Teeny tiny health scare (the C word)

This won’t be news to those of you who follow me on Twitter, but last week I got the results from some mole/mark biopsies and one of them came back as Basal Cell Carcinoma. Yeah, carcinoma, as in “cancer”. It’s benign, not the kind of cancer that kills you…I could have ignored it for the next 20 years and the only thing that would have happened is that it would have become bigger and uglier. My dad had it, assorted aunts and uncles have had it, and heck, there’s even some malignant melanoma in the family too (grandma, aunt, cousin). Is it genetic? I guess, but really I’d classify it as ethnic – damn celtic complexion.

I knew I wouldn’t be in any frame of mind to deal with insurance stuff if the diagnosis on the “pimple that wouldn’t go away for 6 months” turned out as it did, so I picked my dermatologist because the practice he’s with has a Mohs surgeon (minimal scarring) and I could be set up with that directly. My co-pay for specialist visits is $40, so I was trying to keep all that to a minimum. Sure enough, despite being totally prepared for the biopsy result, I barely remember the conversation with the doctor and the scheduler because I started to space out. I kept asking them to repeat things so that I wouldn’t forget – thankfully it was easy,  just no aspirin or ibuprofen, and show up at 1:30pm. That I could manage. I hung up the phone and cried for an hour solid, and then sporadically for the next hour or so. Um, I’m not really much of a cryer, so it gave me a terrible headache and, poetically, I couldn’t take anything for it.

Mohs involves local anesthetic and the removal of skin layer by layer until the microscope tells them there’s no more cancer. The assisting nurse said that most patients just need one layer, and I caught mine so freaking early that that’s what I’d prepared for. Well, they needed to take two. And so I type this post with 10 vertical black stitches under a ridiculously big band-aid on my forehead. Yes, I got the band-aids and Neosporin for free at Walgreens. Hey, c’mon, this a personal finance/frugality blog, I had to mention that!

I would like to take this opportunity to bitch about one thing that really shouldn’t be difficult with our healthcare system: why can’t you get a ballpark figure for office procedures? I’m with a major insurance carrier, shouldn’t they be able to look up the code and say “it’ll be $__ for the first layer and $__ for each additional layer removed if all goes the way it normally does.” How are we supposed to be financially responsible if we don’t know whether to expect a $500 bill or a $5000 bill?

And here’s a real kick in the head – this practice (and I understand this is becoming quite common) will not do anything beyond a co-pay consultation unless you have a credit card on file. If you don’t pay your bill within 30 days, they charge your card. I was planning to unofficially finance it @ $200/month until it was all paid off, but now that’s not an option. I can only hope it takes ages to process the bill while I save up. Normally I could take a $1000 hit without touching my savings account, but that hasn’t been the case for a year now.

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16 Responses

  1. I hate that about health care too … I had some back surgeries last year, and I swear that even the person who brought me water billed my insurance under a different name. So not only do i have no idea what I owe/owed, I’m having trouble keeping track of what I’ve paid (not usually a problem for me).

    Glad to hear that it turned out as expected. Gz on the freebies!

  2. I’m glad it was “only” basal cell — I was worried about you. But I’ve never heard of the credit card on file thing. Perhaps that’s because I’ve been lucky enough to not have to deal with anything super-major. Although I’ve had my battles with medical insurers before (and won).

    • I’ve won battles with insurance companies before too, but not lately. Even though no legislation has been passed regarding reform, I think they’re getting ready for it by sucking as much money as possible while they can, much like the credit card companies.

  3. I hate health insurance practices as well. I went to the Dr. yesterday for my annual check up. I’ve ALWAYS had to pay my co-pay at these visits. This time the person who checked me in said I didn’t have to because it was my preventative once a year visit. I can’t wait to see the bill that “magically” lands in my mailbox on this one.

  4. My dislike for our healthcare system is well-documented and your experience reminds me yet again why. I know some people think that patients should be more aware of and negotiate pricing to help keep costs down (the free market idea) but it is extremely difficult to compare prices on various procedures. If you’re hospitalized, they can never seem to give you a correct estimate and additional charges will appear.

    I am not completely blaming hospitals and doctors. It is nearly impossible for them to bill properly because we have so many health insurers and each insurer has several plans. Plus health insurers routinely reject claims as part of their profit-making mentality.

    Anyway, glad to hear that you have taken care of this and it wasn’t cancerous!

    • I know…I’d like the concept of health care reform to focus on stuff like this first, things that are relatively easy to implement and still make a big difference.

      P.S. It was cancerous – just not the bad kind like Canadian Girl below (phew!).

  5. I’m in my early 20’s and am a Melanoma survivor. If it wasn’t for my parents, Mohs surgery here in Canada wouldn’t have been an option without a long wait. I would’ve died without it.

    I went to the US, and had 4 moles removed by Mohs; all but one were Malignant and so began a journey as a survivor.

    I’m so glad you’re ok. I know first hand just how hard it can be.

