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Fri Dec 7, 2018, 09:07 AM

My chemo

I've been waiting to have my chemo scheduled, and I got the call last night. They've been holding off until they could get hold of me to make sure I would pay the $1000-plus copay for each treatment. Jesus christ--over a thousand dollars copay. Each. My husband called the insurance company, and they told him not to pay until they review what was ordered, but what the hell am I supposed to do? I've had such an upbeat attitude, even after learning I have triple-negative cancer, one which is likely to recur and which has a lower survival rate than other cancers, and the fact is we can afford to pay this, but it has for some reason totally taken the wind out of my sails, and I just want to curl up and cry--not die, cry--I just want this over with.

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Arrow 7 replies Author Time Post
Reply My chemo (Original post)
cyclonefence Friday OP
safeinOhio Friday #1
gademocrat7 Friday #2
Jarqui Friday #3
still_one Friday #4
cyclonefence Friday #5
still_one Friday #6
alfredo Friday #7

Response to cyclonefence (Original post)

Fri Dec 7, 2018, 09:12 AM

1. I wish you all of the luck in the world.

DU will be pulling for you.

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Response to cyclonefence (Original post)

Fri Dec 7, 2018, 09:15 AM

2. Stay strong.

We are with you in this journey.

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Response to cyclonefence (Original post)

Fri Dec 7, 2018, 09:15 AM

3. I am so sorry you are being put through this

It is brutal. So screw them.

Let your husband deal with them.

You focus on you. Try to forget about it and do something you would really like to do today to help take your mind off it.

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Response to cyclonefence (Original post)

Fri Dec 7, 2018, 10:04 AM

4. The insurance company is telling you not to pay until they review what was ordered, and the

treatment center is saying they won't begin treatment until you pay this high co-payment, is aggravation you do NOT need with all you are going through.

I assume the insurance review of the order is to determine the co-payment amount.

For some treatments or drugs insurance companies want a pre-authorization, to affirm why it is necessary verses other treatment protocols.

If the delay is a few days that is one thing, but if it drags out for months before you get a decision that is an entirely different matter.

Regardless, your oncologist ordered this because he or she, from their experience knows this is the best treatment for what you have.


In other words, one way or another, you are going to need this protocol. If the insurance company cannot make a decision on this in an expedited manner, you will have to make the decision to bite the bullet, pay the high co-payment, and then fight for reimbursement from the insurance company or facility administrating the treatments, while waiting for the insurance decision to come through.

You don't need this on top of what you are going through, but the hard truth is you will need to fight this on both fronts.

What are the risks waiting for the insurance company to get back to you?

Regardless what the insurance company says, you need to get the treatments. That is what your physician recommended. If the insurance company cannot give you an answer how long it will take for them to render a decision on the co-payment, and for one reason or another you determine that the risk isn't worth it, start having the treatments done, and fight for reimburment later.

The important thing is getting rid of the cancer.

Sorry what you are going through, but this is about you and your family, and that is what you are fighting for.






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Response to still_one (Reply #4)

Fri Dec 7, 2018, 10:21 AM

5. Thank you

You have articulated what I am blubbering through right now. I think my distress is mainly having to have this extra burden--on top of everything else, I'm supposed to be an educated consumer?

I will definitely be having the treatment. As I said, we do have the money, but now my husband is making noises about calling around for a better price! He should work for Consumer Reports! And he is feeling terrible because he keeps saying that it sounds like he is weighing how much my life is worth, which he isn't.

Burdens, burdens, burdens. My severely disabled daughter lived with us until she was 27 years old, and our life was totally dictated by her needs--no vacations, no entertainment of friends, the whole shebang. She is now living happily with 24-hour attendants, and we have been enjoying our freedom like lifers suddenly having our sentences overturned. Hubris, I guess.

Anyway, thanks for the supportive words.

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Response to cyclonefence (Reply #5)

Fri Dec 7, 2018, 10:24 AM

6. You are not blubbering, you are quite articulate, and it is not right what you have to put up with

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Response to cyclonefence (Original post)

Fri Dec 7, 2018, 04:03 PM

7. Hang tough.

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