Tougher Than TWOmurs

Having cancer is expensive. I’ve spent tens of thousands over the years for medical care related to my survivorship. The costs related to breast cancer are even more staggering.

But the costs aren’t just financial — cancer also costs you your sanity.

I’m not just talking about emotional well-being… I’m talking about the energy it takes to stifle yourself from bitch-slapping the idiots at insurance companies who make recovering, and surviving, feel like a privilege you must earn.

A couple of years ago, my mom told me a story about a fight she had with our health insurance company while I was being treated for Hodgkin’s Disease. I’d had a diagnostic scan that used a special dye, which was difficult to access and thus very expensive. Insurance would only cover what they deemed a “reasonable cost…” $50 out of roughly $1,000… a whopping 5%.

My mother spent close to a year insisting insurance cover this in full — the dye was part of the necessary, required scan. It wasn’t as if there was an alternative for us. Each time the insurance company refused, my mother escalated the conversation to someone higher and higher. After seven months, the insurance company agreed to cover the cost. The hospital’s billing department told my mom they’d never seen anyone fight THAT long over a bill and win.

My mom told me this story when I was well into my 20s… already seasoned in the art of reminding insurance companies what pieces of garbage they can be.

Imagine the time and energy it takes to stay on top of something like that… when I was 16 and fighting cancer the first time, my mom also had a full-time job, a husband who worked full-time, two other kids in school and a daughter who she needed to take to a hospital everyday and who was sick from treatment. As if she had all the time in the world to call the insurance company, day after day, right? She found the time to be the smart, squeaky wheel she needed to be in order to get the insurance company to do their most basic job and the right thing for the patient.

Now you know where I get it from.

Arguing with insurance companies, and finding ways to pay my medical bills, has been something I’ve had to master in the last decade. It’s like being in a spiraling, destructive relationship that you desperately want to make work… you fight all the time, you know the relationship is toxic, but in the next breath you whisper, “but I NEED you…”

This blog is by no means a forum for a political debate about healthcare access. But in my humble opinion, if you live in this country and do not have any kind of healthcare benefits, you are batshit crazy. You just have to be prepared to be TOUGH.

I’ll give you a taste of what breast cancer screening and treatment can cost if you DON’T have insurance:

• Annual mammo/MRI: $3,300
• Breast biopsy/pathology reporting: $5,000
• Surgeon consults: anywhere from $600-$1,000 per visit… I saw five different surgeons in July alone, some more than once. My plastic surgeon is out of network, so I have to reach a deductible of $3,000 before insurance will pick up the remainder of fees
• Surgeon fees for performing mastectomy: $13,000
• Surgeon cost for reconstruction: $37,000
• Anesthesia: $10,000
• Hospital charge, 7-hour surgery and two night stay: $64,000
• Pathology from mastectomy: $6,000
• BRCA Gene testing: $4,600

Those are some big ticket items. This doesn’t even include follow-up chemotherapy, radiation or hormone treatment. And we’re talking roughly $150,000.

Imagine I didn’t have insurance?

Even when your costs are covered, there is still plenty of spillover. There are deductibles, co-pays, out-of-network costs and specialists who don’t accept any insurance.

And there are times when insurance just refuses, and you have to find the time and energy to fight, like my mother did, or you give up and pay.

I’m lucky that over the years, my doctors fought, even threatened, insurance companies in order to get them to pre-authorize my annual mammograms and breast MRIs. For nearly 10 years, they’ve never wanted to cover both, or even one, given my “young” age. And this is despite guidelines from the American Cancer Society which clearly state: “Screening MRI is recommended for women with an approximately 20–25% or greater lifetime risk of breast cancer, including women with a strong family history of breast or ovarian cancer and women who were treated for Hodgkin disease.” These came out in 2007, precisely when I started my screenings (I was 25).

It doesn’t get much clearer than that. 

Right now I’m battling my insurance company to approve a sufficient short-term disability, an offering I pay for annually. According to my insurance company, it only takes three weeks to recover from a double mastectomy.

I’ve called them almost daily, from the moment I left the hospital in August, and that is the only reason they continue to “reevaluate my condition” and extend my leave in drips and drabs.

