I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: kitkatz on December 09, 2006, 11:04:41 PM
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I figured it out tonight! And I use low figures for doctor's appointments! And did not figure in anything else. Add to it if you can for me!
Eight years of dialysis
Dialysis 30,000 a month
Epogen 2,000 a month
Dr at clinic 540.00 a month
Dr at Kaiser 100.00 each visit/every three months
Blood work each month 200.00
Graft revisions 10,000 eleven of these
200 bucks to Medicare every three months
12 shots of Benadryl each month 200
30.000 times 12 times 8
2,000 times 12 times 8
540 timse 12 times 8
24 times 100.00
200 times 12 times 8
Eleven times 10.000
200 times 24
12 times 12 times 8
Total: $3,097,072
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How in god's name did you get medicare coverage so cheap? I checked for myself and I would be looking at around $480 A STINKING MONTH!!
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But I have three insurances. And I only have to pay for part B, not A.
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What are your other insurances? And what do they cost you?
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I have Kaiser through Hubby's work and Blue Shield through my work. Hubby pays 140.00 a month for family coverage I think. My work picks up the insurance tab for us.
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I'm lucky my insurance runs $400 each month and then all I have is co-pays. Sometimes I can't even afford the co-pays. One time I needed a medication that cost $2400 for a 10 day supply and my co-pay was $400.00. Drug companies make me sick. Mini Rant Over.
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I figured it out tonight! And I use low figures for doctor's appointments! And did not figure in anything else. Add to it if you can for me!
Eight years of dialysis
Dialysis 30,000 a month
Epogen 2,000 a month
Dr at clinic 540.00 a month
Dr at Kaiser 100.00 each visit/every three months
Blood work each month 200.00
Graft revisions 10,000 eleven of these
200 bucks to Medicare every three months
12 shots of Benadryl each month 200
30.000 times 12 times 8
2,000 times 12 times 8
540 timse 12 times 8
24 times 100.00
200 times 12 times 8
Eleven times 10.000
200 times 24
12 times 12 times 8
Total: $3,097,072
I knew it. You are a millionaire. ;)
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More like the million dollar lady!
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More like the million dollar lady!
Between your capital gains value and your strength this year with all the adversity you've been through ... I'm just going to call you the Bionic Woman. :bow; :rofl;
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My Dialysis cost about £300 for treatment so add about £200 for nursing that's £6000 a month if I go 3x a week that equates roughly to $11,800 just for dialysis. I don't understand why you are having to pay so much for it all. Yes, it is free for me here though I have paid something towards my care in the form of National Insurance which comes out of my wages here in the UK.
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My Dialysis cost about £300 for treatment so add about £200 for nursing that's £6000 a month if I go 3x a week that equates roughly to $11,800 just for dialysis. I don't understand why you are having to pay so much for it all. Yes, it is free for me here though I have paid something towards my care in the form of National Insurance which comes out of my wages here in the UK.
Private insurance pays more than the Federally-run Medicare. The monthly amount charged is about $13,000, but the monthly amount approved by Medicare is about $2,200, depending how many treatment days per month. Medicare pays 80% of that amount, which equals $1,760. The remaining 20% (about $440 per month) is paid by the patient's private "Medigap" insurance or the State-run and paid "Medicaid" insurance. These amounts do not include EPO, just other meds.
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The figures seem exaggerated to me. I have paid for dialysis privately in a number of countries, and the amount I have been charged has never been out of the US$300 to US$400 per treatment range, which is also the same as what Medicare allows private, for-profit dialysis centers to charge it per treatment. The general estimate of the cost per dialysis patinet per year is only about $60,00o total, which includes all ancillary doctors' appointments, hospital stays, EPO, dialysis, medical diagnostics, etc.
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The figures seem exaggerated to me. I have paid for dialysis privately in a number of countries, and the amount I have been charged has never been out of the US$300 to US$400 per treatment range, which is also the same as what Medicare allows private, for-profit dialysis centers to charge it per treatment. The general estimate of the cost per dialysis patinet per year is only about $60,00o total, which includes all ancillary doctors' appointments, hospital stays, EPO, dialysis, medical diagnostics, etc.
Once again stauffenberg, you don't undertand. The figures I posted are correct. The larger amount is the monthly "retail price" which is rarely paid, but is charged in any case. The per treatment price (depending on medication) that Medicare approves (and pays 80%) is about $183, regardless of profit or non-profit facility. This amount may vary a bit from State to State.
