Hillary St. Pierre- The financial facts of healthcare with a catastrophic illness-

October 27, 2011 at 10:58 am 1 comment

ED NOTE: I have reposted from Hillary’s site as I believe her journey both fighting to live and living to fight– not only the obscenity of Cancer ( Hillary has Hodgkin’s Lymphoma- the same curable cancer that killed my son)- but the “cost of cancer” needs to be shared .

Financial Facts I wish I knew When I got sick

Dr. O’Conner gave me good news last week. This miracle-maker of a doctor could possibly keep me on my current medication, Adcentris, which has given me few side effects and allowed me to live a relatively normal life, for a whole year!

I could have a year to survive, and feel well too!
This is great news, for me, a person who has fought off Hodgkin’s lymphoma for 5.5 years now against the odds.

But imagine if you received the same news today. Imagine if you heard my reality. Imagine if you heard this news:

Congratulations, I think I can keep you alive and feeling relatively well for the next year using this brand new $10,000 therapy. Thank goodness Obamacare removed that nasty 2 million insurance cap or you’d only have half a year with these expenses.

You’ll have to travel to New York City every three weeks for check-ups and your medication. You may wait 3 hours or more to see me, but it’s absolutely worth the time since I have the most promising innovative therapy to keep you off the “chemo junk” that would disable you for life.

In the interim, you need to take a medication regimen of twenty medications daily including $150 eye drops and shots. You’ll really need those eye drops too. They’re the cure to graft vs. of the eyes, which will leave you blind and unable to realize the debt you’re up to your eyeballs in.

You’ll also need to have an oxygen concentrator and portable tanks just in case your lungs act up again.

Overall, allot a minimum of $1200 monthly for your healthcare expenses alone, because you’ll be paying more than you get in social security disability benefits. Don’t even bother having taxes taken out, because if you don’t have money, you don’t get treated. You need that money now, and with all your write-offs, you’ve paid your taxes and then some, but you’ll never be seeing those expenses back no matter how knit-picky you are in keeping receipts. The government is pretty broke too, and there is no “cancer fairy” watching out to make sure you recoup those costs when you deduct them on your taxes.

You’ll be lucky to get a couple $100.

Good luck surviving cancer. You may just have to opt out of paying for groceries and your mortgage alongside treatment, because as far as needs go, surviving is at the top of the list.

No, I don’t think anybody else would take that as good news, but hopefully others can learn from the mistakes I’ve made or sidestep the horrendous practices that have nearly bankrupted me.

Ten Insider Tips to Avoid Medical Financial Ruin

First
Medical related debt does not go against your credit rating! Breathe a sigh of relief if you are hoping to purchase a car or home. Your medical information is protected by law, and so are your medical expenses.

Second
Know your insurance policies, all of them inside and out: short-term, long-term, life, and health insurance. Memorize the books and fight any charge that appears suspect. People will take the path of least resistance, and billing is no different It’s common practice to submit once to insurance, and if rejected, send the bill to the patient. Medical billing is difficult and the first submission is often rejected due to incorrect wording. My diagnostic PET scans were rejected because “restaging Hodgkin’s Lymphoma” wasn’t covered but “nodular sclerosing” was. Fighting saved me $3000 a scan.

Third
Failure to know your insurance policies and abide by them step-by-step can result in fees later, especially if you become an expensive patient that threatens the companies’ return-on-investment. My long-term disability insurance company sued me for overpayments, because it failed to request my social security benefits to offset my wages. My husband put $8000 on a credit card while he sat vigil in the ICU beside my ventilated, near dead body. Ignorance of the provision is not an excuse. Again, the sole option is a payment plan. Take the payment plan, do not put it on a credit card.

Fourth
Avoid interest at all costs. We all hope we’ll be fixed within six months, but if a six month battle turns into six years, those finance charges will start to be more than your weekly budget for groceries. Hospitals, clinics, medical supply facilities will all offer interest free payment plans. Take those, and if you’re lucky, overtime the hospital will become tired of trying to collect on an old debt and right it off as a bad debt expense. When this happens, your bill is gone.

