Jenny in Florida Posted January 24, 2020 Share Posted January 24, 2020 I'm trying really hard to not lose track of the bills coming out of my breast cancer treatment. It's a non-stop blizzard of paper, multiple envelopes arriving in every day's mail. I wasn't doing a great job of keeping up until a few weeks ago, when I spent nearly five hours sorting through the piles on my desk and organizing things and making a spreadsheet. But since then, I have devoted a big chunk of every paycheck to chipping away at the mountain. Because of some confusion regarding which of my two insurance plans is primary, there are still stacks and stacks of bills that are still working their way through the process.ins Today, I received a finalized bill for a visit I made to the euphemistically-named "spa" based at the cancer center. This is where I was sent by my doctor to be fitted for post-mastectomy bras. I walked in with a prescription and told that a certain number of bras would be covered by insurance each year. I walked out with two bras and one set of silicone inserts. (For the record, I hate wearing them and do so only when I am going to work or to more "formal" social occasions. I find them uncomfortable and heavy, especially now that my skin is a bit raw and tender from the radiation,) Anybody want to take a guess at what the original, pre-insurance bill was and what my portion is? Total Charge: $2,576.50 Patient Portion: $958.46 For two soft-cup bras and two slabs of silicone. I hate them even more now. 4 18 Quote Link to comment Share on other sites More sharing options...
Annie G Posted January 24, 2020 Share Posted January 24, 2020 That’s just ridiculous. I’m sorry. And when they say ‘covered’ you kind of assume a whole lot less out of your pocket, ya know? Quote Link to comment Share on other sites More sharing options...
Jenny in Florida Posted January 24, 2020 Author Share Posted January 24, 2020 In the category of small mercies, at least this came to light before I followed through on my plan to go back for new bras to see me through the next several months while I decide about reconstruction. Clearly, I will be looking for other options. Quote Link to comment Share on other sites More sharing options...
plansrme Posted January 24, 2020 Share Posted January 24, 2020 I do not know what I am talking about, so forgive me is this is a stupid thing to mention, but a woman I know was just telling me she knits breast prostheses for an organization that gives them away because, apparently, many women vastly prefer them to the silicon versions. Google pulled at least one of the organizations up pretty easily if that's of interest. 6 Quote Link to comment Share on other sites More sharing options...
ashfern Posted January 24, 2020 Share Posted January 24, 2020 31 minutes ago, plansrme said: I do not know what I am talking about, so forgive me is this is a stupid thing to mention, but a woman I know was just telling me she knits breast prostheses for an organization that gives them away because, apparently, many women vastly prefer them to the silicon versions. Google pulled at least one of the organizations up pretty easily if that's of interest. That's cool! Wonder if I can find a pattern and figure it out? Quote Link to comment Share on other sites More sharing options...
Carol in Cal. Posted January 24, 2020 Share Posted January 24, 2020 See I think we knitters should all bomb our WTMers with breast cancer with knitted prothesi, in a variety of sizes, shapes, and colors. I have no idea where to get a pattern for this, but it just seems like such a great idea. 2 Quote Link to comment Share on other sites More sharing options...
Jenny in Florida Posted January 24, 2020 Author Share Posted January 24, 2020 17 minutes ago, plansrme said: I do not know what I am talking about, so forgive me is this is a stupid thing to mention, but a woman I know was just telling me she knits breast prostheses for an organization that gives them away because, apparently, many women vastly prefer them to the silicon versions. Google pulled at least one of the organizations up pretty easily if that's of interest. Definitely not stupid. I appreciate the suggestion. Before I had my surgery, it was actually my plan to crochet myself some foobs (fake boobs), and I had multiple friends from my knit and crochet group offer, too. However, after wearing some very lightweight, fiberfill-stuffed inserts before the silicone ones came in, I discovered that I didn't like the way the lightweight ones "floated" around on my chest. At the moment, because I dislike both the silicone inserts and the fiberfill ones, I tend to skip wearing the inserts at all unless I am going to work or to some kind of occasion at which I would prefer not to be flat. But bouncing back and forth between "flat" and not is a hassle in terms of getting dressed -- what shirt works with which bust size, etc. And I have found I feel self-conscious no matter which what I go that day, By the way, I say, "flat," but it's not that simple. Because I had lymph nodes removed on one side, my chest is distinctly asymmetrical. (I am actually slightly concave on that side.) So, what I would really like would be to find some kind of soft, stretchy sports bra-type thing that would fit flat across my chest but have some padding to provide just a little bit of shape without requiring the extra step and hassle of wearing the separate inserts. I would then probably transition to wearing that all the time and give up on the inserts completely. 3 Quote Link to comment Share on other sites More sharing options...
Jenny in Florida Posted January 24, 2020 Author Share Posted January 24, 2020 12 minutes ago, ashfern said: That's cool! Wonder if I can find a pattern and figure it out? 2 minutes ago, Carol in Cal. said: See I think we knitters should all bomb our WTMers with breast cancer with knitted prothesi, in a variety of sizes, shapes, and colors. I have no idea where to get a pattern for this, but it just seems like such a great idea. You guys are sweet! Again, it's not my thing, but I do know many women really like them: https://www.knittedknockers.org/ 2 Quote Link to comment Share on other sites More sharing options...
