I was first diagnosed with breast cancer back in 2011 at 33 years old. In the fall of 2015, the cancer came back, even after a double mastectomy.
Yes, even without breasts, I got breast cancer.
In the past 6 years, I’ve had numerous surgeries to remove breasts and tumors and tissue and ovaries, to reconstruct my breasts, to place and remove a port in my chest that directly administered the chemotherapeutic drugs. I’ve had pints of cancer-fighting chemicals go through my body doctors referred to as “The Red Devil,” and then some.
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I’ve beat cancer twice, but the trauma of having cancer almost matches the trauma of trying to figure out what to do to pay for it all.
Friday, Dec. 15, is the deadline for signing up for health insurance, and it’s fast approaching. While dealing with health insurance is a pain—I’ve only touched the tip of the iceberg here—life without it, especially as a two-time cancer patient, would be even worse.
Let me be clear: I’ve been fighting hard to preserve the Affordable Care Act this year because without it, my family would be at least $500,000 in debt. While there is much to be improved on with the cost of health care in America, I know that the coverage it provides has saved my life and my livelihood as a small business owner.
Treating cancer is a bit like running a marathon: You plan as much as you can before you begin, you pace yourself and make adjustments as you go, you work your way toward the finish line, and you hope you don’t poop yourself until it’s over. I’m attempting humor here, but the truth is that treating cancer—then dealing with the subsequent pile of bills—is a relatively linear process in that it has a beginning and an end, even when you’re on medication for the rest of your life.
The same cannot be said for dealing with health insurance bills.
For example, the day before my first surgery, my husband called our health insurance company to confirm that they had all that they needed to process and pay for the procedure so that there weren’t any surprises with the bill. The response? “The surgeon is in-network, so you should be fine—but just hope that they use an in-network anesthesiologist or you’re going to pay a fortune. You should be able to call the hospital and find out but I’m not sure.” He did call, but the shift rotations were posted until the morning of the surgery so we either had to make shift request changes at 5 a.m. as we were driving to the hospital or cross our fingers (which we opted for, and thankfully the anesthesiologist was in-network).
Between chemo and surgery and radiation and follow-up visits, I would periodically ask what I owed. I’d get emails from my oncologist’s main billing department telling me one amount and when I’d call my oncologist’s office, their amounts were different.
Keeping my bills straight was practically a full-time job, and I had one of those, along with an 18-month-old daughter who never seemed to sleep. And oh, I was in the middle of fighting cancer.
In September 2017, we were enjoying our less exciting post-cancer-patient life when I got a statement from a billing/collections agency telling me that I owe for my treatments from early 2016.
That was odd, since my oncologist’s office had just told me that we were at a $0 balance the month prior.
I was confused. I thought that I had paid for everything that was asked of me, and I had statements totaling over $1000 to prove it. When I called my health insurance, I was told that a new contract had been negotiated so the rates for my 2016 treatments had changed; now I owed more money.
This made no sense to me. It was like getting a call from a restaurant asking for more money for the steak you ate… from two years ago. More calls from the collections agency came and more bills started showing up in collections. This time I was told that my claims had been reprocessed repeatedly; in some cases, the company did this up to 5 times for one line item.
I tried to go over each line item with them but our health insurance’s dollar amounts and the amounts that were in collections didn’t match. “It’s close enough,” their rep told me.
In a final, Kafka-esque twist, I had a printout from my health insurance that stated clearly that I had fully met my $2000 deductible in 2016 and paid $5351.09 of my $5500 max out-of-pocket as of June 24, 2017, so if I owed anything it would have only been $148.91—except my health insurance records didn’t (and still don’t) show this, nor do they have immediate access to that information (I’m still waiting on my complete explanation of benefits from them for 2016).
Long story short, I honestly have no idea what I owe, if I even owe anything in the first place, and if so who I owe this money to, but apparently I’ve got to pay something to somebody or else ruin my credit—and how is this is even more stressful and confusing than having cancer?
I could go on and on about the hours spent on the phone, scanning records (because having digital copies of these files is apparently a luxury), and trying to get a straight answer from my health insurance but I’ll spare you the rest of the details. I will say this though: Something is very wrong with our health care system.
If I was anyone else—someone who worked multiple jobs to make ends meet and didn’t have the time or wherewithal to pick up the phone during business hours, or someone who couldn’t comprehend how to question or fight this, or someone who couldn’t come close to paying this amount, or someone with mental health issues or who was elderly and didn’t have an advocate—I might have just paid what was presented to me (again!), or ignored it. It’s easy for the insurance companies to do what they want and take what they want, hoping that most Americans won’t have the wherewithal to fight it.
If there was legislation to help reduce the costs of actual health care, like regulating the costs of surgery and treatment and drugs, then maybe the costs that insurance companies have to shoulder wouldn’t be so high. Or maybe we need legislation to help regulate the billing process to simplify the way we pay for treatment so that you wouldn’t have to scrutinize over a mountain of bills (the stack of bills I have just from 2016 stands about 3 inches tall) in order to ensure that we’re not being overcharged once, twice, or even three times.
But here’s the thing: Despite the fact that I’ve spent hours on the phone fighting these charges and there’s seemingly no end in sight, we enrolled for 2018 coverage through the marketplace. As a two-time younger breast cancer patient, I know how a life-threatening illness can come from nowhere. My family would prefer ponying up over $15,000 a year in premiums—and the $15,000 in deductibles we’d have to hit before we didn’t owe anything further—than gamble with what’s around the corner when it comes to our our health and the care we’d receive.
And for now, I’m taking another gamble with my credit to take a stand, as I hold my breath and continue to brace myself for the next statement.
