feeling a little overwhelmed with no insurance

[timbuk1]

hey everyone. i was diagnosed with tc on july 27. have been through the barrage of ct scans blood test, x rays, orchiectomy etc. i am scheduled for an RPLND on october 26 at the university of michigan.

The one thing about this whole experience is that most everyone i have seen seems more concerned with what insurance they should bill than they are about how i am doing. it took several calls to my urologist to get someone to return my call about a question i had, but it only took them ten minutes to call me back to ask about insurance after they scheduled my surgery.

I dont have medical insurance, I do work hard at my job and try to make ends meet. I dont own a home, or have a 401k. as far as assets go, i have none. I pay child support for 2 children and am not behind in payments. my expendable income after my child support and bills are paid are very minimal.

I have applied for and been denied medicaid. i have an application in front of me right now from the u of m for assistance, but feel it is a futile effort.

It seems as if everyone is very understanding; but when it comes down to it, the bottom line is everyone wants their money. I understand that they are not doing charity work.

I am gonna whip this cancer **** no problem, but i feel like the financial situation is going to be a lot harder of a battle.

anyhow i am open to suggestions, seems to be a lot of info out there, not sure where to start, thats what this forum is for i guess.

thanks

Tim

[Scott]

Hey, Tim, I'd start by seeing what resources LIVESTRONG SurvivorCare can connect you with: http://livestrong.org/Get-Help/Get-One-On-One-Support

[Paul54]

Tim,
If I were you, I would hold off on the RPLND. Aside from the insurance problems, my reasoning is:

1. IU was leaning toward RPLND, and if they thought it truly necessary they would have said so in stronger language.

2. From reading your posts, your scans and markers are good. Correct? With 5 types of cancer, chances are that anything floating around would elevate markers.

3. If your local doctors are surgeons, note that they always lean toward surgery because it's what they know and do.

4. RPLND's are done much less frequently in Europe and the long-term survival rate from TC is identical to the US.

5. If they find anything in the lymph node pathology, you would likely need chemo anyway.

Note that I have some baggage when it comes to surgery as a cure-all. My mother was one of millions of women on the Great Hysterectomyy Conveyor Belt (as she calls it) in the 1960's and '70's. A retrospective study concluded that something like 75% were totally unnecessarily. Bad enough, but we watched her suffer with complications for 25 years.

Strangely enough, if you did relapse and then the situation was considered life-threatening, someone would have to treat you regardless of your ability to pay. Moreso when universal healthcare kicks in.

This is such an incredibly difficult situation and my heart goes out to everyone who has to make it. As I said, if I were faced with the same situation, I would hold off.

[timbuk1]

how can i afford all the follow up with surveillance?

heres the kicker though, if i go the surveillance route i think that will be more expensive in the long run. I believe my oncologist dr. smith told me that they would recommend monthly blood test and bi monthly ct scans for the first year. how could i have those done, when they are considered a preventative type of treatment? I Feel that if it is up to me to foot the bill for all of that there is no way i would have it done. my blood test on the 17th of september did show normalized markers. they told me that with the angiolymphatic invasion and embryonal carcinoma being 40% there was a 50% chance there was cancer present in my lymph nodes

I understand that in europe they don't lean towards the RPLND. Again the whole insurance and cost effectiveness thing comes into play. not really sure and guess i never will know if i am having the right thing done. In the end cancer treatment is still a business investment. trust me when i got denied medicaid i was about ready to say screw it and not have anything done, but better judgement won.

bottom line is I have had enough of the unknown and feel that with the RPLND i can put this behind me and not have to worry about it coming back quite as much. there is still the chance of it coming back after rplnd, i understand.

enough second guessing, time to make a decision and go with it.

p.s. never believed in the whole bankruptcy thing, but in my situation it might not be a bad route?


Tim

[Paul54]

Tim,
You make some good points. I don't know how much an RPLND costs but maybe others can tell you. You are going to be on surveillance after an RPLND anyway, albeit at a reduced frequency. I suspect you can get a ton of surveillance for the cost of one surgery.

