Insurance Agony

As a cancer survivor, you will at some point begin haggling with your insurance company to get some test or procedure covered. But, what do you do when your insurance company severs ties with your healthcare facility? That is what is happening to me this summer.

Insurance-Related Panic

I am on Social Security Disability and of course, have Medicare as my primary insurance.  But also have a state based Medicaid program as my secondary, called CareSource.  Well, as of September 1^st, CareSource is cutting ties with my healthcare facility.  Insert - PANIC. What do I do now? My medication for immunotherapy costs $40,000. each time I go - twice a month.  Doing the math, that means my 20% is $16,000 A MONTH - not happening.

So what to do when you have ANY type of financial type of issue with your treatments/procedures. CALL YOUR FINANCIAL RESOURCES DEPARTMENT AT THE HEALTHCARE FACILITY! Do not wait. Do not pass go.  Go straight to the financial department, not your doctor's office or their staff. Think of it this way: you are doing them a favor by choosing them for your very expensive healthcare - it is up to them to determine a way to get everything you need covered.  And if that is not possible, every hospital/healthcare facility has financial resources to help you.

Finding Helpful Advice

In my case, I called each doctor's office and informed them that I did not want to switch health teams. I told them I was contacting BOTH financial resources at the hospital and CareSource. I explained my situation, and low and behold, I found out all I needed to do was get a pre-authorization to go to that hospital and anyone and everything I have done there will be covered for 90 days.

Of course, I asked what happens after 90 days, and I was told to just make a note on my calendar to call financial resources approximately 2 weeks before the 90 days end, and they would get another pre-authorization. I really panicked for no reason. I didn't realize it would be this easy,

I'm NOT stating that it would be this easy for everyone but one or two simple phone calls solved my problems. It may be the same for you. Just be proactive and contact your healthcare providers and be persistent.

Remember, we fight for ourselves. We advocate for ourselves. We can do it. For me, it was simpler than I planned, but if it isn't, contact a social worker at your facility. That is their job - to help you maneuver your way through the healthcare system and make your life easier.

Editor’s Note: We are extremely saddened to say that on January 28, 2020, Jennifer Toth passed away. Jennifer was a passionate advocate for the Lung Cancer community. She will be deeply missed.