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Yup - I'm still among the livin' - barely...

Haven't been on for a long, long time.. All it would be is me posting about my days of misery so I thought I'd spare everyone the agony of listening to it.. I dunno, feel like chattering today for some reason, I guess it gets kind of lonely after so long just dealing with everything solo.
I been on this chemo type drug for the TB thing for over 2 months now, have lost 40 pounds (which i am NOT happy about) losing all my finest ASSets! Did the IV treatment for the RA (1/2 a dose) and will get a full dose next week. I do not know how people without insurance afford it - I can't and I have excellent insurance! The Actemra IVs are 3,600 a month (just for the medicine) and my cut is till 721 a month. Wonder why I haven't taken a medical and continue to drag my miserable body in here everyday??? That is just the tip of it. I have a stack of medical bills 4 inches high that I have not even had the energy to open. Every one of them are from different doctors or for different procedures or blood work, and my cut is always at least 1 - 2 hundred on each one. I have filled out some paperwork to see if the hospital will let me off the hook on that bill, around 4 grand - hell I can't pay it. My insurance paid almost 24,000 and I still owe that much. It floors me how much doctors charge. Everyone thinks it's the insurance companies - it isn't - it's the doctors. Think about it - it is the ONLY place you go or deal with that you don't ask for an upfront price and shop around. I also happen to know a few other things. In talking to my PM doc, we got on the subject and I said, well my urine test was charged to insurance for 1200, and they paid over 800 and I still owe 400. She said well, if you call they will knock it down to 50 and I think that's fair cuz that is what we charge our patients that have NO insurance. I said you think that is fair? Well yes she said - you both end up paying the same price. I said, except for the fact that I pay 1200 a month FOR health insurance and they pay that same company an additional 800 dollars, and uninsured pay 50 total? No I don't think that's fair at all. Hmmm she said, I never thought of it that way... I'm sure.. So she bills my insurance around 300 every month office visit - which since they are a preferred provider - my insurnace pays 100 percent of, however uninsured pay 75 a visit each month - thats it. Nah, I don't think it's fair at all. I was in line at the pharmacy to get some additional pain meds last night and to refill my chemo drug, paid a little over 100 for both (had two infected back teeth pulled out yesterday) anyway, the peeps in front of me had at least 10 prescriptions that totalled over 900, and their cut was 15 bucks because they had their state medical card. Unbelievable. I am dragging my ass into work feeling like shit to pay their way - ya I'm loving that... I doubt either of them ever worked a day in their life and i have no doubt I'm paying their rent and utilities as well. Anyway, life has been pretty lousy for me. I finally got on anti-nausea medicine that has helped some but still have no appetite to speak of. I used to enjoy cooking, well I still do but can barely gag down a bite. I don't know what I'm gonna do with myself. Everything just sucks. Everything hurts, everything makes me so tired, life is one big downer. I wish I could snap my fingers and go back to where I was 3 months ago and I was whining then! I guess I had no idea how much worse it could really be...


  • MsHumptyDumptyMMsHumptyDumpty Posts: 1,567
    edited 06/14/2012 - 6:13 PM
    Oh Mouse!!!!!!!!! :hug: I am SO SO sorry life is so rough for you right now. I sent you a few emails here and there but did not hear back from you and I did not see you around here, so was starting to wonder if something was wrong.

    I hear you on the ins, drs, medical services & $$$. After my last car accident I went to my massage therapist who charges me 40.00 and he had me sign a paper for car ins co for 120 each appt. I said "why" he said "cause they will pay it". I was really Pi@@ed! I had 5,000 t spend of it and planned to get a LOT of deep tissues massages at 40.00 a clip, but with PT, Dr appts and 120.00 massages the 5,000 went FAST! :(

    Are you still able to take care of your horse?

    Even with all this health stuff going on your but head boss won't let you work from home?! Tell him your TB is catchy ;)

    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • dilaurodilauro ConnecticutPosts: 9,837
    Its good to hear from you, but not to hear about your recent situation.
    I do hope things turn around for you and brighter days will be ahead
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Indeed it is pricey but at the same time, I don't want to switch to socialized medicine b/c they I'll have very few options to control my own destiny.

