single blood draw, sometimes months after it occurred. And then once I get the first, I may get a second notice on that same blood draw less than two weeks later, which only amounts to many duplications. Of course, it'd be much easier if they would just send you monthly statement, but then again we're talking about the medical industry.
I could understand if I were traveling all over New York being seen by specialists from several different hospitals or centers, but I'm not. My breast surgeon, reconstruction surgeon and two oncologists are all a part of the same hospital and even have offices in the same building. One day I was able to schedule appointments with all four within three hours, a feat they even thought was a bit absurd.
I know I'm probably simplifying the issue to extreme and that there's most likely a good reason for the massive paperwork, duplication of invoices, statements coming more than four months after a visit and more. So my advice to stay ahead of the game? Not sure if it's advice but it's what I've been doing so far that seems to be helping. With one surgery left to go, here's where I stand:
- keep a record, whether electronic or manual, of each and every visit and what happens
- when going through the mountain of bills, enter each one corresponding to that visit.
- you'll soon start to see, as I did, duplicates and how easy it can be to write a $35 check four times for one blood draw
- I made columns for the cost before insurance, what insurance paid, what I owe, how much I paid and when and how (i.e. debit or check number)
- and again, pay the lower amount bills first so that you only have a couple of bills hanging I've your head and not many
Where do we stand now, even with one surgery remaining plus follow-ups? Well, take a deep breath. My bills prior to insurance have surpassed the quarter million mark. $263,764 to be exact. My portion of that? About $42k, or 20%. Now, here's the real kicker. The medical industry doesn't take notice that my tests, diagnosis, surgery, treatments, and follow-ups have lasted no more than twelve months. That first appointment in which I went to my gynecologist's substitute to confirm that the lump I felt was in fact something to be concerned about was on August 1, 2011. However, the medical industry doesn't look at it that way. They see that this course in my life has spanned two fiscal years. So the maximum deductible was reached in 2011 with my mammograms, biopsies, MRIs, body scans, double mastectomy, and four chemotherapy treatments, which means that insurance sees it spanning two years. With two chemotherapy treatments, 30 radiation treatments, a pet scan, blood tests, and my exchange surgery in 2012, my out of pocket is even more.
What would have happened if I had simply waited 5 months to start all of this on January 1st? I'm sure I'd be paying a lot less. But then again who knows how fast the cancer could have spread since it was so aggressive. So even though our savings are erased, retirement gone and we had to put off saving for the girls' education, the end result is I am in fact cancer free. And yes, there are others out there that have it much worse than I do, not just regarding cancer but in life in general. My mantra has been, "At least I don't have to walk three miles a day for clean water!" And there is no comparing one's cancer to another. We are all different so no matter the diagnosis, how our bodies react to treatment isn't the same, and neither is how we deal with it. All we can do is the best we can, the best we know how. After that, well.....let the medical industry figure it out.
