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All TopicsForum: High Risk for Breast Cancer → Topic: can't afford another MRI

Topic: can't afford another MRI

Forum: High Risk for Breast Cancer — Due to family history, genetics, or other factors.

Posted on: Apr 23, 2010 09:25AM

pattimay wrote:

Okay, just got the bill for the MRI which surgeon advised to get after my ADH ALH surgery.  The hospital charged $10, 600 which we owed 85% of.  Now just got the bill for the MRI with contrast and diagnostic lab test which totaled $21, 708.  My insurance company, Blue Cross/ blue shield, allowed $11,939.  This is a preferred provider and now we owe 85% of that which came to $1,790.91.  I cannot believe how much hospital is charging for this.  My surgeon want's the mammo and also MRI with/without contrast every six months.  I had the biopsy for suspicious area and it was negative.  Surgeon said Mri will show many benign findings but since I'm high risk I need it.  NOw if everytime I go every six months something shows up and I need a biopsy, how will I afford this? I live on LI, NY.  Anyone else with the same problem. 

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Posts 1 - 14 (14 total)

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Apr 23, 2010 09:27AM pattimay wrote:

Sorry. Forgot to mention that we just also got the bill for the MRI with/ without contrast which we owed over $700 besides the mri guided biopsy that just came.

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Apr 23, 2010 01:01PM mawhinney wrote:

Possibly once you have paid out a certain dollar amount each year, your insurance will pick up more of the costs. With my policy my share of the cost is higher until I have paid out a certain dollar amount and then they pick up more of the costs.  Check with your insurance co.  Also call the hospital &/or testing center and see if they can offer you any assistance. Sometimes hospitals will reduce their costs or have special program that you may qualify for.  Oftentimes medical facilities have social workers that can recommend options and be of assistance to you.

Dx 5/18/2008, IDC, <1cm, Stage Ib, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Apr 23, 2010 01:57PM, edited Apr 23, 2010 01:58PM by Jenniferz

Looking at the same problem, only slightly different. I am going in for a "closer look" at something that has shown up on my remaining breast. My insurance won't cover the MRI at all because I haven't met my deductable. I think that's why mawhinney was talking about. Good thing is...I'm healthy and don't use the insurance. Bad thing is....I don't meet my deductable. After it'smet, it's 80/20.

No answer to your problem, but do understand where you are coming from.

Jennifer

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Apr 24, 2010 08:26AM Mantra wrote:

Not sure where you live but if you're close to the border, we have private MRI clinics in Ontario. The cost for an MRI for both breasts is $800.

Dx 7/10/2009, DCIS, <1cm, Stage 0, Grade 3, 0/3 nodes, ER-/PR-
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Apr 24, 2010 08:33AM awb wrote:

My MRI last year was $1897; this year it was $2263.  The difference is my husband's company changed insurance companies, so now we have to pay for my MRIs as we have a large deductible to meet.

Anne

"I don't know what the future holds, but I know who holds the future"

Dx 9/5/2003, LCIS, Stage 0, 0/0 nodesSurgery 09/16/2003 Lumpectomy (Right)Hormonal Therapy 10/30/2003 TamoxifenSurgery 04/05/2005 Prophylactic Ovary Removal (Both)Hormonal Therapy 02/28/2009 Evista
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Apr 24, 2010 10:52AM kk69Z wrote:

I know two years ago when I was diagnosed I needed two MRI's and all the rest of the testing. My insurance is a $500.00 deductible and 80/20 to a certain amount then 100%. I would call the hospital and set up payment plans to pay so much a month. I'm sure they aren't expecting you to pay all that at once. Who can these days.Good luck

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Apr 25, 2010 12:06PM pattimay wrote:

Thanks for your replies.  We did meet the deductible but they still only pay the 85%.  BlueCross/shield told me that they "allow" the hospital to charge a certain amount for a procedure and then the hospital has to accept a certain percentage of what insurance will pay.  But if the hospital wouldn't charge these high amounts of $10,000 for mri and $12,000 for the mri guided biops, then the insurance would pay them less and I'd pay less also.  I made the mistake of going to the hospital for the mri with contrast.  Next time I'll go to the imaging center .  I think they charge much, much less.  Then of course if something comes of it again, I'll have no choice but to go to the hospital for the mri guided biopsy.  At least we'll save a little doing it that way.  

 

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Apr 26, 2010 07:34AM tweetybird wrote:

Patti,

That's amazing the amount of money the hospital charged you. I'm also on Long Island, and have Blue Cross/Shield, it's the Empire plan, thru my husband's union. Not sure which hospital you went to, but I went to The Woman's Center at St. Francis Hospital, it's by NYIT, not by the actual hospital, and they charged a little under $5,000 for the same type of MRI that you had, and the doctor's reports, etc, ran about $2,000. I didn't owe a cent, not even a co-pay. If you're close to there, and your insurace accepts going there, you might want to check it out. I'm extremly happy going there. I also get my mamo's and ultra sounds there. I also had 3 separate biopsy's done over the last few years, and they also do them there.

