CPR for Copays

In the early 1990s, a humorous definition of "survivor" was, "someone who was diagnosed with cancer and didn't die of a heart attack when they heard the news." Nowadays you could tweak the ending, "who didn't die of a heart attack when they got the bills not covered by their insurance."

How can you become a Healthy Survivor if you can't afford good care?

Debbie comments on my April 29th post that her medical coverage is a stress. She's not alone. A May 4, 2008 New York Times article reports, "millions of people who have insurance but find...that they cannot afford their own share of medical costs." Debbie says she hopes to get information when she walks the upcoming Relay for Life.

Debbie's response is that of a Healthy Survivor: Obtain knowledge. The following links offer a start for accessing and asking for help:

Patient Advocate Foundation offers "CPR" through its Co-Pay Relief Program. In addition to direct financial support to those who qualify, the program offers call counselors who personally guide patients through the enrollment process.

Patient Access Network  "is a non-profit 501(c)(3) organization dedicated to supporting the needs of patients that cannot access the treatments they need due to out-of-pocket health care costs."

The NCCS (National Coalition for Cancer Survivorship) has a free pdf download, entitled, What Cancer Survivors Need to Know About Health Insurance.

The NCI (National Cancer Institute) has a section devoted to Financial Assistance and Other Resources for People With Cancer.

Comments

[Jill Eurick]

Wendy,what valuable information you have provided. Thank you so much! Although I am done with my treatment and don't have any bills coming in at this time, I just now paid off the last of my debt from various treatments I received and this October is my 10th year anniversary of healthy survivorship. Thanks for all of your great help, encouragement and information on your blog. Jill

[James Kos]

Wendy, As I reach my 1 year anniversary of my last chemo treatment I am still paying some medical bills. Although it could be a lot worse.

I carry my own private health insurance as I am a Business Owner. I bought high deductible insurance ($5000) to save on the monthly payment. So far the insurance has paid out about $250K to my approx. 15K. That has not been too bad and that won't break me but I am a lot smarter about insurance now.

One thing that was a blessing in disguise was a cancer policy I bought from a annoying salesman just so he would leave me alone. It runs $25 a month and has been nice to have since it pays directly to me money based upon procedures done, treatments received and milage to and from those treatment. I have received about $5,000 from them over the last 2 years.

The only problem I have had is that my insurance co and the infusion pump company are not on the same page. My oncologist picked the company and my insurance won't recognize them so I have to pay them directly.

But I must say that they have been very helpful in resolving the account. I let it go for about 9 months to see if they would just right it off and go away but they didn't so I called and explained how my insurance co won't pay them and we negotiated a settlement of about a third of the bill. Which I thought was in line with the amounts the insurance co paid for the rest of the cancer procedures.

So I am really a lucky one to have the coverage I have. Next week I go in for another CAT scan and the first $5000 will come out of my pocket but the insurance co will pick up the rest and the one in 6 months and the colonoscopy I'll have at the end of the year.

[Wendy S. Harpham, MD]

Dear Mr. Kos,
Your point is well-taken: Negotiation is often an option. Pursue it. If you can't or don't know how, you can hire a medical claims adjuster, consulter or assistant. Usually it is money well spent. Fees range from $25-$100 per hour or operate on a commission of 10 percent of recovered funds, and are usually negotiable. Most contested claims can be resolved with less than ten hours of professional time, and consultants can offer tips for managaing future claims.

As with every aspect of survivorship, knowledge, hope and action help you get good care and live as fully as possible.

With hope, Wendy