Karen A Posted January 24, 2020 Share Posted January 24, 2020 Is that seriously what you are having to pay???? I'm livid for you! I would be complaining to the MD who sent you there, the "spa", and anyone else involved about this surprise expense. Do they know it is costing their patients that much?? The only way it might be remotely not worth your time and energy to do so is if you are going to reach our OOP maximum and it really won't matter what you spent that amount on if you're going to spend that $$$$$ anyway... And by the way--good job working at tackling the paperwork. I also think that is all unnecessarily confusing and frustrating all around. Gentle hugs to you. Quote Link to comment Share on other sites More sharing options...
prairiewindmomma Posted January 24, 2020 Share Posted January 24, 2020 It’s especially disgusting how much they charge when you compare prices for the same products on the general market. I am angry for you, Jenny. 1 Quote Link to comment Share on other sites More sharing options...
TravelingChris Posted January 24, 2020 Share Posted January 24, 2020 I would be super angry.. I am really glad that Tricare has now turned to using co-pays for most things but not for all things like hospital stays and surgeries are still percentages and you can't even tell how much because usually it is a very small percentage of the actual cost. My dh's surgery on his finger last year was after we had met our catastrophic which is very low- only 3000. i would be complaining to the doctor and the facility. That seems outrageously high for such a piece of equipment. Quote Link to comment Share on other sites More sharing options...
Arcadia Posted January 24, 2020 Share Posted January 24, 2020 1 hour ago, Jenny in Florida said: Because of some confusion regarding which of my two insurance plans is primary, there are still stacks and stacks of bills that are still working their way through the process.ins Are you max out on your primary and secondary insurance? Either way speak to medical social welfare about the bills. 15 minutes ago, Karen A said: Is that seriously what you are having to pay???? I'm livid for you! I would be complaining to the MD who sent you there, the "spa", and anyone else involved about this surprise expense. The oncologist or the surgeon might have assumed it is zero as many max out their out of pocket amount before or at surgery. Below is what I was billed for herceptin (Trastuzumab) which was a 30mins infusion (IV). My patient responsibility is zero because my out of pocket annual of $6k was maxed out by chemotherapy, CT scan and MRIs. 2 Quote Link to comment Share on other sites More sharing options...
Arcadia Posted January 24, 2020 Share Posted January 24, 2020 My insurance paid for two post lumpectomy bras. This was the approved one for me. It came with inserts and detachable drain pouch under my insurance plan. Hannah Breast Surgery Recovery Camisole - White $67.95 each https://www.amoena.com/us-en/accessories/post-surgery-recovery-care/hannah-breast-surgery-recovery-camisole-white-6626-size-XS-A-B/ Quote Link to comment Share on other sites More sharing options...
Jenny in Florida Posted January 24, 2020 Author Share Posted January 24, 2020 4 minutes ago, Arcadia said: Are you max out on your primary and secondary insurance? Either way speak to medical social welfare about the bills. We hit our out-of-pocket maximum for 2019. No clue yet how things will go for 2020. I didn't discover until after we had made the decision that any plan in my name through my employer would be default be my primary plan. So, I signed up for the high deductible plan, assuming we would use it as the back-up to my husband's pretty good plan. Consequently, months' worth of claims have been filed with my husband's plan, which is rejecting them. We are now going through the process of making sure all of the assorted facilities and providers have the correct information and are re-filing all of the claims. 2 Quote Link to comment Share on other sites More sharing options...
BeachGal Posted January 24, 2020 Share Posted January 24, 2020 That seems criminal to me. Just disgusting. How are they able to get away with that? Horrible. Another sports bra you might like are the racer backs made by Champion that are sold at Target. I bought three last November. The material is soft and stretchy and has some light padding that could be easily removed if you didn’t like it. The model # is N9069. Quote Link to comment Share on other sites More sharing options...
kiwik Posted January 24, 2020 Share Posted January 24, 2020 (edited) 1 hour ago, plansrme said: I do not know what I am talking about, so forgive me is this is a stupid thing to mention, but a woman I know was just telling me she knits breast prostheses for an organization that gives them away because, apparently, many women vastly prefer them to the silicon versions. Google pulled at least one of the organizations up pretty easily if that's of interest. My mother has a set of something similar she wears when she can't face the silicon. They are a little less realistic but fine for the supermarket or park. She finds the silicone ones benefit from breaks. Maybe they could be filled with something heavier? Not wheat but something inorganic. My mother does say they are a bit perky even with some stuffing removed. Edited January 24, 2020 by kiwik Quote Link to comment Share on other sites More sharing options...
Jenny in Florida Posted January 24, 2020 Author Share Posted January 24, 2020 I guess one other issue with most sports bras is that I still don't have complete and comfortable range of motion with my left arm/shoulder. So squeezing myself into something that has to be pulled on over my head is less than ideal. I would strongly prefer something with a front closure. 1 Quote Link to comment Share on other sites More sharing options...
