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When chemotherapy costs more than my house...

The cost of medical insurance is incredibly high. In December of 2014 my husband was diagnosed with Lymphoma. A six day hospital stay resulted in a $191,000 charge to our insurance. My house is not even worth $191,000.

A recent one week stay in the hospital resulted in a $161,000  charge

This year a 2 week stay resulted in a $234,000 charge to my insurance

My husband gets chemo three days a week every 21 days. One day of chemo costs $25,000
A week of chemo costs $75,000. Without this drug, the cancer will return. 

I didn’t plan on writing a blog today about the high cost of health care.  But after examining the claims for my husband though I felt it necessary to write a blog. And I hope this blog goes viral because it is outrageous the high cost of health care. 

This is not a blog criticizing doctors because they are not the ones who are charging an arm and a leg. This is not even a blog about insurance companies, because we have been blessed with an insurance company that covers the cost of my husband’s treatments. We have thankfully not had to deal with the nightmare of the insurance denying a claim or refusing to pay for a service. Although that does happen.

This is a blog about the incredibly high cost of health care and the high mark-up of drugs and services.

In 2015 my husband was hospitalized 9 times. He spent over 100 days in the hospital. He received 8 cycles of chemotherapy. He received platelet transfusions. He received shots to boost his White Blood Count. He visited his doctor on a regular basis when he was not in the hospital. And when the year came to a close our insurance had been billed close to a million dollars.
2015 medical expenses

In 2016 he received 4 cycles of chemo and 18 days of radiation. He is waiting to get a bone marrow transplant which will involve more hospital stays and a lot more expenses.

The charges to his insurance are almost $400,000 just six months into the year. And many claims have not posted to our insurance yet so that amount is actually significantly higher. 

When a person is diagnosed with cancer their life is turned upside down. It typically involves a lengthy treatment and recovery. Many times the illness prevents them from working so income is cut in half or even more. My husband’s take home pay was larger than mine when he got sick. And for the last 18 months he has been unable to work. Because he was just shy of work credits he does not get any disability. And because we are in the wonderful position of being middle-class we get no government assistance. So our income was cut in more than half. But our expenses did not budge. And medical expenses were added.

If we didn't have insurance or if my insurance refused to cover the cost this bone marrow biopsy would eat up 4 months of my paychecks. 

We have health insurance. Thank God we have excellent health insurance. Our out of pocket max last year was $2,500. And this year it is $3,000. So we paid an incredibly small percentage of the massive amount of medical expenses. Yet it is sad because so many people who have been diagnosed with cancer end up filing for bankruptcy because even though they have health insurance, their out of pocket max is high and they are unable to pay for their medical expenses. Not only that there are times when the insurance company denies treatment because the cost is so high and so a patient is forced to pay out of pocket.

Out-of-network vs in-network
Most people do not know that even if a hospital or facility is in your network the particular doctor who treats you may be out of your network. And the insurance will not cover out-of-network charges or they cover it at a lower percentage so you end up getting a bigger bill. And that cost is separate for one’s out of pocket max

Last year my husband received a bone marrow biopsy in the doctor’s office. The doctor was in-network but she sent it to an out of network pathologist. So we received this wonderful message on our insurance claims. This out-of-network charge was:  
That charge was separate from our out-of-pocket max. So in addition to the $2,500 out of pocket max we had to pay we got a $2,381.64 charge.

Some insurance companies will convert all out of network charges to in network if they occurred while one was hospitalized. Cigna, our new insurance, does just that. Every time my husband got chemo in his spine that was done by an out of network provider. Cigna thankfully converted it to in-network.

Blue Cross does not convert out of network hospital charges to in-network. They were our insurance carrier when my husband was first diagnosed with cancer. So even though the hospital in our network, the emergency room doctor was not, so we were charged an additional $785, outside our out-of-pocket max.

When a person is faced with a life threatening illness they shouldn't have to worry about the cost of treatment. In addition, a pharmaceutical company shouldn't be able to charge incredibly high amounts for a drug. 

I encourage you to share this post. In addition, if you have stories of high medical charges and cost share those as well.


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