Fifth-
If battling the bills becomes too much, and often companies profits are banking on the fact you will give up, that doesn’t mean the war has to stop. Find a financial advocate immediately who will do the fighting for you. Cancer Connect http://news.cancerconnect.com/ will help you do just this. You don’t need the stress of fighting your disease and fighting to get treated.

Sixth-
If you made the mistake of using credit cards to pay for medical expenses, stop right now. It is illegal to deny emergency care for inability to pay. If you are in dire financial straights and need treatment, such as surgery or chemotherapy, talk to your doctor, nurse practitioner, nurse, secretary, social worker, human resource person, Someone will help you find financial assistance.
Then proceed just as with any other debt, If you have high-interest credit card debt, pay that off first.

Fifth- The worst thing you can do is ignore bills. Communicating with the hospital or clinic will keep the costs from going to claims. With the hospital, clinic, private practice, whatever, you can set up a no interest payment plan at a cost you can afford. I worked out $20 monthly to both the hospital and clinic I attend which I would pay monthly, same as cash, for hopefully the rest of my long healthy life.

Sixth- If your situation becomes so bad you can’t pay the bills remember medical bills do not hurt your credit, when an agency sends your bill to “claims,” they are essentially paying for someone to harass you. These calls are awful and annoying, especially when sick, but that is all they are. Turn off you phone. Get a second private line. Get caller ID, and if you get really angry, fire back.

Seven
Consider reporting the agency that sent your claims to the Better Business Bureau. Did they disclose legally protected, private medical information to a third party without your consent? This is illegal. You’re protected among the strongest of all healthcare laws: HIPPAA.
But If you really want something fixed call your government representative. They are elected officials who represent you. They have the knowledge and connections to answer your questions. Though you may not speak directly to the official, you will speak with their specialists.

Eighth-
Shop for more affordable and appropriate insurance. Yes, I said it: compare and save. The days of being tied to employer health insurance, COBRA, or a $20,000 out-of-pocket plan you don’t need are almost over thanks to websites on-line that allow comparison shopping just like searching for auto-insurance. Ehealthinsurance.com is an internet site that compares different plans side by side online.

Even better, if you’re too sick , tired, or busy to undertake the task of understanding and comparing plans that will suit you best, there are also sites that will match you with a person to assist you. NHAU.org, trustedchoice.com, as well as ehealthinsurance.com all provide help for people in need of sorting through plans to find out which suits the individual or family best.

Ninth-
Don’t settle for a one-plan fits all strategy. You can now also mix and match plans within families when purchasing health insurance. If you have one family member who will probably live until 90 with no other problem than some hypternsion, cut back a little on their coverage to take care of the spouse with arthritis, depression, fibromylagia, and a family history of breast or ovarian cancer.

Tenth
If you know exactly what needs to be done, what surgery you need or what treatment, you can now compare treatment costs between hospitals. Previously, prices and reimbursement rates were determined behind closed doors among businessmen with little consideration to the actual quality of the service. Better group rates were given to customers of certain insurance companies while patients paying out-of-pocket often paid more, shouldering the costs of any financial loss the hospital took in negotiations with the big business. Don’t be a victim anymore, price compare.

Finally, if you’re not just concerned about finances but quality of care as well, there is now http://www.hospitalcompare.hhs.gov/ that allows you to compare the success rates of different hospitals. can find a few hospitals that are within your budget for treatment, find the one that will best suit your needs, and get treated with confidence that you are receiving the best care at the best cost.

Still need to afford your medications? You may be able to negotiate with your hospital to get a discount. You could also buy generics or compare pharmacy costs and ask for the better price. Most pharmacies have a lowest price guarantee. For over the counter medications, use coupons or rebates. You’d be surprised what you can get for free. If you’re in a huge lurch, you can always ask your doctor for samples or go to http://www.pharmacy.ca to buy the same medications for less money in Canada.

Remember, you are a consumer and health care is big business. We’re in a recession, if that hospital or pharmacy wants your patronage, they’re going to have to be competitive.

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Entry filed under: commentary, health, medical, personal opinion. Tags: , , , .

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