I didn't realize that I had great insurance, until I didn't anymore.
Three weeks ago I went to the annual meeting for Open Enrollment for health insurance through my workplace. I really, honestly, naively expected to just be able to check the requisite box, and continue with the same coverage that I currently had. Ha! As our broker gave her power point presentation explaining how this insurance was better than our previous coverage, my face just drained of color. I went stark white, and I couldn't hear what she was saying. (My co-worker explained this phenomenon perfectly to me the other day. She said, "It was like my brain knew what was coming, and it tried to protect me from the trauma of hearing it by making me deaf.") I swear to god, that's what happened to me.
So as our representative stood up there, explaining the prescription drug tier system, I was watching her mouth move, but not catching whole sentences. This is what I was able to piece together from what I did catch. "Generic drugs $20 co-pay." I am definitely not on a generic, because, to my knowledge, there isn't one yet. A few months ago my doctor discussed switching me to a different kinase inhibitor (Spycel or Tasigna) as they have slightly better response rates than Gleevec does. At that time, I resisted because I have heard that the patent for Gleevec expires in 2015. At that point there is a possibility that it could become generic, thus making it a lot more affordable over the long term. And my type of cancer is long term. I have to think about what makes sense for me for the next 50 years, because I could potentially be living with cancer for fifty years. Don't get me wrong. If Gleevec is not working like it should, or if I should develop a resistance to it, I'm all for trying something else/newer/better...but for the time being...if it ain't broke...
So the twenty dollar option is definitely not me. The next tier has a $50 dollar co-pay. Doubtful that I fall into this tier. As she was describing the third and fourth tier medications "preferred specialty drugs" I'm thinking, this sounds more like me. She breezes over the third and fourth tier options, telling everyone in the room that it is very unlikely that they will need anything in either of these two tiers. In fact, I probably am the only one in the room that does. And how much is it going to cost me? Jury is still out, but it's looking like $300 per month. (If I do not qualify for financial assistance from a foundation.) Potentially forever. Fuck me.
Besides that little gem of information, I found out that labs will now cost me $30 every time I have to have blood drawn. A visit to my oncologist will come in at $60 now instead of $40, and if I need a CT or any other imaging test, that will set me back $250 per visit.
Buuutttt....good news is, and she really honestly told us this like it was good news, if I have to have another hospital stay in the upcoming year, well that's only $500 a day for the first three days. Hooray. They pretty much may as well admit me if I need anything more than a blood test.
Don't get me wrong. I still have fan-fucking-tastic insurance compared to what most people I know have, but I'm now someone that actually needs insurance, and has to know what my health care is going to cost me.
Thanks cancer. Looks like I work for you now.
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