    Yes, I learned with my 1st surgery that everything is negotiable. I went with an out-of-network doctor and told them I couldn't afford it so had to go back in network. Low and behold, they said 'wait'...we can work with you. Really?

    Ahhh, but yes, up front price would be great. I find it hysterical that hospitals charge $15 for a dose of tylenol. I could buy 50 doses for that price. I also think the worst part is the piece meal billing and the insurance 'legal' bundling rules. Those bills you have stacked up...I guarantee you are being overbilled b/c of wrong billing codes. The insurance company denies them b/c the charges should have been bundled under a different code, but then the medical provider doesn't understand so they just say "oh, insurance company didn't cover it so I'll bill patient". It is a full time job managing medical bills for yourself and family.

    I have one from my 2 months of PT that they still keep sending me as overdue. B/c I screwed up the 2nd one, I did the math and realize they actually ow me $160 but they are SO slow at processing the check they already cashed (I check bank statements) that they are telling me I have late payments and own them another $200. And, I'm not still getting treatment so I know how crazy it is to think someone dealing with medical issues can focus on the crazy insurance/billing scam that is going on.

    I do hope things turn around for you. Good to hear an update from you.
  • Hi Marion!!!! I have missed hearing from you. I hate hearing how horrible of a time you are having :-( Being nauseous is awful. Ugh...

    Take care of yourself and email me any time you feel up to it. I am not taking classes this summer so I am a lot better about keeping up with emails :-).
  • The "New" Mouse:

    I have missed your posts. In fact, my blood pressure was dropping because of it.

    Hate to hear of your current situation. This natural aging process sucks. In fact, some times life sucks all the way around, but much moreso in your situation.

    From a male point of view, the loss of weight in the "important" areas is a real concern. We won't have as much to look at!, so try to eat as much as you can! Hell, if I lost 40 pounds I would be downgraded to the bantum category and a gust of wind would take me out of action.

    Hang tough, as you know well how to do. All of us are in this walk of life together, but we all plod a different path. Thinking of you.

