The COST of dialysis, etc.

[Bajanne]

Rerun, I am doing as you suggested and starting a new thread concerning the cost of dialysis.  I am still staggering from your quotations -  "my fistula was $25,000 and my Hickman Catheter was $13,000".  I could not believe when the surgeon quoted $3,100 for my graft and the hospital quoted $1,300.  And it only cost that because I went to another island to do it.  My Hickman Catheter was done for free.
They have not started to charge us for dialysis as yet, and I am hoping they don't get around to it for a while.  But the hospital which was government run, now is under a statutory board, so I don't know what is going to happen.  How much of the cost of your operations did your insurance cover?
I would like to hear from others what the cost are like where they are.

[Epoman]

Rerun, I am doing as you suggested and starting a new thread concerning the cost of dialysis.  I am still staggering from your quotations -  "my fistula was $25,000 and my Hickman Catheter was $13,000".  I could not believe when the surgeon quoted $3,100 for my graft and the hospital quoted $1,300.  And it only cost that because I went to another island to do it.  My Hickman Catheter was done for free.
They have not started to charge us for dialysis as yet, and I am hoping they don't get around to it for a while.  But the hospital which was government run, now is under a statutory board, so I don't know what is going to happen.  How much of the cost of your operations did your insurance cover?
I would like to hear from others what the cost are like where they are.

Luckily In America Social Security covers 80% and my secondary insurance covers the other 20% I have been on dialysis for over 11 years and I have never paid a penny for any treatment or surgery. However I have heard of people in America who have a PPO for insurance and they go bankrupt because of having to pay for dialysis. That's why HMO's may not be the best, but for me I have NEVER had to pay a penny.

[cabarle]

For me, I use the VA so it doesn't cost me anything but time. Plus, I also file a travel claim 3 days a week since my condition is considered "service connected". The travel claim is a whopping $6.00/trip.

[Rerun]

In America, Epoman is right, Medicare does kick in.  But, for me, it won't kick in until the 3 month waiting period is over.  I guess they want to see if you can take it!!   Then my insurance is primary (Pays 80%) and Medicare is secondary (Pays 20%).  Then after 30 months (don't know where they came up with that) the coverage flip-flops and Medicare pays 80% and my insurance becomes secondary and pays 20%.   

So, without Medicare at the beginning, you may have to pay 20% of all bills.  That could wipe you out financially in just one surgery.  I am under an HMO, which is basically a health care organization who contracts with certain doctors and hospitals.  If you go to a doctor not contracted with them, they don't pay as much.  If you stay with-in the contracted doctors they usually cover everything.  I think the hospitals and doctors look at what insurance you have and if it a good one they go for the jugular.

If you ask in advance how much a procedure is..... they can never tell you.  My scenario to them is.... "How would you like it if you went to the grocery store and got a gallon of milk and the cashier said he didn't know how much it would cost and they would just bill you.  When you get the bill it is $845."  Medical Costs here are outrageous. 

People may say that they didn't pay anything... insurance covered it.  But, you know what?  Someone paid it.  Whether it is the insurance company or the tax payer... someone is paying WAY too much for our dialysis treatments and our surgeries. 

What is the answer?

[rhood151]

You would be very suprised at the difference between the cost to medicare vs. the cost to the private insurer.  Typically under Medicare, dialysis costs about $133 per session and EPO is $10 per 1,000 units.  That very same service by a Davita clinic to a privately insured patient costs $888 for dialysis and $107 per 1,000 units of EPO.  That's one of the reasons insurance rates are so high. 

[Epoman]

You would be very suprised at the difference between the cost to medicare vs. the cost to the private insurer.  Typically under Medicare, dialysis costs about $133 per session and EPO is $10 per 1,000 units.  That very same service by a Davita clinic to a privately insured patient costs $888 for dialysis and $107 per 1,000 units of EPO.  That's one of the reasons insurance rates are so high. 

Hey welcome to the board! Do me a favor and go to the "Introduce Yourself" section and make a new thread to tell us about yourself.

Also I love hearing numbers information like that. Welcome to the board but please go introduce yourself.

[Rerun]

I'm hitting this subject again because I received my Explanation of Benefits (EOB) for my trip to Spokane for Christmas where I dialyzed twice.  $6,718.74...........  You do the math.   

