Shortly after returning from our historic visit to Western Armenia, I learned that I had breast cancer. From early July until mid-September, I have been poked, prodded, cut, radiated, examined and injected more times than I can remember. And, that is just the beginning. So, why write about it?
I have learned a lot over the past two months, and have realized that anyone who doesn't have the energy to pursue the red tape can really be faced with insurmountable medical challenges. So, this is for those who may not be so fortunate to be the pest that I can be!
We take for granted that when a claim is submitted to our insurance carrier, all will be well. NOT! I have been through the gamut of "this is not covered" (wrong), "you haven't met your limits) (wrong), "we can't do anything to help you" (wrong), etc. etc.
First, READ YOUR CERTIFICATE OF COVERAGE. This is often mailed to you when you first enroll, and it can often be obtained from the insurer's website.
Know what is covered, what your limits are (deductible, out of pocket limits, maximum amount of benefits paid, co-pays, etc.). Make sure your policy covers the procedure you are planning to have BEFORE you schedule it. If your policy requires pre-certification (ex. MRI), DON'T rely on your doctor's office to get the pre-certification. Yes, they will make the initial inquiry. But, YOU have to be sure it gets done. Call the insurance company's customer service department and ask whether it is covered, or whether you have any pre-certification conditions that must be met before certification is offered. Remember -- pre-certification only means the procedure is medically necessary. It does not guarantee that the claim will be paid, or how much.
Second, REVIEW YOUR CLAIMS ONLINE, BOTH PENDING AND COMPLETED.
If your health insurance has a web portal for you to review your medical claims, sign up and check it regularly. Why? Because a claim will show up there, before you receive your Explanation of Benefits (EOB) and often times you can make the necessary phone calls to correct mistakes before the check is cut (or not), and before you receive your EOB. You can also call your provider's billing service for assistance. I have found that most billing services are very helpful -- much more so than the insurance companies.
Third, ASK QUESTIONS! Be aggressive -- knowing beforehand is a double edge sword - - in some ways having too much knowledge can add to your stress. But, I have found that arming yourself with as much information as possible is a blessing -- each little fact helps you face your challenge with a sense of peace.
Fourth, USE THE WEB!! I have learned that Google and other search engines are blessings. If you have a question, an answer is on the Web -- and, even more valuable, regardless of what your challenge is, support groups and companies who offer support, are also out there. I found sites that support breast cancer that 1) send chemo patients beautiful pre-tied scarves at no charge (www.franceluxe.com), 2) have discussion groups for chemo patients (ex. www.breastcancer.org), 3) offer opportunities for volunteering (ex. http://www.knots-of-love.org for crocheted and knitted chemo caps), 4) offer sponsorship opportunities and information, such as Avon, Revlon and Susan B. Koman, 5) offer support for people who are uninsured for the treatments they need, and more!
Finally, DON'T GIVE UP! Help comes to those who help themselves. Yes, we do feel like victims from time to time, and I firmly believe we are entitled to do so. We ask "why me" -- a friend who had been through cancer treatment before I started all of this said to me "Don't ask 'why me' - ask 'why not me'?"
During my first chemotherapy treatment, a young man was in the infusion center with me -- he was probably in his mid-thirties, and was having his last of bi-weekly chemo (over six months) for lymphoma. He told me that he had kept his cancer a secret from his mother and sisters because he knew that they were not emotionally prepared to handle this crisis in his life. He relied, instead, on friends.
He offered me a piece of advice I found so valuable: Once you go through a challenge like cancer and its treatment, you look at life differently. You cherish every day as a gift. You cherish each friend and family member and live for each day -- life has a different focus and you gain an entirely new perspective on what and whom is important. Don't be afraid of that -- embrace it.
Good advice, whether you have cancer, financial challenges in your life, or someone whom you care for is facing similar challenges.