  • I'm sorry to hear about the mounting medical bills. Doesn't your insurance have an out of pocket maximum? Mine pays everything (except meds) after a certain amount each year, and I hope I never reach that, but it's nice to know that if something catastrophic were to happen, I'd stop bleeding at a certain point. I hope you have some luck in getting the bills cut down.
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    Good to see you post. But you medical costs are unbelievable!.............NO JUSTICE!!!
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • jlrfryejjlrfrye ohioPosts: 1,110
    If your insurance company paid the 24,000 and you still owe that much something is wrong, ask for a audit. It doesnt sound like the proper adjustments have been taken or there are procedures that were billed that have not been paid for. If your insurance was in network with the hospital something is wrong! The procedures that were not paid for may just need a proper diagnosis to get paid. I am going to go on the defensive for the doctors and what they charge. The doctors hands are tied when they are a provider of a insurance company. Example, my docs charge 94.00 per office visit, the allowed amount with the insurance company is 53.15 the rest is a write off, legally the docs cannot bill the patient. If a patient comes into the practice where i work and has no insurance we charge them insurance allowable. Yes it is unfair because those of us that work pay into premiums every month and in the end pay more but with the economy and people with pre-exisiting conditions many people would not get proper medical care if the docs did not give discounts and make their healthcare more affordable.Is it fair to those of us that work and pay out the "you know what" for healthcare nope!!! We have our system to thank for that not the docs. Now on the other hand what the hospitals charge I agree is out of control. The 15 we pay for a tylenol is due to the pharmacist that dispenses the meds has to be paid along with the nurse who give you the meds has to be paid. Am i saying they are overpaid, absolutely not! Now if we look at the salaries of the CEOs that run the hospitals they are being overpaid. Thats a whole different story! I am sorry you are having such a rough time right now and all the issues with the medical bills cant be helping any, Im sure it is adding extra stress which we all know can make our pain worse. I work everyday fighting insurance companies for our patients to get unpaid claims paid so if you need any help please PM me Ill be more then happy to help you in any way I can. I hope you feel better soon!
    Also the pharmaceuticals company that makes your ACtemra offers a discount of up to 4000 per 12 calender months. here is the number 1-888-MY-ACTEMRA (1-888-692-2836). There is no financial qualifications to meet for this from what I have read, it seems this is available for all patients who use this drug
  • Your right 4 grand! That takes me thru 5 months of treatment anyway then hopefully I can figure something else out. Thank you so much for that info - I have it in hand and ready to rumble - that will help so much! Thats 721 I dont' have to pay each month for 5 months! hallelujiah! I have been up and down day to day. One day I am considering the bullet (seriously), the next the kids are over and playing on the deck and in the pool and I think, now I would have missed this if I werent here. It's been rought -= up and down. Sometimes I just wish I had someone to do it or some of it. I do everything solo, take care of all the GD bills, call the doctors, hospital, all the bullshit. Drive the 20 miles and sit for an hour to get the IV, feel achy, feel my bone marrow screeching the entire drive home. I don't know - this life is just biting right now. I really want to move to South Carolina - on my own. BY THE BEACH! I have been looking at places there on-line. Anybody live there? I wanna take me, my horse, and my pup - that's it. Leave the house, the bills and the bullshit behind.!
  • I messed up that first post, Insurance paid 80 percent. I still owe a lot tho. They have a 5,000 per member out of pocket, then they pay 80 percent, the other 20 is mine to deal with. Sorry about that..
  • Your so yummy to chatter with - how come you don't email me anymore? I always enjoy your smartassness - and I kinda miss it. I was kinda getting to know you just chatting.
  • I haven't gotten an e-mail from you lately either. I know you aren't feeling too great either tho - sorry for that buddy. This shit just bites sometimes doesn't it! It gets very, very, old, and it CAN get worse. That is the really shitty part of it all - it can get worse. UGH! Take care Jim!
  • I wonder what happened - I didn't get your emails buddy. Everything that comes to me is encrypted so it would have came in as such. I got nothing.. Wierd. Anyway, yes I still take care of Blitz, I cant not take care of him!!
  • I have missed chattering with you too. I know everyone either feels like crap, or is busy with the wonderful summer. I wish it would last forever! HOT is soooo much better than cold and snow!!!
  • dilaurodilauro ConnecticutPosts: 9,837
    and I am sure you will figure things out... Most importantly, how are you feeling? And secondly, I am glad to see you back posting. I love your emails, but seeing you post here is something extra.
    Take care
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Cath111CCath111 Posts: 3,702
    edited 06/23/2012 - 3:20 AM
    I really can't begin to imagine what you're going through, but my thoughts are with you. Somehow, these things have a way of working themselves out, but you have so much crud to deal with I can imagine the thought of moving is very tempting.

    It's good to see you posting again (I've been on hiatus myself) and it's nice remembering how helpful and supportive everyone is on here. I know almost all of us take breaks from being on here for a while, but we always come back...we just need the understanding, caring, help and support that we find here. I'm so glad that Susan could help you so much. That's what it's all about.

    Nice to see you again, but sorry you're going through so much. I'm thinking of you.

  • MsHumptyDumptyMMsHumptyDumpty Posts: 1,567
    edited 06/23/2012 - 5:28 PM
    I sure hope you turn the corner of life soon my friend :hug:
    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • firewater1981ffirewater1981 Posts: 84
    edited 06/27/2012 - 8:08 AM
    Ah Marion, my heart does go out to you. You have been through so much! I am so proud of how far you have come! You have endured more than most would accept. My hope and prayer is that you learn the lessons you need to learn in this life and be done with it as soon as possible. In the meantime, my hope is that you find something to take the edge off and make things more tolerable. That you are able to endure each day just as you have for so long. It may not seem like it at times but there are people and forces both seen and unseen that support you and support each one of us.You are loved immeasurably and you mean so much too so many people. Hang in there. Every day you are closer to this being over then the day before. One day at a time, in our pain sometimes we do not realize how for we have come or how close we actually are to the finish line.
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