Tag Archives: health care

Thank goodness for healthcare

I am pausing from pre-Christmas prepping – which for me is a VERY fun marathon and sprint and 5K rolled into one – to complain just a little.

These days everyone has a position on healthcare – or at least on Obamacare. I try to be apolitical online and will refrain from too much proselytizing BUT I just got my statement of account – count it the thirty third – as related to my reconstruction adjustment end of August. So, to clarify, this is one bill, from one procedure. (I counted recently that I have had 8 surgical procedures thus far with the big C – this was #8)

For those of you who have been playing at home, I popped a stitch out of my radiated reconstructed left boob while cruising the lazy river with my family and friends. Because of the fear of infection from the oh-so-clear Hyatt Lost Pines pool I had emergency surgery on August 21st. Today I got a bill from Seton – the hospital where I went for aforementioned surgery.

The bill says patient name: Ward, Lauren. Statement date: 11/28/13, admit date: 8/21/13 (only 3 months behind – if I ran my family finances that way?? really??)

Discharge date: NONE. Meaning I didn’t stay the night. At all. Important for what comes next.

Total charges: $23,687.75

I’m sorry, but WTF? I was in an operating room for an hour, woke up in the room next door an hour later and it’s more than a car?

AHHH but it gets better:

Previous Balance $4576.12 – which implies that A – I either owe the hospital more than we pay for five people to go on vacation for a week AND DIDN’T KNOW IT or B – that I have received sufficient bills from aforementioned hospital that I just ignore them at this point and/or C – they are just making this SH(&T up as they go.

Now transaction dates and description

9/10/13 HMO ADJ – A      $18,198.62

9/10/13 HMO ADJ – A     -$18261.97

9/20/13 I99/Aetna(178209)    $.00

9/27/13 I99/Aetna(178209)    -$4,278.19

I have no idea what any of that means. Literally, figuratively, completely. Other than another really?! How mixed up are we that someone who is or was seriously sick now has to decipher a bill that looks like the WWII Enigma code books in Henry’s history project?

I recognize adj as either adjective or adjustment. Which do you think? Aetna – thank god for Aetna – is also familiar. Though I’m not sure what any of that means. Listed twice. Some positive. And with SUCH precision. AND ninety seven cents. Because that last cotton ball was two extra cents.

Then at the bottom with a big blue arrow: PLEASE PAY THIS AMOUNT: $238.68

I can’t really describe how I feel – frustrated that I have no idea what any of this means. Happy that we have this money in the bank and I can pay it. Pissed that I have to pay for something that was completely NOT my fault at all on so many levels. Sad that others receive these bills and can’t pay for it. Relieved and exhausted by reading the entire bill so that the final total seems like – WHEW dodged a bullet there.

Maybe that’s the strategy – overwhelm with paperwork, bills, numbers and codes. When did healthcare become so unhealthy?

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Cancer Doesn’t Make Cents (Only Dollars)

I’ve already crossed lots of thresholds and boundaries here – talking openly about bodily functions, losing hair, gaining and losing weight … gaining and losing body parts. Now another taboo will fall: finances.

I am motivated in part by an article I just read in Time magazine – their Special Report on the Bitter Pill of Health Care Costs. It went into nauseating detail on five different individuals and their financial travails in the health care system. Three of them had cancer.

When I first started the article, it talked about a man who was diagnosed at age 42 with non-Hodgkins lymphoma … and proceeded to MD Anderson to get the best and brightest treatment. I felt a sense of thrill – MD Anderson, part of UT, highlighted nationally for its cancer care. But then I realized this was no warm and fuzzy piece, it was an expose.

This gentleman was made to wait in the hospital while his check cleared as prepayment for the treatment he would receive. Over $90,000 of treatment. The article only got worse.

He and his wife were considered “under insured” – they owned their own business and therefore had some health care coverage but not much, and certainly not enough. In the article they also follow people with no health care coverage, or with Medicare – 60% of all personal bankruptcies in the US are health care related. But, lest you think that you are immune, let me tell you our story.