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You only listed benadryl, kitkat. What about other meds, vitamins, otc painkillers? We had a post about how many pills we're all taking on here somewhere - retail cost of all of those isn't cheap.
I'd have to add in blood testers and misc. diabetic supplies like needles, lancets, glucagon shots. . .
Even with buying the cheapest brand on the market, blood testers run me about $800 a year.
And travel expenses - didn't we say we should add that when we started this last nigh in the chat?
Add in lost wages for time spent at appointments, treatments, traveling, and days too sick to work - or on disability completely. . .. yikes!
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The figures seem exaggerated to me.
This is a copy of my Medicare claims report, covering dialysis treatment (along with some meds) for the month of September, 2006.
Under the "Notes Section" you'll see what Medicare paid, for that month's total treatment, including my meds (one blanked out because it's an experiment).
The amount paid by Medicare was $2,059.15 and in addition, $516.42 was paid by my "Medigap" insurance, the total equaling $2,575.57 paid for my monthly dialysis treatment, regardless whether the provider is for-profit or non-profit —and a far cry from the Amount Charged (the "retail price") of $16,240.06. Since there were 13 treatment days in September, the per treatment cost therefore was $198.12 with my medications included.
That's $30,906.84 or a possible high of $35,264.28 (using the "m" charge) per year for hemodialysis treatment.
When I receive more medications, the total cost reflects that additional charge, as in "m" and "o" in the Notes Section for July and August.
Private insurance, I believe, pays a higher reimbursement rate than Medicare. But Medicare pays closest to the actual costs.
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I have seen the bills for the month and they total between 30,000 and 37,000 dollars a month. Who knows why it is so expensive but it is!
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I have seen the bills for the month and they total between 30,000 and 37,000 dollars a month. Who knows why it is so expensive but it is!
Maybe because you have private insurance as the primary payer and Medicare only as the secondary (20%) payer. Private insurance pays a much higher reimbursement rate for the same treatment. Yours seems to pay more than ten times the true cost of you treatment.
Or maybe because you receive lots of EPO?
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After eight years on dialysis Medicare is my primary insurance and the other secondary. I just think dialysis is a big pit of money. Thank the good Lord for my insurance!
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Are you sure you are paying a $100 copayment for each visit with a Kaiser Nephrologist? I've checked all the plans and the copay for Dr. visits aren't that high for any of their plans. I pay $20 myself.
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That was an estimate of how much it actually costs to see the doc.
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That's $30,906.84 or a possible high of $35,264.28 (using the "m" charge) per year for hemodialysis treatment.
Your saying that you get charged around the same amount in one year what kitkatz gets charged in one month? Something sounds fishy here. Who is closer to right?
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I went up to Aberdeen from London and arranged dialysis. This was still the same NHS and Aberdeen Hospital charged my hospital £400 for treatment. The cost in the UK is about £134 per treatment. Whenever someone has the opportunity to make money off dialysis they will as they know we have no other choice.
In my case I did not have to pay, but it was the same health service who receives the budget from the state. Just the one trust charging more than it would cost them.
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That's $30,906.84 or a possible high of $35,264.28 (using the "m" charge) per year for hemodialysis treatment.
Your saying that you get charged around the same amount in one year what kitkatz gets charged in one month? Something sounds fishy here. Who is closer to right?
From my understanding, if you got private insurance they end up paying more?
I went back to the first (http://ihatedialysis.com/forum/index.php?topic=1994) post
In Canada we pay high taxes so our health care is covered (I am only speaking for Ontario mind you). My doc visits = covered. My hospital stays = covered as long as semi-private or 4 beds to a room. My dialysis = covered. My eprex (Epogen) = covered. My heparin = covered.
Do I have private coverage? No.
Do I have disability = yes.
Disability covers my transportation costs and medication outside of dialysis (vitamins, BP meds, etc).
I don't have a lot so I am thankful that I live in Canada. I can't even afford rent but am lucky enough to live in special housing where I only pay $152/mth.
And on top of it I am allowed to work a few hours while on disability (provincial not federal).
So for me to see how it is for Americans scares the living CRAP outta me!!
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Your saying that you get charged around the same amount in one year what kitkatz gets charged in one month? Something sounds fishy here. Who is closer to right?
