What Breast Cancer Taught Me About Medical Debt

Let me start by saying that I wasn’t being diligent about regular mammograms, which I should never have allowed to happen.

My mom and her sister both had breast cancer, so it ran in my family. My only defense is that life was going well, and I was in the best physical shape of my life. I had healthy eating habits (if dark chocolate counts as a health food), so I was sure nothing could be wrong with my health.

I wasn’t worried when I made the appointment. After my mammogram that day, I expected to leave with a “See you next year!” wave at the front desk. Instead, the technician pulled me into a different room for additional X-rays. It was then that I started to worry a bit.

A doctor told me I had a suspicious lump, and she recommended a biopsy. I’m an unflinching optimist by nature, so I still managed to convince myself that it was probably benign. Optimism doesn’t change medical facts, though.

On Feb. 20, 2018, I was diagnosed with breast cancer. It’s a shocking thing to hear. I finally understood why my cancer-survivor friends celebrated their “cancerversary” every year. Whether you choose to celebrate your diagnosis date or your surgery date, it becomes the most important day to mark for the rest of your life.

Dealing With Treatment Decisions

There was a tumor in my right breast, but there were also abnormal cells in my left one. As I mentioned, my mom had breast cancer, so my doctor recommended an aggressive approach.

I made the gut-wrenching decision to get a double mastectomy and total reconstruction. With this approach, I was told I wouldn’t need radiation and maybe not even chemotherapy, depending on the results of future blood tests that would reveal my recurrence risk for cancer.

After I had surgery a few weeks later, when I was brought back into my room, I could hear my daughter shout, “It didn’t spread!” Although my cancer was labeled “invasive,” it was stage 1 and hadn’t spread to my lymph nodes. I was in the hospital for less than three days and was sent home feeling relieved and grateful to be alive.

Little did I know at the time I left the hospital that my biggest fight wouldn’t be with cancer; it would be with a recurring infection. MRSA is a bacterium that’s difficult to treat with antibiotics. You know the waivers you’re asked to sign where you pledge not to sue the hospital if something goes wrong in surgery? I think hospitals had MRSA in mind when they created that document.

Fast forward to seven days post-surgery. I’m at home and feverish. Not a high fever, so my doctor said he wasn’t worried. But in another three days, I had a raging fever (almost 103 degrees) and hallucinations. The pain was almost unbearable. I couldn’t stand up without screaming.

When I got to the emergency room early on that Sunday morning, doctors immediately knew it was a MRSA infection, and I was admitted and put in isolation.

Two days later, I wasn’t recovering quickly. The infection wasn’t getting worse, but it wasn’t getting better, either. I was told by a team of doctors (they were literally circling my bed and staring at me) that I needed surgery to “wash out” the infection. My blood volume was half of what it should be due to all the trauma, so they asked me to consent to a blood transfusion before the surgery, which I agreed to do.

I burst into tears after they left. A hospital employee named Yvonne came into my room to change the sheets and asked me why I was crying. I went through my laundry list of woes, and she listened silently. I felt much better after baring my soul to a woman I’d only known for 48 hours.

She suggested we do a gratitude list. This had an amazing impact on me. My list included my family, my great health insurance and, of course, my dog, Marshall. I was lucky to be alive, and that’s what I needed to focus on.

When I got out of the hospital, I called the hospital administrator to say what Yvonne had done for me. I will never, ever forget what this almost total stranger did for me that morning.

I wish that was the end of my MRSA adventure, but it came back twice. Fortunately, though, it’s been two years since the last appearance, so I’m hoping I’ve seen the last of MRSA.

Early Detection of Breast Cancer Saves Lives

You know what reminded me to get a mammogram? Several courageous friends on Facebook shared their stories about being diagnosed with breast cancer. Every one of them urged women to get regular mammograms. This was a jolt of reality to me. When I was diagnosed, I shared my story on Facebook, too, as a way of paying it forward.

