Why does it all boil down to money?

[dede10]

We live in the most progressive nation in the world, the most knowledgeable, the most money....... We have huge cancer centers we give money to for research...Sarah Cannon, Susan B Komen...we do the walks, fundraisers, ...all this for research, correct?

Now, I take a chemo drug...right now I am on Avastin & Xoloda. The Xoloda is $150 a pill...I take 3 a day, which is $900.00. The reason its so high is because of the...RESEARCH? These cancer drugs are very expensive...all of them, and the people taking them are being charged are charged 2 arms & 2 legs & their firstborn. Now, you would think in this country of plenty, that people battling cancer would not have to worry about the money involved. Money causes stress.

[Vi Schorpp]

That's why so many are filing bankruptcy. My insurance just came up this year with a cap of $40,000 a year for prescriptions...doesn't seem right, does it? Does insurance cover any of your prescriptions?

[dede10]

nope...of course not, in fact, at stage 4, I'm on Medicare, now (for the past 3 yrs) and Medicare pays 80%. No other insurance is going to touch me to help out on the 20%, because hubby makes too much money! Well...with all this medical, and us falling further & further behind.......he doesn't make that much money!

[Vi Schorpp]

to your post. Before my husband died we racked up a lot of co-pays and lots of prescription charges. Cliff, also, was on Medicare. While helpful, and I'm thankful he had it, it wasn't easy. It was a very costly and grueling road...we got through it, but it wasn't easy.

[naturaleigh]

Being single with no one to help me financially, I am sinking fast. I just found out that my insurance has a "lifetime" maximum. What happens when insurance no longer pays any more, period?

I just read somewhere, when I find out where, I will post it, that many insurance companies have an open enrollment period where people can get their insurance plans with no questions asked. I don't know what will happen after they find out you are a cancer patient, but I hope to check into this further.

I had excellent credit before all this mess happened, and now I get phone calls daily from the medical profession harrassing me for more money. They do not like the amount I give them every month.

It does seem there should be some solution to the cost of this disease

[runtolive]

xeloda 500mg tabs are actually about 23-25.00 per pill... retail

you may want to double check what your pharmacy quoted you.

run to live

[Sheila]

I am fortunate to have BCBS of IL through my husband. They too have a 1,000,000 lifetime max....when I was nearing that, I called them (this was well over a year ago. I found out as long as I am using a PPO Dr. and hospital/clinic, I have no lifetime max. I was also paying for insurance through medicare as I am on social security disability. They were paying nothing as my husbands insurance covers all the eligible PPO amount, so there was nothing left for medicare to pay. I called the insurance company and dropped the part of medicare I didn't need.

[Brenda_D]

I don't know about Xeloda, but it sounds like you may be getting it through your Onc and he's jacking up the price.
I went through something similar with Herceptin.
My insurance didn't want to cover what my Onc was charging for it because he wasn't getting it through their pharmacy, even though he's in my HMO.
Then my insurance company decided that they also couldn't give me the provider discount for the same reason.
My Onc wrote off all the remaining charges other than what the insurance paid him.

I said before that all the wonder drugs are great, but what good do they do if you can't afford them?

[madubois63]

If you have medicare, you should have part D for prescription coverage. That pays for more of your prescriptions than the 80% which is what they pay for medical care. Medicare covered my Xeloda that was filled through my oncologist's pharmacy. That is covered by part B. I haven't paid a penny for the Xeloda and I think you need to call medicare and find out more about your coverage. There is help out there for prescriptions. Call the pharmaceutical companies and ask about assistance and use your seach bar and type in prescription assistance. Apply to all of them. You may get denied by one, but accepted by another. Good luck.

[dede10]

I think my onc office will write off anything over the 80%, and I am getting the Xoloda from his office. My reg Doc writes off anything above the 80%...

I am more worried about the hospital stays, & the scans, than his office.

[sarah]

Because you don't live in a country with universal coverage where by having everyone in the system it actually costs the government less per person that in the US. yes, really.
And you're going to get Fox TV News (if you can call it that!) scaring you to death that you won't be able to chose your doctor (yes you can and change if you want - all the doctors are in the system!) and won't get good treatment (yes you will) and it will cost more (you'll be paying one way or another and it will possibly be less) but the US health insurance companies make so much money they can spend enough to scare you to stick with a system that isn't working. Just ask doctors how much mal practice insurance they need - notice most of your doctors now are from a foreign country. I'm not saying they aren't as good just that Americans don't consider it the good job that they used to.

[jones7676]

I used to have BCBS of Michigan through my employer. I now use BCBS of Arkansas through my husband's employer. I have a lot more trouble getting bills paid. They say that the hospital has not provided the right info (like I want to have a PET scan just for fun)...it is a nightmare compared to Michigan. They paid for the dye for my PET and MRI but won't pay the rest. I am arguing with them right now. It is crazy. I could go on Medicare (I qualify) but I'm afraid to. For instance, I heard that Mayo Clinic doesn't accept it. I am afraid I would lose choices or the ability to get a second opinion if I went on it. Please send me an email if you know much about this. Thanks. I haven't been online much for a long time because the computer was in a spare room where I had limited access. But I'm back as it is moved! I've got a lot of catching up to do. Thanks for still being here!

[Sherryg683]

That is such a frightening thought that insurance would put a cap on what they would pay. What do you do then, there's no way to afford what treatment costs. I was talking to a woman awhile back, her husband had recently died of melanoma and was at MD Anderson. His insurance had a 350,000 a year cap and he had reached that. She had 3 small children and was a school teacher...she had recently received a bill from MD Anderson for over 80,000 and still had other outstanding bills. She did not know what in the world she was going to do and was afraid she would lose everything she had...this is just so sad and unfair...sherryg683

[karen z]

Health coverage and benefits: vote very wisely for the next president of the US.

[Brenda_D]

Health coverage and benefits: vote very wisely for the next president of the US.

karen z, my thoughts exactly.

[madubois63]

Jones 7676 - I am no expert on medicare; but since I've had coverage for nearly five years through medicare with medicaid as my secondary, I can tell you first hand that I've never had a problem getting second or even third opinions covered. I believe you can have medicare and keep your present insurance. Whereas medicare would pay the first 80%, and then your present insurance (or any plan you might choose through medicare) would pick up the leftover 20%. You should call your insurance company and speak to your rep. I would also call a medicare rep and discuss your options. Are you being treated at the Mayo clinic?? Instead of being afraid, ask. You might be surprised. I have incredible doctors and have been able to choose.

[StephN]

Dede -
There are numerous plans that WILL "touch" you with coverage for the 20%. Who told you they won't??

Medicare sends out a packet with all the info on the Supplement Providers. If you did not get it, try going on line to their site and see what they suggest for the additional coverage.

You CAN get something to fill that gap.

I am also on early Medicare with the whole nine yards that goes with it. I had Regence Preferred Plan and with Medicare I just switched to Regence Medadvantage, which includes the Part D and Prescription coverage. It was a very easy transition for me. Plus they pay for more than my old non-Medicare plan!

If treatment is given in a medical facility they pay for it.

Remember: "Knowledge is Power."

[ElaineM]

I agree. Most of us have medical debt including me. We have to deal with life threatening health problems, important medical decisions and financial problems all at the same time. It is very difficult. Somebody on this site suggested a funraiser for patients like us. Fantastic idea !!