    • I lived in the UK with nationalized health care for 8 years, and it never failed to horrify me the things they considered wait-list-able. My ex-mother-in-law had a heart attack and spent 10 months on The List for bypass surgery. It’s like they were punishing her for being a smoker and having an unhealthy diet (which she immediately gave up/changed, unlike many). However, you did have the option of buying private health insurance that basically put you in a nicer hospital and eliminated the wait list – in the late 90s, it cost PEANUTS. Seriously, like $35 a month. I know because when my ex-hub became a self-employed software contractor, we signed him up for it.

      I didn’t realize Mohs could be used on Melanoma – everyone I know who had that kind got it gouged out of them. But then, it wasn’t on their faces (legs and back, strangely enough).

  6. Dude. Oy. Glad to hear it wasn’t the evil kind. So sorry to hear the health maze decided to be the evil one. The lack o’ clarity is absolutely absurd. No other industry (save home repair/remodeling?) can get away with that shit.

    My Ma is an NP and is constantly doing this on the down-low to help her patients. I wish more docs/NPs would do the same.

  7. Whenever I’ve had things done, I’ve been given a ballpark, but I can see why they might be reluctant to do so. There’s always the possibility of complications or the individual’s body having an unexpected quirk. They may be resisting giving a ballpark figure because they don’t want people to get mad if their individual case isn’t in that ballpark range.

    As for the credit card thing, I’ve had that occur a couple of times, but not too often. That said, I think that your original plan of “unofficially financing” it is exactly why they do it. And I don’t blame them. When people don’t pay their bills on time, it hits their ability to pay employees, purchase supplies, and maintain a decent standard of care. Plus if someone declares bankruptcy, the medical office has to stand in line with the other creditors. If they put it on the person’s credit card, they know they’ll be paid on schedule and potential bankruptcy is the credit card’s problem.

    • Well, I’m talking about “unofficially financing” my 20% co-insurance. They’re already sitting on the 80% from the insurance company and are well in the black on already. Hm, and maybe if people didn’t “finance” it usuriously on a credit card and actually paid without plastic every month, we’d all be in less of a mess.

  8. Oh my goodness. I’m so glad it wasn’t worse, and I hope you’re feeling better. BTW You probably can take pain relief that is paracetamol based. (I don’t know any brands for the US.) Often aspirin and ibuprofen are not allowed because they are blood thinners and would make you bleed more, but paracetamol doesn’t have that effect. If you are suffering it may be worth checking with your doctor. (Or to have the information for the future.)

    I share your frustration with the healthcare system and costs, although we’re under different systems. How frustrating and exactly what you do not need after your procedure. *Hugs*

    • It’s called acetaminophen/Tylenol here, and yes, it was okay to take that. However, it doesn’t have that much of an effect on me on its own. I take Excedrin, which is half aspirin, half acetaminophen, with a caffeine kick. Works like a charm for me.

  9. I hope the mention of a wait-list in a universal healthcare system doesn’t scare Americans away from reform. No system is perfect but I think a wait-list is preferable than not getting surgery at all if you can’t pay. While I’m sure there are horror stories about wait-lists, I’ve known Italians who have gotten major heart surgery, cancer surgery etc.. without delay and without worrying about bills afterwards.

    I’m also glad you mentioned the private option (which is an an option in Italy, Germany and most European countries). If you can afford it, you don’t have to wait. If you can’t, you’re not denied surgery or have to go bankrupt in order to pay for it. Medical related expenses account for a large number of bankrupcies in the U.S. (Yes, I do hear that there are programs available but I’ve done my research and financial assistance programs are available only to the very poor; if you’re middle class, they may or may not help you with a payment program but definitely no financial help). There is something fundamentally wrong about this U.S. system.

  10. Hi, may I call you Kate? I, too have had BCC with various prognosis (plural), advice, and therapies. I, too have gone thru the Mohs surgery where being told that a second scrape is necessary and viewing what I thought was a (moon) crater only to see it convert shortly to a smaller scar that cooperated with vertical face lines. But, the diagnosis of the tip of my nose caused me the greatest of anxieties. Working in the public with a blackened “thing’ on my nose had me many times very uncomfortable and the specialist rendering of the proposed surgery was nothing short of devastating. The surgery would begin with a clipping off of the tip of the nose cartilege (sp?) followed by a reroute of a vein from my forehead to the skin graft from my shoulder implanted to my nose. And, my recovery would be over 3 months with dressings that would need daily attention. Kate, i just could not do this. What I am about to tell you will no doubt sound loony but it is the truth. I prayed to God for healing because I could not accept the surgery and through a time of faith and patience, God healed me. The tip of my nose has some light scarring but most people do not notice it unless I point it out. God was merciful and faithful to me; that’s His true nature. I hope you will interact with Him during this time of difficulty. My heart goes out to you as you traverse this path and you will be in my prayers. Sincerely, Jan B

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