STEAM ROOM FOR ANGER
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jojo:
My father, who is loving, struggles with substance abuse and mental health issues and life improved for us kids sometime after my mother divorced him and kicked him out of the house because his issues were so disruptive. At 17 and 18 your kids need to be gearing up to spread their wings and take off in life and should not have to be hindered by their father's issues or abuse. I hope you will be around for quite some time but if you think you might not then I would recommend finding a someone who is willing to serve as a guardian for your kids. Even though one is a legal adult and the other almost is, most young adults don't feel like full fledged adults until sometime after the age of 22, and still greatly benefit from a parental figure to help guide and mentor them.
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Here's a fun game. It's called "How much will my meds cost with my new insurance?"
I've talked to all parties involved and apparently no one can tell me the answer so I'm currently straddling my old insurance and new insurance not knowing which is more affordable.
The goal is to get my monthly out of pocket health care expenses below $1,000 per month.
With my old insurance, I have no deductible but the premium is a little over $1000 per month and the lupron now costs me about $200 per month, down from about $800 per month. I'm not sure the reason for the drop but in any case, the amount I pay is the difference between the base price and negotiated rate. Old insurance likes to call this my copay, only it isn't written anywhere in the plan benefits.
With the new insurance, the premium is about $300 per month but there is a deductible which a lot of things don't apply to and while I'm told my out of pocket reaponsibility for the lupron will be 15% after the deductible, 15%, no one can tell me, 15% of what of the base price? A negotiated price? And if so, what is it? If the base price is $5000 then that would be $750 so that is still over $1000 per month after the deductible with the premium and copays.
Bonus: The state ACA website says I qualify for medicaid. The state medicaid office says my income, based on my 2020 tax returns, is $60 too high.
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I hear ya. Working through insurance is a special hell of its own, prescription coverage in particular. My husband just got a break with his 2 most expensive prescriptions - he gets them free from the manufacturer. Qualification was based on how much the household spends o meds in a year. Sadly, those programs don't work the same for most of our meds. (We're both on Medicare). I hope you can find a way to reduce your monthly costs. You certainly don't need the stress.
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Jo jo, it's good you are seeing a licensed professional to discuss the matters you're dealing with. We are here to support you, but someone with training will have the time and insight to hopefully help you navigate the choppy waters. I will say that as women, we are often trained to put everyone else first. At one time, you may have made your husband's issues the priority and though you've done your best to be there for him, you may have to admit you've reached a point where you've had enough. Again, society tries to instill in women that they must suffer through all for their loved ones, as if sacrifice is a hallmark of womanhood. Whatever guilt feelings you have towards making yourself the priority, I hope you can work through them. It is still hard for me to do, but I am learning and making progress, even if at times it's baby steps! Best wishes to you.
Nipab, I had a similar thing happen with my older sister who mentioned not getting a mammo for 15 years. This was years after I'd been diagnosed! What pissed me off is that it seemed pretty intentional that she said it to me, almost like a braggy thing. It also felt like she was implying that my diagnosis was insignificant to her, that it did nothing to make her think she should get a mammo. I chose not to react but it was one of numerous red flags I started noticing with my siblings and have since put more firm boundaries into place in my relationships with them.
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divinemrsm, you are so right. I also feel when I talk to some people that they think they are superior and somehow, it's my fault that I have cancer. I did not smoke or drink that I got lung or liver cancer. Some 'friends' also let me know that they breastfeed their babies for two years, so they don't get this problem! Like my one year of breastfeed got me into this mess!
Sometimes I wish I was so bad that I would like for them to get cancer and learn their lesson. Fortunately, I am not bad, and I do not want that on anybody, but oh I wish, I wish!!
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nipab, you make very good points about how some people act superior since they haven’t got bc, like they did everything the right way (how perfect of them) and/or some try to insinuate we brought this on ourselves. When it comes from a friend or relative, it makes you question how much they actually care for you to make those kinds of remarks.
I remember when my sister’s close friend was a victim of identity theft and had to battle to get it all cleared up. My sister went right out and bought a shredder and proudly claimed she now opens her mail in the garage before she even gets in the house and shreds everything except the truly necessary stuff so no one can ever steal her information. So it’s okay if her friend goes through something it spurs her to action, but when it’s me, it apparently means little. And I mean, she doctors for numerous things, so it’s not like she avoids medical care.
