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The Vicious (Billing) Cycle

A recent Saturday I worked over 14 hours photographing a wedding in Rochester, MN, which is two hours south of the Twin Cities. Being on my feet for that many hours (except for a very quick dinner at the reception) while lugging around heavy camera equipment, and assisting the head photographer with camera gear all day and night was exhausting and painful. I’ve done it before and I usually know what I’m in for and how wrecked my body will be the next few days afterward, but I tell myself that it’s worth it. Why? I like working with my boss (who is also my friend), and, well, the pay is good. And I really need the money.

I went to the bank and deposited the big fat check I got from the Rochester wedding, which was a great feeling–for about 15 minutes before I started paying bills. A hundred dollars to this medical bill, $50 to that doctor, $100 for this clinic bill, and so on. The medical bills are never-ending. How depressing is it that all of the physically grueling photography work I did that day (and all of the other jobs) was to pay for my healthcare costs? Even with insurance, for years now I feel like I’ve been drowning in medical debt, barely able to keep my head above water.

Luckily I do have health insurance, but it’s coinsurance, and on top of the expensive monthly premium payments, I also have to reach a $500 deductible and then $3,000 out-of-pocket maximum before medical costs are covered at 100%. Until the deductible and $3,000 are reached, my plan covers 75% of the total cost of everything (office visits, prescriptions, X-rays, lab work, etc.) and I’m responsible for the remaining 25%. It could be worse, I know, but those costs add up very quickly–especially when you’re going to the doctor all the time for RA and other health issues (that are often connected to RA in some way). The Affordable Care Act/”Obamacare” has recently cut my premiums by nearly half, which is wonderful and helps a lot. But despite that, I’m still in loads of debt and honestly can’t afford most of my health care costs each year.

Ever since I was diagnosed with RA 17 years ago, managing my health, and specifically the RA, has been my top priority. I don’t skip doctor appointments. I get my prescriptions filled. I try to ignore the insanely high cost of my Remicade treatments (and other biologic drugs in the past) and get my infusions on a regular basis. There have been a few times when I’ve had to schedule things around insurance issues and that I have put off getting proper care, but for the most part I just bite the bullet and pull out my poor old credit card and deal with the anxiety and stress of constantly being in debt.

A reporter from Bloomberg News recently interviewed me for a story he was writing about patients having problems with health insurance: access to prescriptions, access to care, insurance costs. He was surprised and a bit dumbfounded when I told him that I know of people with RA and other auto-immune diseases who have gone without medications and treatment because they simply couldn’t afford it. They sacrificed their health and risked their lives because they didn’t have good, affordable access to care. Maybe if I didn’t have a chronic illness I would be surprised too, but living with RA all of these years, even with health insurance, I’m not surprised at all to hear stories like this. It’s sad, cruel, and just wrong, if you ask me.

So what can I do? Risking my health and going without good health care isn’t an option. I am grateful that there are some assistance programs out there to help with the costs of the biologic drugs, and I’m currently on Remicade’s RemiStart program. In the past I’ve also had financial help from the Health Well Foundation and the Patient Access Network Foundation (PANF). I would be a lot worse off if these programs didn’t exist, but even with their assistance, there is still a huge financial burden that I’m forced to carry to pay for my health care needs. RA is a very expensive disease. It drains your energy, your hope, your happiness, your patience, your time–and your bank account.

I don’t know, maybe I should try to think up some clever money-making scheme like that guy who raised over $55,000 on Kickstarter to make POTATO SALAD. Asking people for money isn’t really my thing though. More than anything I want to be independent and able to pay for my health care without having to sacrifice the other areas of my life. Is that too much to ask?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


    5 years ago

    Working in the insurance reimbursement industry for a medical office I see this problem all of the time.
    I would like to remind patients to check with the pharmeceutical company for copay assiatnce cards. Rituxan and Remicade both offer these finacial assictance and it has saved me by paying my OOP (out of pocket)costs for the drug. My rituxan reimbursement is maxed at $10,000.00 so the copay for my portion is picked up by Genetech which is a Mastercard when you register. You can go online and apply yourself or have you Dr’s office assist you.

  • Carla Kienast
    5 years ago

    The one thing I can say for ObamaCare is that it makes certain health insurance coverage for people with pre-existing conditions. Otherwise, I’d be without. And with RA and other chronic health conditions (32 medical and dental appointments a year!), I’d be bankrupt. The downside is, that it’s aged based and a 30-year-old would pay about $325/mo. for the same plan that costs me nearly $1,000/mo. which includes a $3250 deductible. I’m on an individual policy because my husband and I “make too much money” to qualify for a subsidy. Now that I’m on Remicade ($16,000+ per infusion), I really can’t afford to be without insurance. The really sad thing is that RA has so affected my life that, while I’m now only working part time at best, I will have to quit work altogether next year and I have no idea how I’m going to afford both the premiums and the out-of-pocket costs. Sigh.

  • Anita
    5 years ago

    You’re lucky, in a way. Obamacare is actually increasing my costs, since I have what is termed a “Cadillac plan” for my health insurance. That whole concept puzzles me, since I’m paying a very high premium for the benefits I get from the plan (I buy a small group plan through my own business). It actually saves me money in the long run, since there’s no deductible or co-insurance, so the higher premiums end up costing me less than the nickel-and-diming that occurs with other plans. Deductibles make no sense and don’t save money for people like us who have to actually use our health insurance. It’s only useful for healthy folks who don’t always have to go to the doctor or take medications. Honestly, how can insurance be “too good” and why should we be penalized for saving ourselves some money?

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