1. < Prostate Cancer
Profile picture for sanDGuy

Mighty pricey, this Prostate Cancer stuff.

Posted by sanDGuy @sandguy, 3 days ago

Well, I fnally got what I think was my final charge for my prostatectomy, etc. which cost me out-of-pocket now a total of around $500.
I was curious, though, and went through all the charges billed to Blue Cross.
All told, it seems they were billed in the neighborhood of 200 grand!
Here's a partial breakdown:
Surgery itself. (Da Vinci) including anaesthesia and pathology:
$141 grand.
MRI, inc. "3d rendering" 14 grand
PET scan including "attenuation" $38,800
Needle Biopsy + + lab biopsy + ultrasound (+ second biopsy?) 10 grand

I have no idea if this is typical, but it did surprise me. So glad I had opted for a "Silver 94" plan which gave me great benefits, and for which I have been paying about $750 monthly, with ACA/Obamacare paying the other half. Of course I'm concerned about what my premiums will shoot up to if the ACA is disabled, as is being attempted now, and over which the government is presently shut down.

It's a pretty clear insight as to why many people who are not covered or cannot afford insurance, end up on the street due to medical debt.

I find it both sobering and chilling.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Profile picture for topf
topf | @topf | 1 day ago

Mine was $148k sticker and $53k after plan discount, fully paid by insurance.

REPLY
1 reply
Profile picture for jime51
jime51 | @jime51 | 1 day ago
In reply to @northoftheborder "@jime51 This isn't a simple solution, but if you're within travel distance of Canada and can..." + (show)
Profile picture for northoftheborder @northoftheborder

@jime51 This isn't a simple solution, but if you're within travel distance of Canada and can find a Canadian doctor to write you a prescription (I'm not sure if that's still allowed), Orgovyx here in Ontario would cost about US $215/month *without* insurance — the same as Firmagon — so you could take a nice weekend trip to your nearest cross-border city and load up with 6 months' or a years' supply.

Note again that while this practice used to be common 10–15 years ago, I don't know if they've clamped down on it now, so a lot of research would be necessary before planning anything.

Jump to this post

@northoftheborder Thank you! My wife’s employer retirement coverage offers Orgovyx and Eliquis, my only brand name Rxs, at $125/mo. or $250 for three mos. Fortunately, my grant pays for Orgovyx and I burned through my coinsurance early this year so haven’t had any copays for months. Next year, costs reset.

REPLY
Profile picture for xahnegrey40
xahnegrey40 | @xahnegrey40 | 22 hours ago
In reply to @northoftheborder "@survivor5280 Yes, that makes sense. With my spinal lesion, I was on the operating table for..." + (show)
Profile picture for northoftheborder @northoftheborder

@survivor5280 Yes, that makes sense. With my spinal lesion, I was on the operating table for at least 10 hours (two shifts of anaesthesiologists), in the ICU for one night, in a critical-care bed for two months, and in the rehab centre for another month and a half. I was seeing specialists almost daily, getting radiation and frequent imaging, and needed full personal care (I was paraplegic), including being mechanically hoisted out of bed during the first month. All my meals and prescription meds were provided by the hospital.

There's no way to know, since no invoice was ever written, but I expect I must have cost the Ontario healthcare system at least several hundred thousand dollars over those 3½ months. In the U.S., perhaps it would have been millions, at least on paper (I note the point about inflated billings and "discounts").

p.s. In my case, at least, no waiting and no rationing. I got all the care I needed as soon as it was ordered. Even my emergency spinal surgery happened less than 12 hours after it became clear what was wrong.

Jump to this post

@northoftheborder I read your story from time to time when I feel bummed..what a courageous battle you put up..and now doing well !! one thing about cancer, it shows you what you are made of... I cant imagine the grit it must have taken for you to endure and survive that ordeal ..pat yourself on the back now and then !

REPLY
Profile picture for heavyphil
heavyphil | @heavyphil | 13 hours ago
In reply to @topf "Mine was $148k sticker and $53k after plan discount, fully paid by insurance." + (show)
Profile picture for topf @topf

Mine was $148k sticker and $53k after plan discount, fully paid by insurance.

Jump to this post

@topf Dirty little secret: The ins co demands that providers bill for these much higher amounts - even though they have already agreed to accept the ‘negotiated’ price.
So when the patient sees the gigantic fee billed vs the much lower accepted fee, their mindset is: OMG!! My insurance co is REALLY fighting for me!!
They probably spent millions hiring PR men and psychologists to come up with this cockamamie mindf***…games are played that the average consumer knows nothing about.
Phil

REPLY
1 reply
Profile picture for xahnegrey40
xahnegrey40 | @xahnegrey40 | 11 hours ago
In reply to @heavyphil "@topf Dirty little secret: The ins co demands that providers bill for these much higher amounts..." + (show)
Profile picture for heavyphil @heavyphil

@topf Dirty little secret: The ins co demands that providers bill for these much higher amounts - even though they have already agreed to accept the ‘negotiated’ price.
So when the patient sees the gigantic fee billed vs the much lower accepted fee, their mindset is: OMG!! My insurance co is REALLY fighting for me!!
They probably spent millions hiring PR men and psychologists to come up with this cockamamie mindf***…games are played that the average consumer knows nothing about.
Phil

Jump to this post

@heavyphil kinda like negotiating pprice of a new car with sales force of dealership- its a movong target...constantly evolving.

.( I once knew a car salesmen and he loved folks with bad credit to come in..he would take their trade in and give them mostly nothing, then let them sit around for a few hrs while he looked busy, went to lunch etc..then came back and said " well folks, my mgr didnt want the deal but I talked him into it, you get the new car ! "...the buyers were so tired and stressed and broke, they were ready to sign anything !! and they did.

REPLY
Profile picture for stew80
stew80 | @stew80 | 10 hours ago

In the USA model of health care, it seems that any notion of universal health care (other than Medicare) smells like socialism and that is a swear word in that country.

REPLY
Profile picture for kenporter
kenporter | @kenporter | 7 hours ago

Pricy for sure. Total cost for my 44 radiation treatments $184,000. My co-pay $2,980. PSMA test was $14,300. Orgovyx is $2,928 for 30 pills, pretty much $100 each or per day. My co-pay $920.00 per month. Fortunately we now have a $2,000 max out of pocket for prescription drugs. So my co-pay was $2,000. (Plus another $2,000) for my wife. Been retired 17 years and kept accurate records of every dollar we paid for health care. That includes insurance, deductibles, co-pays, dental and prescription drugs. Well I STOPPED this year as I was going nutty realizing we had taken $232,000 out of our savings to pay for health care. We were averaging almost $15,000 per year, so sick!!!!!! It continues I just don’t keep a spread sheet anymore. But I know in back of my mind we will be close to $20,000 for 2025. Looking forward to the day when the doctor says “you need an emergency operation” and I can say “I’m totally out of money” what should we do now????

REPLY
View MoreView Less
Please sign in or register to post a reply.