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I think I've mentioned before that my sister, now in her mid-70s, FINALLY got her first mammogram a year or two after my lumpectomy, and she kept whining ahead of time how it might huuuurt, and then afterwards how the technician hated her because she didn't know what to do and they had to keep redoing it. I told her if she'd have kept still like they told her, it wouldn't have been a problem, and that she needed to find a new audience because complaining about it to me was so out of line. She didn't understand why. AAARRRGGGHHHHHH!!!!!
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To All: like some of the other threads, I have been gone for a while. My heart breaks and my head nearly explodes when I read about the hassles and the costs of your health care. It is just SO WRONG. Yes, the Canadian system stutters and stumbles but I never have to worry whether I can afford the care I need. Our RX costs are lower than yours, even for things not covered under the Provincial plan. Why does insulin (I don't need it thankfully) cost roughly $36 /mth when I hear that in the USA it costs nearly 10 times that?
SO WRONG
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wcj that is crazy that one is saying you qualify for assistance and State is saying you do not . A social worker work at your cancer clinic might be able to give you some guidance and where to turn for assistance.
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It also horrifies me how much other people in the USA have to suffer when it comes to cancer treatment and insurance companies. Cancer is bad enough on its own! People who oppose Canadian or European style health care don't know what they're missing. No, it's not perfect. Nothing is. But it's SO MUCH BETTER!
And it's not like we don't know how to do it. We DO! It's just restricted to military and veterans only. (and Medicare to an extent I think?) All of my cancer treatment has been through the VA system and it's been great. It makes me so mad that people would rather keep struggling with our crappy system rather than do what it takes to get better and affordable health care for everyone.
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parakeetsrule,
👏
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I've got Medicare Advantage, which is the bargain version of enhanced Medicare, and I'm so glad I didn't have any health issues between ending work and starting on this plan. I was on my husband's work plan, but paying any out-of-pocket costs would have tanked us. I did not have insurance during most of the 1980s, because at that time we could not afford the premium on my husband's insurance. Our son, who was a baby then, was eligible for visits through a clinic, but we still had out-of-pocket expenses. One time I fell off the porch of a house we were renting (do not mix flip-flops and a rain-covered wooden porch!), and I went airborne, then made a one-point landing on my lower back on the corner of a step. Since I was neither bleeding nor paralyzed, I didn't go to a doctor. That's how I had to make medical decisions. I could barely walk for a couple weeks. Another time I cut my thumb badly and I just kept a pressure bandage on for several days until it completely stopped bleeding. I knew I wouldn't bleed to death from it, so self-repair it was. I've got some lasting damage from both of those. 😡
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Agree Alice, love my Advantage Plan. For medical, it’s been great. Both eyes cataract surgery, out of pocket for me, around $300. Dental insurance, not so great. But they did pay a little bit on the 4K I had to pay last month.
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Alice: I sliced the top of my thumb, had a chunk hanging there by some skin. Yes - I should have gone to emergency and had a stitch put in, but I figured I wouldn't bled to death if I kept applying a pressure bandage. I didn't want to go the ER - it was in the midst of Covid. But I believe even had there not been a pandemic raging I would not have gone. I hate sitting in those rooms with genuinely hurt and sick people. I don't want to burden the system with something minor.
What I don't understand is the fear folks seem to have about universal health care. If I don't have to pay for it I won't get it? Or it won't be good? Or worse yet - the slippery slope to socialism
I guess I am a socialist. I believe education, health care and safe housing are human rights and everyone should have access to them.
Okay - that's my rant
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Elderberry- Wish I could "Like" your post--- "I believe education, health care and safe housing are human rights". Guess I am a socialist too.
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elderberry, I've become more of a socialist the older I get. What got me started was spending about a year as an events coordinator at a not-for-profit, and having to deal with some of the most loathsome rich people imaginable, and their expectations that everyone has to bow, defer, and get out of their way just because of who they are, not because of anything they've accomplished. This bitch don't bow.
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not a socialist, although I do strongly believe in social responsibility, and notice that many people only csre if it's mandated
Relying on private sector for insurance is bad policy. As a small business owner, it is our single biggest expense. Some numbers:
Over $3000/ MONTH for our in-network family plan
$60 copay + $73 "facilities fee" EACH TIME I go to a doctor
$11000 family deductible
I am so grateful to have insurance that is covering all that I have done this past year. We have to budget in the base cost and the full deductible. (Although many things aren't covered, like PETscans, and everything has to go through multiple appeals.) But we are both still working 7 days. I don't know what happens in future. I just don't think about it.
Alicebstable even as owner, I am treated as The Help 🙄
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That premium is more than a lot of people's paycheck. It's obscene.