Come on, I posted the actual "Medicare Summary Notice" and explained the difference between what is charged ("retail price") and what is paid by Medicare. It can't be more straight forward than that. :o
Added on 12-13-06:
It doesn't cost anybody $30,000 a month for dialysis treatment in the U.S. Medicare doesn't pay $30,000 a month, and you'd be hard pressed to find a private insurance company in the U.S. that pays $30,000 a month for dialysis treatment.
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I have bills but cannot get it uploaded becasue you can't see what my scanner scans out.
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Your saying that you get charged around the same amount in one year what kitkatz gets charged in one month? Something sounds fishy here. Who is closer to right?
Come on, I posted the actual "Medicare Summary Notice" and explained the difference between what is charged ("retail price") and what is paid by Medicare. It can't be more straight forward than that. :o
Zach, you are very ... damn I forget the word I was going to use for knowledgable .. anyway, for you it is simple and straight forward but for someone with no health issues as Sandman .. but dating a girl on dialysis who is in a country where everything is paid, you have to understand he might be confused and need clarifying.
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I apologize ahead of time for the following question, but I'm panicking, and I need to know: I'm still pre-dialysis, and I'm wondering if you know of anyone who decided against doing dialysis (and yes, I know the consequences) because of being unable to deal with the financial issues. I am not a give-up type person, but I am having a lot of difficulty wrapping my mind around how I can actually deal with it all. I am maxed out on what I can do energy-wise at work due to other health problems, so I know when I hit dialysis I almost certainly will not be able to work, so then I'll be on disability. I mean, if I strip all the "extras" out of my life (except my 2 cats - I have to have them!), and just pay rent, phone, minimum groceries, I still don't see how I will be able to afford the medical things Medicare doesn't pay for. I live in an urban area where rent is really high (I live in a small 1-bedroom in a hi-rise, at the cheapest end of the rent scale, and an efficiency there isn't much less; I can't move to a cheaper place because there aren't any around here). To get cheaper rent, I would have to move way out of the area, and my only daughter lives near me now. And by staying in an urban area, I will still be able to get to doctors, grocery stores, etc., on my own when I am worse.
So in reality, what actually happens to people in situations such as mine - do you just do without medicines and decline more quickly than you would with them, do you charge things as long as possible and then go bankrupt and THEN do without? I don't know that living like that would be better than refusing treatment (I'm 61, which isn't particularly old, but come on, I've had a life).
Damn, I just reread this, and it sounds so petty, but I'm still going to post it, and expose myself to all of you as the coward I am. I don't mind really difficult fights, I can handle having really troublesome times, and I still have a lot of gumption left, but I'm starting to think I just don't want to sign on for a long haul of unrelieved misery if that's all there'll be. I picture the possibility of living with unrelieved suffering and super-sized stress, and the alternative doesn't seem so unappealing!
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Once again stauffenberg, you don't undertand. The figures I posted are correct. The larger amount is the monthly "retail price" which is rarely paid, but is charged in any case. The per treatment price (depending on medication) that Medicare approves (and pays 80%) is about $183, regardless of profit or non-profit facility. This amount may vary a bit from State to State.
Yep. I might add from what the head of our unit told me was Medicare also figures in age, weight, height among other things.
Using the deductible and coinsurance column, which is 20% of the approved amount by Medicare, it shows the price difference in approved amounts by Medicare for the same procedure when comparing it to what Zach posted of his statement. (that is if I am doing this right) :)
This is what mine breaks down for 13 treatments.
Service Amount Non Covered Deductible & You may
Charged Charges Coinsurance be billed
Dialysis procedure(90999) $6500 0.00 385.40 385.40
So if 385.40 is the 20% coinsurance I am liable for, the approved amount for this procedure by Medicare would be $1927.00 in my area.
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So if 385.40 is the 20% coinsurance I am liable for, the approved amount for this procedure by Medicare would be $1927.00 in my area.
BigSky is right on the mark!
I picture the possibility of living with unrelieved suffering and super-sized stress, and the alternative doesn't seem so unappealing!
Nextnoel, don't be discouraged. If you receive disability from Social Security, you should be able to qualify for your State's Medicaid, insurance for low-income (or no income) folks. That in turn should pay for all medical bills, along with Medicare. Once qualifying for Medicaid, you then could qualify for transportation for medical appointments, Section-8 housing vouchers, even perhaps food stamps.
