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Insurance Company Squabbles Cause Stress for Patients


Being unsure of medical coverage can cause cancer patients undue stress, which is very unhealthy.

Medical bills are continual and often lifelong after a cancer diagnosis. Many times, the frequency of visits to hospitals or doctors is greatly diminished as treatment shifts from the active stage into the maintenance stage, but most cancer patients would agree that cancer is quite expensive, and the mounting bills can be a source of anxiety and stress.

For those fortunate enough to have health insurance, the burden of health care is made little lighter, but for those without good insurance, bills for medical care can be exorbitant. Those without any insurance face an even greater problem and are put into the position of struggling to find ways to take care of a bill sometimes before treatment is administered. Worrying about how to pay for treatment and tests isn't something any cancer patient should have to endure, but it seems this is a common, everyday occurrence.

Several weeks ago, I received a voicemail telling me of an impending contract issue between my health insurance provider and the health care facility I use for all of my medical treatments. The message warned if an agreement could not be reached by the end of the month, that all treatments at my hospital and other offices they owned would be considered out of network. I'd heard a little about the contract negotiations on nightly news, but I hadn't paid much attention to it. After receiving the voicemail, I started to realize how I would be impacted and it scared me.

Not long after the voicemails started coming, I received a written document from my insurance company reiterating the information shared in the voicemail. Blue Cross/Blue Shield was being proactive in notifying their patrons about the possibility of upcoming problems. I was grateful for the advanced warning, but very concerned about my health. I'd been seeing the same medical team since diagnosis and I certainly wasn't up for making a change of providers just because of insurance problems.

The insurance/health provider contract deadline came and went with no renewal agreement. This meant I would not be able to attend any appointments at Piedmont Hospital without paying out-of-network fees. To say that I was not happy was an understatement. It was difficult to understand why my insurance company was having such a problem negotiating with the hospital.

The governor of our state, Nathan Deal, was not happy either. Most government employees in Georgia have Blue Cross/Blue Shield insurance. Governor Deal asked the insurance company and hospital to do their best to come to an agreement quickly but to date, nothing has been resolved.

When medical bills arrive in my mailbox, I always review them. It's important to be aware of the charges for service rendered and I check for the amounts paid by the insurance. When I was first diagnosed with cancer, I used to cringe at the cost of some procedures. It was hard to imagine medical care could be so expensive. The first year of treatment came in at just under $88,000 for me. Thankfully, most of that was covered by my insurance after I'd met my deductible. Now, I've gotten used to seeing huge fees. For example, an MRI, in my state, costs about $6,000. My insurance company should pay about 80 percent of that, but if I'm charged out of network fees, that's another matter.

Medical bills cause stress and anxiety for many people but for the person fighting cancer, the stress does much more harm. It not only causes mental anguish, it affects the physical body. Stress has been proven to elevate blood pressure, cause insomnia and nervousness, along with a host of other problems.

So, what do we do when we no longer have faith in our insurance companies to provide the financial assistance we need? How should we feel when we've been religiously paying our premiums for healthcare and all of a sudden, we can no longer count on them for coverage? Shouldn't we get what we pay for?

Being at the mercy of an insurance provider doesn't seem quite fair. As a cancer patient, I know from firsthand experience what it means to have to prove to the insurance company whether a medical treatment is medically necessary. Several times during my first few years of treatment, I've had to submit extra documentation to prove I needed care for prescribed treatment and I had to wait for "permission" from the insurance provider before obtaining care.

How can we help ourselves in situations like this? Should we contact our insurance companies and voice our concerns? Should we talk to the healthcare system and urge them to come to an agreement? Would contacting our congressmen help in any way? I'm not sure what the answer is but we need to find ways to avoid this type of stress.

I am hopeful the insurance company and health care facility will come to an agreement before my next appointment. If not, I guess I'll either be paying out of network fees or rescheduling my appointment.

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