Most hospitals will wil work out a payment plan with you, even if it's only $100 a month. Just get in touch with their billing department.

Good luck with everything.

Janet :)

Dx 7/24/2006, DCIS, 1cm, Stage 0, Grade 3, 0/5 nodes, ER+/PR+
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Apr 27, 2010 07:10AM pattimay wrote:

Tweety, thanks for the info.  My husband has Federal Blue cross/shield.  My doctors are affiliated with Brookhaven Hospital.  I called the insurance and they said until we have the catastrophy amount fullfilled which is $5000 we are only covered 85% with the preffered provider.  We only have $3000 so far so we have to pay out of pocket .  She said even though the hospital is charging the $10, 632 they only allow $5000 and I pay the 85% of that.  I hate to change the radiologist since she has all my records and I've had the three biopsys with her so she knows what's going on in my breast.  But I think initially I will shop around for another place to take the initial mri instead of the hospital.  Don't want to get political but all these people that are now going to be able to get insurance is great but if they couldn't even afford it in the first place how are they going to pay for the bills afterwards at these amounts.

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Apr 27, 2010 07:16AM Mantra wrote:

I'm still in utter shock how much an MRI costs!! Are you able to negotiate the price. I live in the US for 1/2 a year and I know whenever I've needed medical care, they have a "cash" price that is way less than there regular price. Of course, when I'm in Canada I have no idea what any medical care costs but I wonder if the price is a lot less than in the US. As mentioned in an earlier post, I know that they have a private clinic here that does breast MRI for $800. Actually, it might be $600 (my sister thinks she paid $600).

Dx 7/10/2009, DCIS, <1cm, Stage 0, Grade 3, 0/3 nodes, ER-/PR-
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May 2, 2010 02:50PM jessicawollin wrote:

Check with your county's Department of Social Services, specifically Mediaid or Medicare. Sometimes they offer certain assistance with medical bills in this sort of situation.

Jessica Wollin

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May 15, 2010 11:58PM SWELL wrote:

I had this problem also.  I sent my doctor and email to complain.  She said that there was a lot of money to give MRI's and Mammograms to people in need.  Why shouldn't I qualify?  She called the dept and had my bill cancelled.  It is worth it to ask.  She recommended it, after all!

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May 16, 2010 04:18AM hellome wrote:

pattimay wrote:

Don't want to get political but all these people that are now going to be able to get insurance is great but if they couldn't even afford it in the first place how are they going to pay for the bills afterwards at these amounts.

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Sadly this is all very political. I mean think about it. Why is it that you can get an MRI n Canada (as someone stated earlier) for $800 but your hospital is charging $10,000?  Why is it cheaper at an imaging center, or at a different hospital? Profit.  Healthcare reform (which is what I think you are alluding to) isn't just about getting more people covered. It's about working to protect all healthcare consumers, by making healthcare more affordable and more fair by (hopefully) taking the profit motive out of it. And here I'm not talking about doctors and nurses and all the people involved in our care. I'm talking about healthcare corp CEO that make outrageous salaries, and the selling of stocks to shareholders who will profit dependent on how much care you get or don't get

It's really twisted. Healthcare shouldn't be a business, other than the business of healing and making people well. The people who do the healing need to be rewarded for that. The people who do the dealing do not.  I mean, it is bad enough for a person to have to get sick and face a serious diagnosis like everyone here. But then to have to worry about being able to afford it based on a profit margin? Maybe that makes sense to some people, but again to me that is twisted.

Recurent, Original Dx 2001 multi focal grades 1 & 2: lumpectomy w rads. Second dx 2010 multi focal w grade 3 comedo type: mastectomy w implant reconstruction

Dx 3/10/2010, DCIS, Stage 0, Grade 3, 0/3 nodes, ER+/PR+
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May 16, 2010 08:21AM vmudrow wrote:

Your problem is one reason I decided to have a Porphelactic Nipple Sparing Masectomy.  I was diagnoised with ALH and would have to have an MRI every year with probable biopsies every year.  I also have a strong family history of BC and have had numerous biopsies in the past.  So 10 days ago I had the surgery, the pathology report all came back negative - I dropped my risk from 40% to less than 5%, no tamoxifen, no MRIs, no Mammograms, no more worry every year.  Plus my insurance is paying (after my dedcutable, which I met in January for the biopsy) for the surgeon and plastic surgeon!!  Just an option - and I feel great!!

valerie, Diagnoised 1/24/2010 with atypical lobular hyperplasia, prophylactic NSM on 5/6/10, strong family history, 40% risk of breast cancer

Surgery 02/01/1992 Lumpectomy (Left)Surgery 03/01/1996 Lumpectomy (Left)Surgery 05/06/2000 Lumpectomy (Right)Surgery 01/23/2010 Lumpectomy (Right)Surgery 05/06/2010 Prophylactic Mastectomy (Both)