Because, apparently, fighting cancer isn't stress enough...

This morning, day 14 of chemo, one of my to-do's was to address a growing stack of medical bills and contradictory insurance explanation of benefit (EOB) statements. I receive the bills and set them aside until I receive the corresponding EOB from the insurance company to find out what my portion of the bill is. If there is confusion, I call the insurance company. Well, every bill in the stack created confusion because if there was a corresponding EOB they didn't match - either physician name, amount, etc. I knew it would be a challenging task. I called the insurance company first to figure out which of the bills I needed to pay. Verdict...all of them. ;/ I asked the representative why since the EOBs indicated my portion owed was $0 and that my annual deductible and out of pocket maximum was met. She put me on hold and then returned and explained that my out of pocket maximum was not met until 6/24 (by the way, my new year starts 7/1 so that didn't do me much good, did it!? LOL). She had no answer as to why my EOBs dated earlier than that stated that it was met already. ugh. While I had her on the phone I asked her how much of the current year deductible and out of pocket limit had been satisfied (the year beginning 7/1) and she said that the deductible was met already (and that I have another $1500 to go before I meet the out of pocket max)! I was a bit surprised since I have not received a single EOB or physician bill for anything dated after 7/1 yet. I guess the port placement surgery and the first chemo treatment did the trick...but that means that after paying about $1000 of medical bills this morning (my portion of the surgery and pathology in June) did not even include the $500 worth that I haven't been billed for yet for medical treatment received in July. At this rate, I'll meet my $2,000 annual out of pocket maximum (minus copays since I'll have to keep paying those) by September based on planned treatments. Think that's bad enough? Apparently, the insurance company doesn't. I just received a EOB today indicating that I may be on the hook for $3,851 for the cost of my mammogram! I called them to ask what that was all about and I was told: "it's under review for medical necessity". Shall I repeat that? Yeah, I didn't think I needed to. I asked the representative if this was some kind of sick joke and she didn't appreciate that very much and tried to explain to me that because I'm under the age of 39, that makes a diagnostic mammogram an unusual claim. I couldn't help but laugh when I heard that. I reminded her that they already had approved and paid for the double mastectomy and the first round of chemotherapy treatment and asked her if she thought that the mammogram was medically necessary. She didn't have much of an answer for that. Then I asked her why they sent me an EOB stating that the $3,851 was "patient responsibility" if they are supposedly still reviewing and haven't yet decided whether they'll be paying for it. She didn't have an answer for that either. I reminded her that before I went in for the diagnostic mammogram I called and asked if it would be covered and I was told: "if a doctor deems it medically necessary" and I followed it by stating that my doctor ordered it based on my feeling a lump in a self exam and I was told "that sounds medically necessary to me." I asked to speak with someone involved in the decision and was told that claim examiners "don't take calls from customers." Isn't that unbelievable!? The representative then proceeded to try to convince me that it's too early to be upset about this (she actually said that! and I responded something like "if you were me, staring at a $4k bill you probably wouldn't think so") - that they're awaiting supporting medical records from the provider. Again, I had to laugh and then asked them what kind of record might they be looking for - something that says I called my doc and said I felt a lump and the doc said to go get a mammogram? I mean, come on - there's a doctor's order for a diagnostic mammogram and sonogram in the file that was sent to them - what more could they possibly want beyond that and the fact that they KNOW I had breast cancer that required surgery, chemo and additional treatments to come!? Do they actually think I might go get a mammogram, sonogram and biopsy for fun? All of this got me thinking about how awful it would be to not have health insurance at all. I mean, sure it's annoying and still very expensive to be sick WITH insurance. However, for those that don't have insurance, an illness would be financially devastating. I have friends who can't afford health insurance because their employers don't offer it and individual insurance is too expensive for them or because they have a history of health issues that has led insurance companies to deny them policies. It breaks my heart knowing that an accident or illness could ruin them financially because of the way our healthcare system works in this country. The other day we were at the pool with Cooper and we met a neighbor who moved here from Italy a couple years ago. He told us about how his father had two transplants and didn't have to wait nor pay a dime for it, and how his daughter was born in Italy and they paid absolutely nothing for her maternity care and delivery and the mother was on paid leave for nearly a year! My mom, who is a conservative, looked at me and said "if that is what socialized healthcare is then I'm all for it." - I nearly choked. LOL I'm very aware that I am among the lucky and privileged because I work for an outstanding employer that provides excellent benefit options and for that I'm incredibly grateful. I'm more aware now than ever before that most Americans are not as lucky as me in this regard and while I've always believed we need healthcare reform in this country, I believe it now more than ever before. Routine and diagnostic mammograms, for example, shouldn't require a fight with an insurance company when there is a legitimate need for the test. Shortly after my diagnosis of breast cancer, my husband said to me "I see you testifying before congress regarding mammogram coverage/availability for women under 40." and I just laughed and thought about how all my energy needs to be focused on fighting this cancer. But he is right - I can't sit back and watch this happen, knowing it's happening to women (and men) every day. Something needs to be done about it. So, in my spare time, I'll be working on that. ;) Anywho...what's in store for the rest of this week? I start physical therapy tomorrow. Shave my head Wednesday night and donate my hair to Locks of Love. Support group on Thursday. Booby expansion appointment on Friday. I need to squeeze in writing a letter to the head administrator of Northridge Hospital (about that horrific experience I had with the first port placement attempt), and call the breast imaging center to make sure they sent the "records" to the insurance company...and the list goes on (but I won't bore you).