Arcadia Posted January 24, 2020 Share Posted January 24, 2020 9 minutes ago, Jenny in Florida said: . I didn't discover until after we had made the decision that any plan in my name through my employer would be default be my primary plan. I was aware of that and my husband’s insurance keeps mailing us letters asking if I have other insurance coverage. I don’t work so totally reliant on my husband’s insurance coverage. 4 minutes ago, Jenny in Florida said: . I would strongly prefer something with a front closure. The Nike and Dick Sporting Goods sports bra I bought were comfortable and is front closure, hook and zip. The 6th of 8 photos shows the hooks and zip closure https://www.dickssportinggoods.com/p/dsg-womens-seamless-front-zip-sports-bra-19qyfwsmlsszpfrntwaa/19qyfwsmlsszpfrntwaa Quote Link to comment Share on other sites More sharing options...
BeachGal Posted January 24, 2020 Share Posted January 24, 2020 Here are some with zip fronts: https://www.womenshealthmag.com/fitness/g22603720/zip-front-sports-bras/ Quote Link to comment Share on other sites More sharing options...
Arcadia Posted January 24, 2020 Share Posted January 24, 2020 This article is worth a read Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls https://www.npr.org/sections/health-shots/2019/02/26/696321475/cancer-complications-confusing-bills-maddening-errors-and-endless-phone-calls I received a refund check in December 2019 for something we paid in Feb 2019. My insurance resets the out of pocket on April 1st annually. So the check was for a previous billing cycle. Quote Link to comment Share on other sites More sharing options...
BlsdMama Posted January 24, 2020 Share Posted January 24, 2020 6 hours ago, Jenny in Florida said: I'm trying really hard to not lose track of the bills coming out of my breast cancer treatment. It's a non-stop blizzard of paper, multiple envelopes arriving in every day's mail. I wasn't doing a great job of keeping up until a few weeks ago, when I spent nearly five hours sorting through the piles on my desk and organizing things and making a spreadsheet. But since then, I have devoted a big chunk of every paycheck to chipping away at the mountain. Because of some confusion regarding which of my two insurance plans is primary, there are still stacks and stacks of bills that are still working their way through the process.ins Today, I received a finalized bill for a visit I made to the euphemistically-named "spa" based at the cancer center. This is where I was sent by my doctor to be fitted for post-mastectomy bras. I walked in with a prescription and told that a certain number of bras would be covered by insurance each year. I walked out with two bras and one set of silicone inserts. (For the record, I hate wearing them and do so only when I am going to work or to more "formal" social occasions. I find them uncomfortable and heavy, especially now that my skin is a bit raw and tender from the radiation,) Anybody want to take a guess at what the original, pre-insurance bill was and what my portion is? Total Charge: $2,576.50 Patient Portion: $958.46 For two soft-cup bras and two slabs of silicone. I hate them even more now. I am so sorry. I swear the medical bills are the final insult to injury. Like you didn't already hate ALL of it - - - and then you get to pay through the nose for it. I have no help for it all but a ton of sympathy and "been there doing that....." Sigh. ((Hugs)) 1 Quote Link to comment Share on other sites More sharing options...
kbutton Posted January 24, 2020 Share Posted January 24, 2020 13 hours ago, Jenny in Florida said: Definitely not stupid. I appreciate the suggestion. Before I had my surgery, it was actually my plan to crochet myself some foobs (fake boobs), and I had multiple friends from my knit and crochet group offer, too. However, after wearing some very lightweight, fiberfill-stuffed inserts before the silicone ones came in, I discovered that I didn't like the way the lightweight ones "floated" around on my chest. If anyone is looking for patterns, they are called Knitted Knockers. I haven't made any, but that's the pattern I have heard of. There is new fill for weighted blankets in the stores, and I wonder if a tiny amount of that added to fiberfill would help? Or, shaping some quilt batting by sewing it to a little muslin before covering it with soft yarn? I wonder if a tiny line of silicone near the edges would help the whole thing stay settled inside the bra--the silicone would go on the bra side. This must be totally frustrating! Quote Link to comment Share on other sites More sharing options...
annegables Posted January 24, 2020 Share Posted January 24, 2020 How is it that we can send people to the moon and not have a decent, affordable pair of boobs (approved by insurance companies - no offense to the knitted ones) for breast cancer patients? This technology cannot be that difficult. Our health care system is a disaster. 1 Quote Link to comment Share on other sites More sharing options...
JustEm Posted January 24, 2020 Share Posted January 24, 2020 No where in the ballpark of what you're dealing with but I got a bill for a 15 minute long appointment with a midwife. It was $600. It was literally take blood pressure and go over medical records. When I called to inquire why I received it and insurance didn't they confirmed the amount was right but that it should have been billed to insurance. Now I know they aren't going to get that much from insurance but if that is where they start the negotiation then the patient inevitably pays more out of pocket once all is said and done Quote Link to comment Share on other sites More sharing options...
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