Happy New Year, blog readers! We haven't done this in a while. Now that all the big ticket items are (hopefully) behind me, I thought I'd look at what expected future costs might look like.
Before I wax rhapsodic about numbers, I'd like to point out that tracking this has gotten me as close to insanity as I've ever been. In doing this latest round of updates & analysis, I found a half dozen new claims or new adjustments that were not there the last time I did this (in August). And some were related to procedures the year before!! I expect I'd have known about them if I didn't have awesome insurance, because I might have owed someone some money. Since I do, and in these cases didn't owe anything further for a co-payment, no notice whatsoever. And even *I* won't go back to reconcile everything since my diagnosis. Our medical insurance system is so messed up, it's nearly impossible to follow it. I've tried really, really hard.
Anyway. At my last appointment, my oncologist advised that for my survivorship maintenance, he recommends the usual labs and a CT scan every six months for 5 years from end of treatment, and a colonoscopy at least once every 3 years forever after. He might be okay dropping the 3-month labs in between the scans, but we'll see after the next one. (My tumor marker result was higher this time around; still in the standard range, but it went from undetectable to detectable. My oncologist made no mention of it. I try to accept that it means nothing.) Treatment officially ended 4/29/16, and my initial colonoscopy was that summer. So I'm not quite 2 years into my maintenance. I've had both CT scans for year 2 already (June and December), so have just one 3-month lab to go for year 2.
Let's assume for the moment he'll drop the 3-month after this next one in March. Normally you aren't screened for colorectal cancers until age 50, so I'll also include colonoscopies I'll have prior to reaching age 50 as related to my stupid cancer (in 2019 and 2022). And also the ongoing monthly prescription, now required thanks to my medically-induced menopause, which I otherwise would not have needed for a good 10 years, most likely.
Given average costs per the claims I have through 12/1 (so, most recent scan not available yet), we can do tiny math for a Super Grand Total Forecast, for let's say a not unusual course of treatment and maintenance for stage IV colorectal cancer, from diagnosis through a 5-year post-treatment survivorship period. For me that is July 2015 - May 2021 more or less. Again, this is what the providers are charging for these things. This is not what I had to pay, or even what my insurance paid, which was certainly a great deal less, given all the adjustments and "allowable" cost numbers I see on the claim details. If someone has no insurance whatsoever, they are out a cool million.
The true question - what does it really *cost* - may be unanswerable in my lifetime. Enjoy.
Super Grand Total Forecast: $ 1,026,767
Expected thru 5-year survivor period (5/1/21): 79,779.00
3- month labs 1 x 1,697 = 1,697
6- month labs & scan 7 x 9,643 = 67,501
Colonoscopy 1 x 4,431 = 4,431
Prescription 41 x $150 = 6,150
Grand total per claims (thru 12/1/17): 946,988.43
Chemotherapy 112,638.30
Chemotherapy-related 146,856.91 (Neulasta)
Clinic/Consultation 20,368.55
Emergency Room 4,118.00
Inpatient 259,689.98
Labs/Scans 99,702.52
Medical Mileage 222.12
Medical Supplies 9,238.12
Prescriptions 6,211.49
Radiation 119,350.62
Surgery 167,175.16
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TOTAL 945,571.77
then add in the updated out-of-pocket breakdown:
Clothing/supplies 227.22
Copays- appts 400.00*
Copays- scrips 215.70*
Food 385.44
Parking 804.00
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TOTAL OOP 2,032.36
*For these two line items, since full costs are in the non-OOP groupings, I realized I was
double-counting them in the grand total; they are still listed to identify
amounts I actually paid (vs. what insurance covered) but I have removed
them from the grand total.