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The "comany" pays. A large company with many employees can shop for a better price. Bulk pricing. And the company can pay all or part of the plan depending on benefits structure. Many small business owners don't have health insurance
Btw, no dental or glasses.
Edit to add. I keep hitting send too soon! I hope people appreciate their work benefits and understand how much they actually are making. Just add $3250 to monthly take home!
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There are companies that pick up the entire premium? I haven't seen that in decades.
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The U.S. healthcare system scares the heck out of me. I've worked for large and small corporations and have paid a monthly health insurance premium for at least the last 30+ years. I had BC surgery in late 2020 but radiation didn't start until January 2021 so I had to pay my high deductible twice within a few months. I was fortunate that I had money in my HSA to cover the deductibles.
A lasting memory of the BC treatment is that at each radiation appointment, I was asked if I “would like to meet with a financial counselor?" I can't imagine the stress financial concerns would add to the cancer diagnosis. Mapping plus five (5) partial breast radiation treatments was ~$70,000 although I believe insurance paid out $25,000.My fear is that a significant number of people are not getting adequate healthcare due to lack of finances. This is a huge stain on our society when even basic needs are not met.
My son has a life threatening, incurable illness. He needs medication that runs ~$3000/month. I literally lay awake nights worrying about what will happen if he loses his insurance. It's one of the reasons I am continuing to work even though I'm turning 65 this year. I want to continue to save money to help him out if needed.
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Although I am fortunate to have always had very good health insurance I realize how dreadful our health insurance mish mash is for those who don’t have insurance. On another note, as a union employee whose health insurance benefits were part of our bargaining agreement, what one paid for health insurance depended the plan you chose as well as who you were covering in addition to oneself. For at least the last 15 years that I worked, I paid nothing for my health insurance at all. Over the 10+ years of living with mbc, I doubt that I’ve even paid $800.00 out of pocket for all my care. Yes, I was fortunate but what about my fellow citizens?
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I hate fucking drains
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This is for 3 weeks of Ibrance. 21 caps. I’m on this forever or until I have progression. I also have a PAN grant, so I pay nothing. I’d be dead if I had to pay for this.
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That is crazy. There has to be a better way. I know other countries do not have the issues with costs but know sometimes people are waiting on care as well with some of those systems too.
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Those of us with good insurance can be a bit spoiled in that we can get our needs, even non-emergencies, met fairly quickly. I would be very happy to have longer waits if it means that we all have access to decent health care.
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Sheesh, I blew up at my husband in the grocery store today. I don't even remember exactly what set me off. But while I was snarling at him, I explained why - that I haven't been anywhere without him in such a long time, and haven't even seen anyone to talk to except his family ( most of whom I really like, fortunately), and that was in December. I even miss the random weirdos who used to approach me in the store like I'm the local produce whisperer. It took two years, but I finally pandemic-snapped. Maybe I need a dartboard.
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After I was unable to work anymore and went on SSDI and was home with DH all the time we have found sometimes it helps if we just go in different rooms for part of the day. He can watch his sports or putter in the yard and leave me inside alone and that is fine too. A little apart time seems to help sometimes and diffuse when we are ready to blow. Most the time we stare our the windows at the birds and squirrels in the yard and watch traffic on the street. He is suppressed and since COVID we are both stuck inside and I cannot drive now so not like I can go anywhere without him either. Grocery trips are our one outing and we do it about every 2 1/2 weeks to stock back up on produce any other staples we need. We make go super early when they open when no one is in the store and get in and out and then he wants to run through the store the whole time which drives me crazy and get home and do not have something I need to cook dinner because we skipped that aisle because someone was on it. I tried doing grocery delivery before but we had to pay for it and he said not worth the cost and he woudl rather pick out his own fruit. Decided not worth the fight.
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bcincolorado, my husband still works, so I don't see him during the day five days a week. I think it was just that he's almost the ONLY person I see, at least to talk to, that got to me, plus we live in a VERY small house. Well, there's our adult son, but he looks just like his father, so that doesn't help! 🤪 And my sister won't stop texting me, several times a day, to tell me every single thought that passes between her ears. shut up Shut Up SHUT UP!!! If she ever has anything important to say, I'll miss it, because I no longer read her endless finger-babbling. Thank goodness for notification mute, but just knowing the texts are coming in is like fingernails on a chalkboard. And when I ask her to cut back, she sends me more. 😡
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Oh Alice I am happy you at least have hubbs out of the house five days a week. Mine retired early and his retirement gift was my cancer diagnosis. We live on a farm so not much opportunity to see folks. Between the retirement and covid way too much time spent in each others space. Sometimes he just breathes too loud haha
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