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Post Appointment Updates

Posted by miss m on Wednesday, June 22, 2011 @ 12:21am in Family, Finances, General Blather, Hysterectomy, Sickness and Health Issues, Work |

So a very busy day today. Lots to recount so I’ll try to break it up to make it more manageable.

Doctor’s Appointment: 2 week checkup on Lupron / Plan Moving Forward
So apparently things aren’t really bad the first two weeks on Lupron. It gets worse. (Greaaaat.) My body aches and fatigue are going to increase. And so will my temperature fluctuations. Apparently the fact that so far no night sweats doesn’t mean I’m out of the woods. They might still be forthcoming. (Again, greaaat.) So he gave me 3 months of free samples of an “add back” hormone pill to help limit some of the side effects of the menopause Lupron puts me in. It’s called Femhrt.

While looking it up online and seeing kinda scary side effects, it’s actually the exact same two ingredients that were in my birth control pill, just in different doses. So..kinda weird but I was successfully on that Pill for years which gives me hope there won’t be anything too odd with the Femhrt. It should help counter the worst of the Lupron’s menopause symptoms but not hinder the tumor shrinkage.

I have another appointment in two more weeks. (July 7th.) At that point, he wants to try and do a 3 month shot of Lupron. He really feels that it’s going to take that much to get them shrunk enough to make surgery safer. I understand but shit, the thought of waiting ANOTHER three months is really frustrating. I trust my doctor though and I do think he knows what he’s doing even if it’s emotionally stressful on me. (Plus it begs the question of what to do about my job for three months…whole different can of worms there.)

Medical Insurance For Me?
Ok, so I had previously come across Pre-Existing Condition Insurance Plan (or PCIP) before. But it requires you to have been completely denied for medical insurance before you can even apply. Typically applying for insurance with a broker/agent means a month or more of waiting for approval or denial. It’s a very lengthy and tedious process. Well, my Mom is awesome and she made some calls. She found out that I could apply online for a Blue Cross & Blue Shield insurance plan and because the approval/denial was a yes/no thing done by computer rather than a human, it tends to be much more strict and would turn me down based on my condition. And it did! (Never been so happy to be denied for something!)

So after my appointment I went over to her house and applied for the PCIP plan and faxed over the denial documents I needed to prove eligibility. I’m hoping I can get the plan to start as soon as July 1st. Now, it’s not really going to change the amount that this is going to cost me BUT it will cover office visits and won’t leave me at the mercy of the hospital bills or the anesthesiologist and such either. Here’s how it will break down:

  • – Monthly premium: $237
    (which granted, is a lot but beggars can’t really be choosers. Remember, I’m not getting an employer to pay part of the premium like you normally get.)

  • – Deductible: $1,000 in-network / $1,500 out of network
    (And I’ve already looked and my OB/GYN is IN network! The hospital I’m not sure about.)

  • – Co-Pay: 20% after deductible
    (Which certainly beats 100% I’m paying now!

  • – Prescription Drugs: $250 deductible formulary / $375 deductible non-formulary
    (Which is kinda a lot but I’m not really on expensive prescriptions either.)

Figuring a minimum of 4 months on the insurance (3 months for the shot, one month post surgery – bare minimum!) I’ll need $948 in premiums. ($1185 for 5 months) I’ll also need to pay the first $1,000 of treatments/office visits. After that, I’ll pay 20%. So I’m still going to need over $2,000 to cover the basic minimums of the plan. Now, the good news is that preventative care is FREE. That includes an annual physical and a mammogram (yes!!!) among others. It’s still A LOT of money but…it prevents me from getting a $13K bill from the hospital after the surgery itself. For the short-term, given the costs I’m going to be facing, it’s well worth it. (And then some.) I also still have the $600 balance to pay off from the consultation fees when I was in the hospital in the first place so the amount I need remains pretty much the same, BUT it will save me in office visits and surgeries. Basically, I’m getting a LOT more bang for my buck this way.

I’m kinda excited about it. I feel like there’s a ray of hope in all of this now. If I can get the insurance approved (which, I meet the qualifications now that Mom got me denied for coverage elsewhere) it should solve a lot of bigger picture medical bill worries which I’ve been trying not to think too closely about. It also solves the worry that the hospital simply would not allow me to schedule the surgery as an uninsured patient.

Ebay and Garage Sale
Spent the afternoon at Mom’s photographing items to list on ebay for her. Items that are potentially worth too much for the garage sale. So I have my work cut out getting all those photos edited, creating listings, etc. It’s a stupid amount of work to do that sort of thing and takes so much time! But, we’re doing everything to raise money so if I have to spend a few days posting listings, well, that’s what I’ll do.

The garage sale is also progressing. Mom and my sister have dropped off items and I need to gather items too. We’re thinking the weekend before July 4th since it’s too soon this weekend. I thought most people will have a 3-day weekend and with the 4th being Monday, should give them plenty of time to be interested in a sale that Saturday and Sunday. I hope anyway. Every little bit helps though!

And…that’s all for now
Whew, this is getting long. Going to wrap up now but it was a busy day so I had a lot to go over! For the first time since this all happened, I’m feeling slightly hopeful it will all work out. And, today was a good day with Love’s dad too – he’s making good forward progress and has overcome some big hurdles so that’s a relief – that all together, it’s been a pretty good day.

So that was Tuesday! 😉

Oh and happy Summer Solstice aka First Day of Summer too. (Though we’ve been unseasonably hot for months now it’s felt like summer long before it officially became summer. I heard on the news our first day over 90F (32C) was waaaay back in the beginning of April here. APRIL! Jeez. Anyway, happy officially summer to all.

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