I'm not worth $10,000 a week to keep me alive!  And speaking as a tax payer.......Neither are YOU!  My GOSH that is nuts!

The expensive thing is Epogen.  In one of the above posts they talk about the costs differences with Medicare and Private pay for Epogen.  I get 15,000 units a time.  I'm going to ask my Dr. why I have to have so much.  If 5,000 units keeps my blood count to a level that is sufficient, why give me 15,000......... is it "MONEY?"   

The Government would be better off to pay our families $100,000 if we denied dialysis!!!

And I'm speaking for myself here, but good grief some people in my center don't even know where they are!!!

[Bajanne]

I got a pleasant and timely surprise from my insurance company last week.  I had claimed for the dialysis that I did in Barbados - 3 sessions x $300.  I thought they would have refunded 80% and maybe taken out my deductible for this year - 100, so I was expecting about $620.  Well, first of all, it took so long.  I filed since late December.  But this is what made it pleasant - the check was for $900!! the entire sum.  This made it timely - I got it just as I was to take my new car out of customs and the customs bill was $969!! How's that for timing!

[Bear]

Thank GOD I live in one of the few 'civilized' countries that have hospital care mostly governement controlled.
Patient health care comes first, not profits. As ReRun says, in the end _someone_ pays.....so if  you all pay thru
taxes, it will, in the end, be cheaper for everyone. If you have to have even a %age thru insurance companies,
there's a huge roll-on effect: as seen above - if the hospitals/surgeons see a good insurance company, they
rub their hands & bump up the cost....the insurance company has to make a profit for its share-holders,
so they bump up the premiums....so everyone's hit both ways. And big salaries/profits are made by a few.
Sometimes I think in the USA & elsewhere it's the HYPOCRITICAL  oath the docs take, rather than the
 Hypocratic!!    
....for me this all means I haven't paid a cent. I would have been prepared to buy the Fresenius machine I
usse @ home, if it had come to that for home haemo. I think this even applies in some UK local health
authorities (?) ...but anyway, I didn't. It's worth $16500 (about$US11000) & is 'mine' for as long as I need it.
 Queensland Health & my particular unit @ P.A. are great as far as I'm concerned! 

[onesicpup]

I've been lurking around since my last post, been reading about the costs both monetarily and just life style and such. I'm wondering, you can answer if you want or not, how many people feel it's all worth it. I'm not in the same shape most of you all are in, yet,  but I'm beginning to believe it just doesn't sound like something I want to put my extended family through . Sure I'd miss seeing my grandkids grow up but then they wouldn't have to watch me deteriorate like I've seen other people do. Sorry to be so down, but I really am at this point considering all my options. Thanks for the area to talk about things you can't talk to your family and non-internet friends about

[Rerun]

Puppy, it is worth it to see your grandkids grow-up if you are having quality of life.  I'm having quality of life, but it just pisses me OFF at the cost!  I do not like being taken advantage of.  If I could make a statement like on "60 Minutes" where they would watch me die because I refuse dialysis because of the cost, I would do it.  BUT, if I quit dialysis now because of the COST, no one will care! 

You hang in there!   

[Sara]

I've been lurking around since my last post, been reading about the costs both monetarily and just life style and such. I'm wondering, you can answer if you want or not, how many people feel it's all worth it. I'm not in the same shape most of you all are in, yet,  but I'm beginning to believe it just doesn't sound like something I want to put my extended family through . Sure I'd miss seeing my grandkids grow up but then they wouldn't have to watch me deteriorate like I've seen other people do. Sorry to be so down, but I really am at this point considering all my options. Thanks for the area to talk about things you can't talk to your family and non-internet friends about

I'm speaking just as a family member of someone on dialysis...

It's not a burden to me to help or care for my husband.  I don't care how much it costs, how much time it takes, whatever inconvenience it is, he is worth it.  I'm sure your family feels the same way and would be brokenhearted and devastated if you chose not to continue.  There are so many advances in medicine happening, you don't know what's just around the corner.  I hope you can stay strong and work through things.

