Wednesday, October 6, 2010
Hanging in There, Sort Of
Well, times have changed. The same system this time around started at over $5,100. Yikes! There was a discount for this and a discount for that but the total estimate was still over $4,000, well above what I was willing to shell out, the current medical situation not withstanding. And that price expires at the end of October. So I came up with my own low cost, low tech solution. I know it won't last long, but at three bucks a roll for duct tape, I can replace it as often as I need to until I get my buns back to work. Even then I'll take a pass on the five thousand dollar shower system. That's just out of line.
Anyway, after the shower guy left, I called my insurance company. There are no radiation oncologists in my insurance network within at least 75 miles of my home. To see the radiation oncologist at my regular clinic, I needed to get a "gap extension" to be billed at in-network rates. After many department transfers and much frustration I received the bottom line: my policy does not allow gap extensions, and I will be responsible for any non-covered charges plus ten percent of all fees plus anything priced above what my insurance company deems "reasonable and customary" for each service. I need a consultation plus a care plan plus thirty treatments. Even at ten percent, those charges will add up fast. That is in addition to the out of pocket charges I have already incurred for 2010. There is no maximum limit for out of network charges.
This whole situation is compounded by the fact that in 2008, I went out of network to Mayo Clinic for treatment of a uterine fibroid. Mayo offered treatment options not available locally. At that time I had a different insurance company that did approve my visit to Mayo; however, when the bill came the insurance denied the claim. After a lot of appeals and other BS, I ended up stuck with about 90% of that bill. I worked a deal with Mayo where they discounted the charges and I paid it in full, but one of the terms of the deal was that I was not eligible for further financial assistance from Mayo, ever. I figured, okay, they're not local, I have two options in town, I won't need to go back there again. Little did I know. The radiation oncologist I have been referred to works in my town, but he's employed by Mayo Clinic. Mayo leases space in my local clinic and runs it as a satellite of their facility in Minnesota.
I really want to keep my attitude positive as I continue on this journey but it seems every day gets more difficult. I could really use some good news about now.