We have health insurance through Du's job. We used to pay less in premiums when I also was working at the University, since they doubled the employer's contribution, we basically paid nothing for our health insurance. But then I retired. Now we pay a few hundred dollars a month for health insurance--I still consider it very reasonable. I remembering asking Du before I took the plunge to retire, "Are you going to get sick?" "No," he assured me. Then a month after I retired, he was in the hospital and ultimately diagnosed with Stage 4 Prostate Cancer.
This is such bad news in so many ways. Of course the death sentence involved with this diagnosis is devastating. I can't imagine my life without him. I can't imagine my life without him still feeling strong and pretty good most of the time, as he is now. I can't imagine a time when we can't go places together, as we did this weekend, traveling to Kansas City for a Royal's baseball game. It really scares me to think of him growing sick and weaker. No...it terrifies me.
Du at the Royals' Hall of Fame in Kaufman Stadium, in front of the display honoring George Brett's 3,000th hit.
And to add to all this worry, is that darned health insurance. When he can no longer work, we will not have health insurance. When you are faced with a health crisis like this, you shouldn't have to worry about money, but that is a huge fact of life in this country, with the horrible mess our health care system is in. I don't even think it's fixable. So all I can do is hope. I hope he stays well for a long time and can keep working. He will be 65 in a little over four years....if he can work until then, he can get Medicare. I hope when he gets worse, breaks a hip or something, that his job will allow him to continue to work, perhaps from a wheelchair, doing the paperwork that is part of his job as Pressroom Manager. I'm afraid bankruptcy is in our future if we lose that health insurance, because there is no way anyone, except maybe Angelina Jolie, could afford the bills we have been getting. When I see the original charge, and then the percentage the insurance pays, and then ultimately, what we owe (which at this point, is literally nothing, since we met our $2,000 stop loss limit), I am astounded.
His hospital bill for four days in February was well over $25,000. The scans in March were $5,000/each, and he had two, and will need more to check to see how the cancer is responding to his treatment. We traveled to the Cancer Treatment Center of America (CTCA) in April, and spent four days, investigating possible treatment there, the bill just arrived for that. It was over $30,000. Of course the insurance got them to cut it back to around $22,000, of which we owe $120. Now $120 sounds like nothing in comparison, and it is. We can afford it, but I wondered what charge it was on that bill from CTCA that the insurance company did not cover.
So I called the insurance company Friday. She was very friendly, and checked on it for me. The University is actually self-insured, but pays Blue Cross/Blue Shield to administer the plan. Of course, the University gets to set all sorts of restrictive limits on what they will cover...and they take full advantage of that power. They cover nothing having to do with treatment of obesity or its related problems, which is very short-sighted, but how do you fight a policy like that?
It turns out we met with a nutritionist twice at CTCA, and the cost was $60/each visit. As far as the insurance lady could tell, that was the $120 charge that the insurance did not cover. Now it is a well-known fact that not only can diet increase your chances of getting cancer (I regret all those years of high-fat foods and red meats in our diet), but we have also discovered that a good diet now will increase Du's longevity and we are doing everything we can to eat right: No processed meats, lots of fish and chicken, Brazil nuts and pomegranate juice, all of which have been shown to be effective in the fight against prostate cancer. We learned about all of this through the nutrition counseling we had at CTCA. But because the University does not cover "nutrition education" we have to pay that charge out of our pockets.
I may do some more research and file a protest about this--just on matter of principal. The University "says" they promote healthy habits in their employees, but they do little to support that monetarily. When I used to walk on my breaks at work, I felt like a criminal for leaving my desk, for even 20 minutes, although I always considered it was my break time, since I never took a break normally. There is little support for exercise plans, or memberships in health clubs and/or weight-loss groups. And now they refuse to pay for nutritional counseling in cancer patients. Seems like a slap in the face to me.
I have read other blogs, where weight loss coverage from insurance, helped a person get off various drugs, and obviously avoid a multitude of obesity-related problems in the future, ultimately saving the insurance companies a bundle of money. Yet the University refuses to recognize this possibility--that they might save money in the long run if they helped people get control of their weight. I, myself, am off of four of the five prescription drugs I took for high blood pressure. I was also headed for diabetes and high cholesterol problems at my weight, and all of this has been avoided due to my weight loss. So....look at all they are saving on me....and yet they are still refusing to pay for nutrition counseling. Good Grief. They are a University, aren't they supposed to be smarter than that???