[anja]

Pup,
  I think that at one time or another we all have the same thoughts as you are having- but I have to admit that this PD is not near as life-altering as I had anticipated it to be.  I hook up every night, go to sleep with the cycler programmed and in 9 hours I wake up and am done with dialysis  and the day is mine to do with as I wish.  You aren't a burden to anyone, as long as you can hook up the bags to your machine and empty the waste water in the morning yourself.  I can travel, I can visit my grandkids, I can garden, and do most all things- I just have a little tube in my abdomen...I do give myself a shot once a week, also no big deal, to keep my anemia at bay.  Please, please ask questions, get answers, know all your choices, so you can make an informed decision- that is what I did, even though my Neph. wasn't exactly for it.  It is our body, we can make our own choice.  Good luck and write again.- Anja

[Rerun]

Anja,

What do you mean "even though my Neph. wasn't exactly for it"?   Please expand on this.  I curious what he wanted you to do. 

[onesicpup]

Puppy, it is worth it to see your grandkids grow-up if you are having quality of life.  I'm having quality of life, but it just pisses me OFF at the cost!  I do not like being taken advantage of.  If I could make a statement like on "60 Minutes" where they would watch me die because I refuse dialysis because of the cost, I would do it.  BUT, if I quit dialysis now because of the COST, no one will care! 

You hang in there!   

Thanks for the input everyone. But that's what I'm talking about the quality of my life. It just seems that today is always worse than yesterday in how i feel and what I'm able to get done. I seem to be at the midpoint at about 18% function, not bad off enough to get real medical help, just bad enough to get nothing accomplished anymore. I am lucky in that the company i work for is very understanding, but it's like in the post about stupid things people say to you, I must look really bad because every day somebody(s) telling me I look bad. Always something you want to hear.

[Bear]

Ahah!!!!!  SO you're functioning @ 18%, 'Pup, & therefore not on any form of dialysis!???
...if so then many of us will know how you feel...the Oz phrase is 'ratshit!'
You are in the process of 'sliding downward', which they don't seem to be able to do
much about until you actually need dialysis.
I didn't really realise that IgaN was dragging me down. With the sickness every morning
(I knew I wasn't pregnant! ); the 'fall-over' weariness & certain other 'discomforts'....
well to be honest I thought I might've had the "Big C' in some (presumably terminal) form.
So in fact, I was quite relieved when I eventually ended up in hospital & found out the real
deal       ...then unfortunately, I spent a year on P.D. & in my case, it just did not work.
During that year, I wasn't sure whether it was all worth it either. I was so low anyway, when
I went in for my first catheter surgery, I thought dying under the anaesthetic was as good an
option as any   ...same with the 2nd op., ... same when I went in with rapid heartbeat
...same with my fistula ops.
BUT!!!!!...once I got onto haemo, I started to pick up.    O.K., so I still feel 'ratshit' for a few
hours after haemo, but later & on the alternate days, I feel good! Well...not bad for a 57y.o.
SO...hang in there 'Pup - whichever method (P.D./H.D.) works for you, it should have you
climbing back out of the 'pit' you are currently unfortunately sliding into. 
...if you're a drinker, enjoy a few beers or glasses of wine, while you're still not on fluid restricts.!
 

[Rerun]

Bear is right.  You feel like "ratshit" now, so when they put you on dialysis and you upgrade to mousepoop you are thankful!   

[Bear]

"Mousepoop"?     Oh! I'm way above that now ReRun.  I would say up to "bovine excreter"...but everyone I know
would say I've been full of that for years... 
My wife says she knew I was getting better when I started to heckle the telly & get 'cheeky' with her.....after 2 years
of near-silence, she reckons! 

[anja]

Rerun,
  My Neph. is more for the hemodialysis route than the PD-  And since my dad is on hemo, and doesn't fair too well (b/p issues and washed-out after treatments)  I wanted badly to try pd and have been so extremely fortunate that it is working so well!  But , had it not been for the internet, I would not have known I had choices other than hemo.          Anja

[onesicpup]

Rerun I really like that term "mousepoop" makes me laugh

[Black]

In America, Epoman is right, Medicare does kick in.  But, for me, it won't kick in until the 3 month waiting period is over. ...

The director at the Atlanta DaVita clinic told me that if you start training for home dialysis during that first three month period, Medicare will pick up the cost of the first three months.  Medicare has finally figured out that home dialysis saves them money in the long run and do this as an incentive.  Every dialysis center should be familiar w/ the procedure of back billing for the first three months -- if they're not, then they can call Medicare for instructions.

[Rerun]

Actually, that has always been the rule.  20 years ago when I first started, I had to do home dialysis because I lived 2 1/2 hours away from a major medical facility.  Medicare started immediately for my home dialysis.   OK then I was transplanted for 17 years......

