Monday, April 9, 2012

Insurance=my nemesis

There are only a few things in life that I can actually associate the feeling "hate" with. Health insurance is one of them though. I know that I'm not alone on that one.

I'm sure that there so many people that have life-threatening conditions and are insured, yet their insurance denies appropriate treatments for various reasons, even when their physician goes to bat for them and appeals it. I have seen this with a few friends, and it aggravates me to no end. One cannot help to think when this happens and the outcome is death, if it could've been avoided given their insurance company would've cooperated and approved the necessary treatments. Because really, who has a spare couple hundred thousand dollars (or more) to spare out of their own pocket for these astronomical medical expenses?

Just my treatment of Yervoy every 3 months costs nearly $50,000. For a small bag of "saline" (nicknamed "liquid gold") that takes only 90 minutes to infuse into my veins. Unbelieveable. I'm just grateful that my insurance continues to pay for it. Maybe they figure the alternative could be more expensive if the cancer returned.

In March when I was in SF for my last treatment, my doctor decided he wanted to do radiation to get rid of that last little nodule in my lung that isn't active anymore. Just as an insurance policy. I appreciate that he's thinking ahead because he knows melanoma---he knows that more likely than not, it will return, and that nodule is the most likely place for it to return. I thought his plan was smart Plus, it makes me uneasy just knowing that I have that spot left still. Every 3 months when it comes time for scans, my mind goes to, "What if that tumor is active again?", or "What if it has grown and spread?" I'm sure I would have more peace of mind if that little buggor was gone. Sure, it doesn't mean that I'm out of the woods, it just means we are being aggressive and cautious.

So....we were set to do radiation a couple weeks after that last visit in March. Well, low and behold, my insurance company decided to deny it. They said it "wasn't medically necessary". You know what I say? Obviously they don't know anything about melanoma! It's not like I'm N.E.D. yet. I might not have any active cancer cells that are visible on the scans, but the fact is, I still have evidence of disease!

Anyways, we are in the process of appealing it. If I know my doctor at all though, I know that it will get approved because the man just seems to get it done. In the meantime, I'm praying it works out and if it doesn't, than I guess I just have to have faith that it wasn't meant to be and things will still be ok.

That's just what we have to do. Have faith.

No comments: