Facts and Figures

[kitkatz]

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

[sandman]

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!!

[kitkatz]

But I have three insurances.   And I only have to pay for part B, not A.

[sandman]

What are your other insurances?  And what do they cost you?

[kitkatz]

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.

[Sluff]

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.

[BigSky]

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. 

[kitkatz]

More like the million dollar lady!

[Sluff]

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. 

[MattyBoy100]

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.

[Zach]

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.

[stauffenberg]

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.

[Zach]

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.

[jbeany]

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!

[Zach]

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.

[kitkatz]

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!

[Zach]

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?

[kitkatz]

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!

[livecam]

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.

[kitkatz]

That was an estimate of how much it actually costs to see the doc.

[sandman]

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?

[AlasdairUK]

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.

[angieskidney]

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 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!!

[Zach]

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.     

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.

[kitkatz]

I have bills but cannot get it uploaded becasue you can't see what my scanner scans out.