$2,569: Another lesson in the healthcare maze

Regular readers may recall my rant about the hidden costs of American healthcare when I discovered a lump in my breast a couple years ago and felt rushed into getting what turned out to be a completely unnecessary ultrasound. Because of the way the procedure was coded, my health insurance was conveniently (for it) let off the hook to pay for it—but I didn’t discover this until after the procedure.

Lately, I’ve heard a lot more about how consumers have no idea how much their health care costs because of the way healthcare providers and insurance companies handle the labyrinth process, which makes the story I’m about to bring you all the more relevant.

Uncle Al wrote up the following story after he regaled me and my Beloved recently with the details of a mysterious little tube of medicine he had on his coffee table. When I read it, I suggested the world needed to know about the sneaky ways American health care gets its money so I’m sharing his story here on Minnesota Transplant.

Please welcome guest blogger (and entertainer) Uncle Al:

$2,569 — always ASK your doctor

I’ve had this little mole shaped like a pencil eraser right in the smile line of my right front cheek for a while. It was a problem because I smile a lot and I also managed to nick it with my razor on a regular basis, too … ouch! With its plentiful blood supply, the mole—once nicked—bled for about 10-15 minutes … and then would start bleeding again if I touched it later in the day. How embarrassing for someone else to tell you over lunch that what you are eating is making your face bleed!

So in January, I went to the dermatologist for a “whole body” mole check (something my sister recommended—she’s a retired RN), and they found a suspect, possibly precancerous mole on my shoulder. I also asked about that pesky facial mole, and another mole right in the middle of my chin (which I have almost successfully shaved off over the past many decades—I won’t say how many!). And I also mentioned that I have this seemingly overly-sensitive spot on the very top of my head which I cannot see (girls: I don’t have a hand mirror) so I asked the nurse to look at it. Minutes later “Pssst!” went the liquid nitrogen on three of those spots up there and after a bit of slicing and cauterizing, both those facial moles were gone. Other than a little pin prick to numb things, all went well as far as any pain. Gone. Thank you, Lord!

The nurse practitioner (never saw the dermatologist) is the sweetest, nicest lady. She performed the two facial mole-ectomies. She also suggested a cream to prevent any future cancer spots on top of my head. I thought, “Cool, I better pay attention.” She commented that it was expensive. Since I opted to go directly (no referral) to this dermatology clinic (based on an excellent experience my son also had with them about a year ago), I asked how much the medical cream would cost. She didn’t know and said not to worry—that my medical provider would cover it: “No problem … since you have a precancerous mole and these tiny sensitive spots on the top of your head, it will be covered. We will do a biopsy so we know for sure.” I thought, heck if it is that expensive, maybe I’ll just pay for that ointment or cream today, write a check … what’s a couple hundred bucks for some ointment and no hassles from my insurance provider (since I did not go there on referral from my primary physician).

Again, I said, “I understand there’s a deductible, and it’s expensive. How about I just pay for it today?” I’m still thinking a little tube, the size of a Chapstick container cannot cost that much money, now can it!?

So she suggested again that I just allow the dermatologist’s office, to submit it to the pharmacy and my medical provider will likely cover it completely and then I can deal with any questions later. Seemed logical, so I paid my doctor visit portion of the bill and walked out the door with just a little circle Band-Aid where that pesky “used to be bloody mole” was located … a new man! I felt so good!

A week later, the doorbell rang. I had to sign for the prescription, and I eagerly opened up the box, slid out the 30-gram tube of medication (for us Americans that is 1 ounce) and read the instructions and side-effects carefully. I put a dab on my finger after I opened it (no returning it now you know) and … no pain. Hmmm…not bad. I continued treatment.

Two weeks later I got a notice from my healthcare provider. Yep, they paid it all! Phew! Good! Then I read the second page of the billing statement dated January 22, 2015. This is 10 days after my appointment. I read that with one prescription I had almost exhausted my prescription drug plan coverage and with another $131 of prescription medicine expenditures in 2015, they will move me into the next higher class of coverages (meaning I pay much, much more for any medicines needed in the “remainder of the year.”) WT*? (Pardon me!) What the hell has just happened? I’m only into the 22nd day of the year. The bill for one ounce of CARAC CRM 0.5% costs … get ready …

$2,569!

Can you hear the expletives still echoing?

Yes, $2,569 for a tube of Chapstick in cream form! OMG. I wish she would have said, “Be sure to bend over when the postman arrives!” because that cost would have caused me to rethink my decision to get the medicine!

I think Americans, including myself, have lost sight of what medications actually cost out there in the market place. We are all “neatly hidden” from the actual costs of medicines, and we are allowing drug companies and insurance companies to screw us over. Ditto to the hospitals that charge us for each tissue, Q-tip (excuse me, “sterile swab”) and every time our blood pressure gets checked (by a machine nowadays).

Anyway, nothing I can do about it now. The minute I signed for that postal package, I was screwed. I can’t return it. I didn’t have a bill yet to even know what I was actually signing for when the medication arrived at my door. I learned a valuable medical life lesson in this little mole-ectomy experience, and I hope you now did, too:

Always ask how much any medication actually costs!

I am not convinced I really need to put a little $85 dab on my head each morning (then, like a good beer, in minutes it’s gone!)

Are you kidding me? Ask!

__________________

Minnesota Transplant note: Uncle Al is a dear man living in a beautiful place where his head is regularly exposed to sunshine. Let’s hope his ridiculously expensive skin balm does the trick in one tube. Because there won’t be a second!

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