When we were headed to Dubai, I quit working. Davis has excellent health care coverage through IBM. We pay about $500 per month for coverage. We have a $10,000 per person out of pocket maximum and a $750,000 per person lifetime maximum. I am now pushing halfway on that. (Obamacare will make all insurance companies have no limit which in turn will drive all health care costs up BUT I’m not complaining about that … yet)

From February 13, 2012 – December 31, 2012 Aetna was billed $198,000 for my treatment. They paid $62,000 because of negotiated discounts. My claim statement (not the individual bills) includes almost 200 individual line items. One night with my surgery was billed $25K, outpatient surgery for my portacath was $12K, radiation treatments were billed at about $1500 per appointment for 30 appointments.

We blew past our out of pocket maximum in July. I just completed a deduction table for our 2012 taxes and we spent almost $19,000 on prescriptions, doctor’s visits, etc. So the good news is we will likely get a refund this year. But, think about it – we lost my salary for a full year, had to double up on nanny help, and paid that giant bill out of pocket. What do people do when they don’t have good insurance? When they don’t have friends and family and a nest egg for emergencies?

This also means that for the $500 we pay each month, Aetna actually was worth about $15K per month in 2012. That is a bargain at any price, and literally worth 20 years of the premiums for Davis at IBM. Crazy.

 

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Another Reason to Love Nordstrom’s

I have had assistance in unexpected places the past few weeks. In addition to friends, family, doctors and awesomely supportive survivors there have been two unusual standouts – my insurance and Nordstrom’s.

First, Aetna. We grumble greatly about health care in America – in truth it is more of a “sick care” system that we all must endure when we are unhealthy, already in the weeds. I have experienced what life would be like with a preventative element – a caring, supportive system that would see you through your goals and assist you when you did touch your toe into the medical arena.

Aetna has provided me with a case manager – a former oncology nurse who calls me each week to check on my progress, assist me with any questions I might have, tell me where I should ask more questions, and let me know how to navigate these uncharted waters. I know to them in some ways I am a sudden aberration in their data – spiking high costs of chemo and procedures. But their response has been compassionate, helpful, and effective. And for that, I thank Aetna.

It was my case manager, Mary Anne, who first brought Nordtrom’s to my attention. Clearly, growing up in San Francisco, I need no introduction. In fact, my girl scout troop did inventory to make extra money. I participated in a fashion show for Brass Plum … and my first prom dress was from the same department. I well remember “my store” as well as the flagship downtown with the circular escalators.

I learned during motherhood of their first commitment to service above and beyond – they measure your children’s feet exactly, assist in special sizing, and of course have the fabulous return policy ( no questions asked, whenever).  When I made my first voyage to a store with Henry in tow I learned of their commitment to nursing mothers – a complete room with comfortable chairs and a special changing station.

Imagine my surprise when Aetna tells me that Nordstrom’s is where I need to shop now – in my time of need, transition, and uncertainty. Mr. Nordstrom’s Mom had breast cancer you see, and ever after has remained vigilant in providing a smooth, supportive environment for supporting survivors. They have special staff members who have been trained in prosthesis and orthodics. They measure you individually for the compression garment post operation, and then will specially fit you for your prosthesis – two little chicken patties that come in a variety of sizes, perkiness, and function.

There are special ones for swimming I learned (you don’t want them to float up and ride on the water) and there are some especially designed for hot weather that have bumps on the side that face skin to allow air movement.

Nordstrom’s will also sew pockets into any garment that you buy there for your ladies to hang out. No charge. The ladies and the garment were covered by insurance.

The assistant was so caring, the fitting was so enjoyable and fun that I went and bought some sassy shoes – red is the hot color and I know have ankle boots. The women in shoes thought I had a purposeful Pat Benatar haircut which is quite stylish. I’m not sold but I did buy the shoes.

Is it weird that I look forward to my follow up visit? There might be some serious shopping.

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