Wow, just found out about a biopsy cost!

[brendaelk]

My hep c doctor set up a biopsy for me for next monday. Of course I have some crappy insurance that pays only $40.00 a test. The total cost radiology told me will be $2500.00 to 3000.00. I can not do that right now. That is tough out of pocket for me, my husband is laid off on unemployment and I make hardly any good money working from home customer service. Well I am F1-F2 stage fibrosis my fibrosure test said, think I will have to hold off on the biospy, Tough pill to take right? I will just watch out for myself I guess!

[Bill1954]

Yeah, this is why so many of us eventually buy insurance if we don’t already have it; the whole treatment for HCV is pricey. A person can buy quite a bit of insurance for the cost of the biopsy; even if it costs $ US 1000.00/month, an insurance plan is generally preferable to out-of-pocket treatment. There was an accountant in here that kept track of her Tx expenditures, and she said that one year’s treatment cost nearly $65,000; compare that to $12,000 insurance, it’s a bargain.

I hope that one day soon we’ll have some sort of nationalized health plan so we can spread out some of the cost for managing chronic diseases like this, but until then, we’re going to have to pay these prices. Uninsured people tend to pay more for medical services than insurance companies, because they’re not in a position to contract for group rates.

If I were in your shoes, I’d try to work towards some type of group insurance; even if it took a few years to obtain, it’d probably be worth it.

Best of luck to you—

Bill

[Bill1954]

I should have specified that you obtain a comprehensive policy; it looks like you already have a policy in effect, but it doesn't cover much, it appears.

[jmjm530]

Shop around and/or call the billing office and try to negotiate a price. I doubt very much the insurance company pays $2,500 which sounds like the retail price. If the hospital knows you're paying out-of-pocket they may cut you a deal. Also, find out what type of biopsy the price includes. The other thing is that the higher cost  may be because you're paying for an image-guided biopsy when you probably can get away with a good ole fashioned needle biopsy as long as it's done by a liver specialist with lots of experience. That's how all three of my biopsies were done and no complications.

-- Jim

[Bill1954]

Jmjm has an excellent point; I recall my insurance company paying out $1000.00 total to the hospital, and that included the pathology report and everything.

Bill

[brendaelk]

thks for the tips! appreciate the advice, Do you think I could wait a few months though? The Fibrosis test result of F1-F2 has me spooked, also I seen a lab I took in 2002 and my liver result scores were only 2 pts out of reference range, makes me think it is progressing faster now after turning the big 50!

[meakea]

Absolutely negotiate with the hospital on their bill.  Many times they compromise and give the same discounts that they give to the ins companies.  

[meakea]

PS...if, the first time you try to negotiate with them, they turn you down and say they want full payment, don't stop there.  Ask to speak to someone higher up the chain and keep going up that chain until you get someone who WILL negotiate.  Persistence pays off - usually - but it takes time and patience.

[fretboard]

Yes, you can wait awhile, unless your doctor says you can't.  HepC progresses slowly, check with your doctor.  Besides I thought you were looking for a clinical trial to get into?  They will pay for your biopsy, the boceprevir trial is the only one that would take me b/c I am prescribed methadone.  Telaprevir would not take me, of course I don't know what's happening with the trials today.  good luck

[brendaelk]

Yes I am hoping to get into some studys with a university in Chicago. I did not know they would do the biopsy, that is great! My doctor is a young lady who is an alumni of one of the universitys and she has done some studys with them in the past and now has a few patients in their hepatology center, Heres hoping she comes up with a study or trial soon! That is the only way I can afford treatment now.

[frijole]

Brendaelk - yes, those prices sound about right.  I have had two and they both were in that range.  I find it hard to believe your insurance will only pay $40 -- that sounds like lab testing, not a hospital visit. You might check with your insurance company directly.   Still the best advice is to go for a trial in which the drug company picks up the tag.

Hey, Bill, my ears were burning.  Yes, I did run the numbers and I am pretty sure it was about $65,000 for my 56 weeks of treating.   Even with good insurance, my share was about $6,000.   How are you, my friend?  

Jim, you made some good points here too.  My two were laproscopic biopsies paid for with insurance, but I do think the hospital would reduce the price. It may still not be enough to make much of a difference, however.

It is nice to see that both of you -- JIm and Bill -- are still here on a fairly regular basis, helping out.  
frijole