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High Deductibles Affect Treatment Choices
July 25, 2018 – Bonnie Annis
How Cancer Has Taught Me to Just Say No
July 24, 2018 – Justin Birckbichler

High Deductibles Affect Treatment Choices

The increase in health insurance deductibles has affected health care for many cancer patients. These changes contribute to unnecessary stress in the lives of some affected by breast cancer. Read one survivor's viewpoint.
PUBLISHED July 25, 2018
Bonnie Annis is a breast cancer survivor, diagnosed in 2014 with stage 2b invasive ductal carcinoma with metastasis to the lymph nodes. She is an avid photographer, freelance writer/blogger, wife, mother and grandmother.

Right after Donald Trump took over the presidency, I noticed changes to my insurance policy. Premiums were higher, deductibles were higher, and coverage had decreased. These changes affected the lower- and middle-class people in profound ways and exacerbated the already strained pocketbooks of those with pre-existing health problems.

As a person affected by cancer, these changes were not beneficial to me. Not only had my health care coverage changed, my deductible had been increased by about $500 annually. This increase has caused a problem with my health care and now I find myself in the position of having to choose which appointments I need to keep and which ones I must cancel.

Already saddled with a host of medical bills, it seems unfair to be put into this position. In order to receive the best medical care possible, a cancer survivor needs ongoing and continued care. This involves multiple visits to the oncologist each year and often requires many tests and procedures outside of the patient's control.

Not only have the increased deductibles caused me to rethink which appointments are vital and which are not, I've also had to wait on necessary medical equipment. This has caused mental stress and frustration for me.

Annually, my insurance benefits allow me to receive four pair of compression sleeves for lymphedema control and biannually, I'm allowed a new pair of breast prostheses. But with the higher deductibles, I'm finding it necessary to wait for these items until the end of the year. This way, I can make sure my deductible has been met and will only need to pay my out-of-pocket fees of 20 percent.

While I'm extremely grateful to have health insurance, the changes make it difficult. Cancer has prevented me from working a full-time job as I had done in the past. Paying for ongoing medical bills with only one income is challenging.

Some hospitals and medical facilities offer financial assistance for those going through cancer treatment, but most of those funds are provided to people without health insurance or to those who meet a specific income requirement.

So, what's a person to do? Is it fair to be put into the position of having to choose which treatments or procedures are affordable? And, if recommended courses of treatment are not received, how does the patient explain the problem to his or her doctor?

I ran into this problem recently when my oncologist recommended a chiropractor and an acupuncturist for severe spinal pain. Along with those treatments, he'd ordered several weeks of physical therapy. When the time came for the sessions to begin, I was forced to cancel because insurance deductibles weren't met, and I was unable to afford the care out of pocket. Being unable to receive the treatment I needed, I was forced to live with pain that could have been treated.

It's frustrating to have financial issues dictate the quality of healthcare but often, those affected by cancer are finding themselves in this position. Doctors and medical facilities are also affected by the health care increases and must submit exorbitant charges to the insurance companies for services rendered in hopes they'll receive the actual cost of their services. For example, on a recent bill from my doctor, I noticed the fee submitted to the insurance company for the office visit was almost $600! The insurance company's allowable fee for an office visit is more than likely only a fraction of that amount, but in order for the doctor to receive his typical office fee, the fee submitted must be inflated.

The whole thing is a debacle. Those receiving care for cancer need ongoing treatments, even if their active care has shifted into maintenance care. Doctors and treatment facilities deserve to be paid properly for services rendered. The American public deserves to have affordable health care insurance with affordable deductibles but with the rising cost of healthcare, it seems our benefits will continue to decrease, and our out of pocket expenses will only increase.

Until something changes, I'll be forced to reconsider recommended tests and treatment while delaying some of them until health insurance deductibles have been met. It's a very unfair and vicious cycle but it is what it is and there doesn't seem to be anything we can do about it.

 

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