So, this time I was told I had a 3 month waiting period.  I am in clinic this time.  So, I get my card (finally) and it had a start date of 9/1/2005........  It should have been 12/1/2005.....  Plus they started the premium back in September too and my first bill was something like $600.      So, I called them and they said that because I was on dialysis before (20 years ago) that there was NO waiting period this time!!!  WTF  SO, now I have to notify my insurance and all the Dr. etc that Medicare was indeed my secondary those 3 months!

I'd like to find the "dumb ass" that told me I had a 3 month waiting period!!   

[geoffcamp]

In the beginning I had no insurance so I applied for Medicare and Medicaid and paid all the bills for the work ups on my own. 28 and no job, it tore thought my savings then I got benefits but did not qualify for Medicaid.  So I ended up paying 20% went even further into debt and collections.  I got a transplant very fast (before I knew what was really going on) and went back to work right away.  I paid $1000 deductables a year and more for drugs and co-pays, never really dug out of the hole.  Three years went by and I was starting to make some headway at restore my credit and financial situation when my kidney rejected.  I was put back on dialysis and continued to work for about a year and a half still the bills were overwhelming, my company's insurance company denied my claims every quarter and I had to call and straighten them out (I think they did this on purpose to see if they could get out of paying the bills).  i came to a place where working was not "working" for me any longer so I left and took the COBRA coverage almost $500 a month.  Between the Ins. company denying bills and me not working any longer I have gotten deep and deeper into debt, thank god for my family they have helped me very much.  I cannot afford and apartment let alone a house have no assets, credit cards.. etc.  nothing someone normally my age (36) should be working on.  No 401K or retirement plan (if I get that far).  It is depression and a constant battle with the government and insurance company's to pay bills.   I spend at least a couple hours a week trying to work it all a out.  I recently went back to work because I could not afford to live on Social Security and pay my medical bills, I know I should not be working now it drains me and I feel tired all the time, also I have no time to myself 8-5 M-F  Dialysis M-W-F 5:30-10.  This truly has been the hardest part of being sick to me, all my financial goals have gone up in smoke and there is no easy solution!!  I too looked at my bill for dialysis it was in the range of $29,000.00 a month CRAZY,  I say give me the money I go have a good time for a couple of weeks then die... at least I'll have fun for a couple of weeks right???  Well that is my rant....

Geoff

[Rerun]

I received a billing statement from my Nephrologist's Office today. 

The last one I received was April 2005. 
4/5/05  Office Visit Established PT  Charges $150 Payments $110
11/1/05  Hemodialysis  Charges $475  Paid 273  (I have no idea what this is for)
1/1/06 Dialysis 1 visit per month  Charges $370  Paid $167
2/1/06 Dialysis 2-3 visit per month Charges $465 Paid $456
3/2/06 Hospital Visit Charges $100  Paid $97
3/7/06 Dialysis 2-3 visit per month $370 paid $166
4/1/06 Dialysis 2-3 visit per month $465 paid 209
5/1/06 Dialysis 1 visit per month $370 not paid yet.

What a racket.  For 3 minutes if their time they charge $370 and get $166?  AND that is PER Patient.

I don't know why I posted this except the cost of dialysis makes me nuts.

[Epoman]

I received a billing statement from my Nephrologist's Office today. 

The last one I received was April 2005. 
4/5/05  Office Visit Established PT  Charges $150 Payments $110
11/1/05  Hemodialysis  Charges $475  Paid 273  (I have no idea what this is for)
1/1/06 Dialysis 1 visit per month  Charges $370  Paid $167
2/1/06 Dialysis 2-3 visit per month Charges $465 Paid $456
3/2/06 Hospital Visit Charges $100  Paid $97
3/7/06 Dialysis 2-3 visit per month $370 paid $166
4/1/06 Dialysis 2-3 visit per month $465 paid 209
5/1/06 Dialysis 1 visit per month $370 not paid yet.

What a racket.  For 3 minutes if their time they charge $370 and get $166?  AND that is PER Patient.

I don't know why I posted this except the cost of dialysis makes me nuts.

You get 3 minutes  Damn what do you guys talk about that takes that long  Your doctor must have ALOT of free time to be wasting that much time on you. Damn 3 minutes, WOW. He must be one nice doctor. Your lucky!