Each State has different requirements and benefits. Best to ask a social worker at your Nephrologist's office.
Just don't dispair! I've been on hemodialysis for almost 25 years ... and I work full-time.
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Thanks, Zach! I'm breathing a bit easier now. I'm not afraid of a rough road, I'm just scared of The Great Unknown! Your reassurance helps a lot. :thx; :thx;
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so I know when I hit dialysis I almost certainly will not be able to work, so then I'll be on disability. wn when I am worse.
After I started dialysis I felt better and with my EPO my HB levels are higher than before I started dialysis. I know it is the great unknown, but once you start dialysis you will not regret it. I work full time along with many others and dialysis just fits into your life.
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So if 385.40 is the 20% coinsurance I am liable for, the approved amount for this procedure by Medicare would be $1927.00 in my area.
BigSky is right on the mark!
I picture the possibility of living with unrelieved suffering and super-sized stress, and the alternative doesn't seem so unappealing!
Nextnoel, don't be discouraged. If you receive disability from Social Security, you should be able to qualify for your State's Medicaid, insurance for low-income (or no income) folks. That in turn should pay for all medical bills, along with Medicare. Once qualifying for Medicaid, you then could qualify for transportation for medical appointments, Section-8 housing vouchers, even perhaps food stamps.
Each State has different requirements. Best to ask a social worker at your Nephrologist's office.
Just don't dispair! I've been on hemodialysis for almost 25 years ... and I work full-time.
Just a quick note on Medicaid. I get Social Security Disability (SSDI), and that is my only income. I do not work. I do not qualify for Medicaid or SSI beause my income is too great from SSDI. However, I don't get hardly anything on SSDI so I qualify for extra-help. Basically someone other tha me ispaying my Mdicare premiums, and I also have a Medicare Supplemental insurance and I have someone other than me paying my premiums on that also. So Medicare pays 80%, my supplemental insurance pays the oter 20% so I pay NOTHING. The point i'm trying to make here is if you can't get medicaid, there's lot's of other help out there, and your social worker can help you get it. Don't give up. ;D
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Thanks, Angela. I didn't realize there were so many possibilities for financial help out there. I'm going to go back to not obsessing about it, and get information from the social worker when the time comes (well, long before that, actually). At least now I know there's hope! THANKS!
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Your saying that you get charged around the same amount in one year what kitkatz gets charged in one month? Something sounds fishy here. Who is closer to right?
Come on, I posted the actual "Medicare Summary Notice" and explained the difference between what is charged ("retail price") and what is paid by Medicare. It can't be more straight forward than that. :o
I'm sorry Zach. It's just that kitkatz had posted an amount that just sounded so unrealistic. I mean really, how is ANYONE suppose to aford costs like that? It just can't be done.
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kit was trying to figure her total retail cost for her treatment - not how much she has to pay herself, I think. We're all pretty high maintenance around here.
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I was not saying what I paid. Hell, you guys think I am Rockerfeller around here???? I am just a little school teacher on a school teacher's salary who happens to be VERY lucky to have insurance and Medicare to pay all of this stuff! I was adding up total treatment costs. The only out of pocket expenses I have had in these eight years have been for medication copays, dr copays, and emergency room copays. Oh and the 200 dollars Medicare demands every three months. They hit December pretty hard this year.
Thank the Lord and pass the ammunition I am well and able to work still!
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I'm sorry Zach. It's just that kitkatz had posted an amount that just sounded so unrealistic. I mean really, how is ANYONE suppose to aford costs like that? It just can't be done.
No, it can't be done. I think that's the sad, sad point of it all. I just got approved for my Medicare and I'm happy to have it!
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Here in the British Virgin Islands everything was totally free, because it was all done at the general hospital. Then the general hospital came under a statutory board. The ruling was that once you had insurance, the insurance had to pay. However, treatment will not be denied to anyone who doesn't have insurance. The cost here per month is about $6000 (500 per session, including medication given). We pay for Phoslo and any diabetes and hypertension medication that is prescribed.
In my home country, Barbados, we pay a health levy in our taxes and all treatment at the general hospital is free. At private clinics, the cost is $300, $350 per session.
I am going home on holiday, and since I am not presently resident there, I have to go to a private clinic and pay up front, but the insurance company will reimburse.