Never mind that my doctors’ have reconfirmed ad nauseam that the average bilateral mastectomy patient requires three months of initial recovery and that my reconstruction is staged (second surgery is in November, at the three-month mark). By week three, when I was “supposed” to return to work, I still had drains in. Today, six weeks later, I still have extensive numbness in my arms and chest, muscles spasms 24/7, compromised range of motion and cannot drive safely, cannot lift more than 10 lbs and am undergoing fertility treatment so that I can harvest my eggs before I start taking Tamoxifen. Basically I’m still seeing doctors every single day. How am I supposed to work?

And on that note, it is very common for invasive breast cancer patients to harvest and freeze eggs in order to preserve chances of conceiving a child later in life, once it is “safe” to. I of course need to harvest them as soon as possible so I can resume my road to a cure. My insurance company considers this fertility preservation elective, and doesn’t cover an ounce of it… it costs $15,000 to harvest your eggs.

It’s gonna be a long season of being the squeaky wheel, providing the insurance company with proof that they already have, calling to make sure they actually read all of the medical reports, petitions and letters my doctors send. I’m basically doing their job for them… because you know… I have all this free time… who needs recovery?

The bottom line is, insurance companies never want to pay, so they hope people won’t have the time to call, or the energy to fight.

They hope people will give up. Isn’t it ironic.

This post feels like a bit of a rant, but it boils down to two things:

1. Money makes the world go round. Money may not buy happiness, but it most certainly makes living life EASIER. It is critical for people to have back-up funds reserved for emergencies which will without a doubt arise.
2. Knowing what it costs to save your own life, should you ever need to, creates a fire in your belly to be prepared, to be educated and to be sure you NEVER have to depend on anyone else.

Medical bills played a big role in a pile of debt I incurred in my 20s. I’m an intelligent, intuitive, ambitious woman, with a solid corporate career, making a very healthy salary, and somehow still couldn’t seem to make a dent, let alone build a savings to pay for a wedding one day, a house one day, a family one day. To add insult to injury, if you’re sick and cannot work, you’re pretty much screwed.

A few years ago, after years of skepticism, I did something unconventional — I partnered with the two brilliant female dermatologists who created Proactiv and became the owner of a premium skincare microfranchise. These two doctors own the worldwide acne treatment market and are visionaries… they saw the growing potential of the anti-aging market, the power of social commerce and the opportunities that independent business ownership could offer to ordinary people who strive for something more. Who NEED something more.

I had every reason NOT to join them. When my best friend introduced this opportunity to me, and told me it was a multi-level marketing business model, it seemed way too good to be true… how could I build a successful business from scratch? I was flat out stubborn and denied it would ever amount to anything. Mainly, I also clearly had no time to dedicate to starting my own business. But I also was running out of choices… I had no back-up plan and intuition, and experience, told me I needed one.

As I watched friends who’d started their businesses before me build legit empires, friends who were equally busy and some who had no real business experience, I knew there was something to this, bit my lip, and gave myself a year to try it out.

Thank God I did.

When I joined the doctors two years ago, I was still in debt. Two years later, I’ve mastered running a virtual business in a way that doesn’t interfere or conflict with my corporate 9-5 job and my debts are long paid off. I’ve built a huge savings which I thought I’d use to buy a home and am now thankfully using for ALL of my out-of-pocket medical bills.

My general cost of living has also increased… when Duane moved out, all of the bills we shared doubled. Given my physical limitations, I’m unable to mow my lawn, clean my house, carry heavy groceries or shovel the piles of snow expected this winter… I will have to pay people to do these things for me, things healthy people consider luxuries but that I truly need so that I don’t hurt myself.

The me two years ago would be losing her mind with stress and anxiety. The me today is grateful. Paying for these things will not be something I have to worry about anymore. This business has given me more than savings… it’s given me sanity and independence.

I’ve never stopped believing that things work out exactly the way they are supposed to. People, and opportunities, come into your life to test you, strengthen you, prepare you and teach you. I’ve lived a most unconventional life that I never asked for, and that I never planned for, so I’ve followed my intuition to get to where I am. Wherever you are in your life, whether you are living in bliss or dealing with a challenge, go with your gut and you’ll never go wrong.

And if you don’t have a gut feeling, I’ll share mine with you — no matter how great your life is, do whatever you have to, even if it seems unconventional, to prepare for an unpredictable future. The numbers don’t lie. And neither does your gut.

Don’t rely on others to cure what ails you… you have the power to do extraordinary things. I am living proof.