The other thing is that surveillance scans and tests can be shopped around. You might find centers that would charge you the approximate amount they would net after discounts they would normally accept from insurance companies. The difference is huge. Labs and imaging centers make money keeping the staff and equipment fully booked. I doubt you would have any luck negotiating the cost of an RPLND.

I don't advise bankruptcy, but you wouldn't be the first. I read recently that 75% of all personal bankruptcies are due to medical costs. Most people might guess mortages gone bad. Nope. Medical.

"...not have to worry about it coming back quite as much." That really is a personal choice.

P-

[timbuk1]

medical extortion

well as I have posted earlier i have made my decision to have an RPLND scheduled for the 26th of this month. it is to be done at the university of michigan, which is about a 5 hour drive from where i live. I had my pre op appointment scheduled with my local dr. to save a 5 hour trip. got a call from the dr. office today asking me to call them back because they didn't have my insurance information. after explaining to them for the umteenth time that i didn't have insurance they told me that full payment was expected or they couldnt see me. this is the same b s my urologist office pulled before my orchiectomy. i informed them that i have about 20 dollars to live on till next payday, and short of taking up bank robbery there wasnt any way i could pay them right now. they suggested i have the pre op done at the hospital. the lady i talked to said she would have to talk to her supervisor on monday and in the mean time they will have to reschedule. im kinda at my wits end with all this.

I did contact the livestrong foundation, but amazingly someone got me on the mailing list to receive e mail about all the activities but nobody contacted me about helping me other than to say someone would. i have got ahold of them since then and am working on it, but nothing at this time.

please nobody try and talk me out of getting the RPLND, thats why i started this thread on the insurance forum.

Tim

[Scott]

Have you already been in contact with the Michigan Department of Community Health to see if they can offer any help?

[timbuk1]

Been there done that

Apparently if you are pregnant or a woman with children you get everything covered. I was denied. The fact that I pay child support for two children doesn't seem to matter much because I don't claim them as dependants. ( i did consider offering to show them my blood test results to show them that i was pregnant)

[Bryan'sPrincess]

Same boat, broke and in need of treatment...

Im sorry to see someone else face the struggles we are.... My fiance' is the patient and I am here with him everyday trying to figure it all out and hold his hand. Ok so medicaid denied you.... Appeal it.. they always denie first time... and as you said your not female with babydaddy drama..... We had a difficult time getting assistance too, we dont have children and now may never..... If you are able to continue working you wont qualify for SSDI... if you are unable to continue working you may qualify for SSDI which automaticly quailifies you for medicaid and food assistance. In the mean time.... contact the american cancer society, cancer treatment center ( they wont treat you but they do offer financial assistance for treatment and meds and rent and other bills,) Also contact the livestrong like earlier post.... and then grab a phone book.. call your local churches, DHS offices, any missionaries. Take a trip tp the local hospital and ask to speak with a "patient advocate" they specialise in helping people get connected with groups and organizations that help patients without insurance... they may also set you up with a free socail worker... and please, even though it is easier said than done, accept all help offered and given. It is easy to let pride get in the way, asking for help is not a pride kick, it is a realization that there is help for those that ask and are in need. Dont struggle with the things that can be simplified, your health will improve faster when you allow the help, I promise, I'm living it now. Also ask around, here in Oklahoma if we dial "211" from any cell phone we are connected with what is called a help line and they give info on where to go for help with bils, food, clothing, medications, other financial struggles, and discount clinics.
Good Luck to you..... Im here if you have questions are need to chat, get well, Jennfier

[timbuk1]

just had to vent

thanks for the advice jennifer. sorry to hear about your situation. as far as denying the medicaid, im not sure if there is much i can do about that, I've been denied a couple times now, and the reasoning they give me is not that I dont meet the requirements, its that they just wont give it to ME. very frustrating. It was pretty obvious from the get go that they wouldn't give it to me and of course they waited till the last day they had to send me the denial notice. they always seem to leave me those voice mails on a friday afternoon, so i have all weekend to stew over it. what really is a kick is when the doctors offices tell you they require full payment at time of service when they know there is no way you can pay. I kinda feel like someone is holding a gun to my head saying, pay up or else. Im not the greatest at dealing with jumping through hoops....

thanks everyone,

Tim