I’m walking proof that mammograms save lives. If you’re over 40 and haven’t had a mammogram, definitely talk to your doctor about it.

But if you’re under 40, you’re not off the hook. Talk to your doctor if you have a family history of breast cancer on the maternal side.

Just to make a point about the need for regular mammograms, here are some stats from the Centers for Disease Control and Prevention.

— In 2017, 250,520 new cases were reported. To compare, in 2005, new cases totaled 199,510. There’s been an increasing trend since then.

— White women are at biggest risk, followed by Black women and then Asian/Pacific Islander women.

— Every five years, your risk of breast cancer increases starting at age 30. After you turn 75, your risk begins decreasing.

BreastCancer.org reports that around 12% of women will develop invasive breast cancer at some point. I know it’s tempting right now to avoid checkups. In an October 2020 U.S. News survey, almost 44% of respondents had delayed seeing a doctor due to cost.

A recent report published in the Journal of the American Medical Association showed that the number of new breast cancer cases this year between March 1 and April 18 decreased 51.8% compared with a similar period last year. This is cause for concern because getting treatment early is key for survival. But do consult with a doctor first if you are at high risk for COVID-19.

What If You Don’t Have Good Health Insurance?

Most insurance policies allow for an annual mammogram, but what if you have terrible insurance? Or worse, no insurance at all?

In the U.S. News survey, 61% say they were in medical debt because they were underinsured (e.g., a high deductible). Fortunately, there are state programs that offer free mammograms to low-income, underinsured and uninsured women. The programs and eligibility requirements can be found on the CDC’s website.

Even with good insurance, if you get diagnosed with breast cancer, out-of-pocket expenses can leave you in medical debt. Next, I’ll share some insights about coping with medical bills while also protecting your credit score.

My medical expenses were more than $200,000. It was overwhelming to see how much it cost. But it did make me grateful to have good insurance, and it gave me empathy for those not as fortunate.

Aside from what insurance covered, I had at least $5,000 worth of out-of-pocket expenses. I had a robust emergency fund, which helped me survive the cost. Let’s look at ways to manage your medical bills even when you have no emergency fund to help you pay for it.

To take care of your medical bills, you need to focus on three things:

Organizing your medical bills.

Dealing with medical bills you can’t pay.

Understanding how medical bills can affect your credit.

Organizing Your Medical Bills

The tricky thing is reading every piece of mail and deciding whether it’s actually a bill. Sometimes, you’re getting an explanation of your benefits from your health insurance company.

If you’re dealing with a disease like cancer, you’re going to have a multitude of bills from many different providers. I set up a filing system (yes, paper) because I got mail every day from my insurance company, medical providers and the hospital.

And while you’re reviewing the bills, make sure they’re accurate. Errors do happen, and you don’t want to get stuck paying for services you didn’t receive.

Dealing With Medical Bills You Can’t Pay

The U.S. News survey showed that almost 46% of respondents say that a medical bill had strained their budget. I know it’s hard not to panic, but redirect your anxiety and focus on these strategies for addressing your medical bills:

Ask for a cash discount.

Negotiate the cost.

Use a 0% annual percentage rate credit card.

Use a CareCredit card.

Get a debt consolidation loan.

Ask for a cash discount. If you do have an emergency fund and you can pay some of the bill in cash, offer to do that if you can get a discount on the bill. It’s hard to say no to cash, so you’re in a good position to make a deal.

Negotiate the cost. Even if you had insurance, the provider wouldn’t receive the full cost of the service performed from your insurance company. Do some research and find out the average amount an insurance company would pay for the procedure you had done. This gives you leverage in a negotiation because the medical provider knows you’ve done your homework.

Use a 0% APR credit card. There are numerous unsecured credit cards that offer a 0% APR on purchases for a period of time, such as 12 to 18 months. If you’re already in credit card debt due to medical expenses, then consider a 0% balance transfer credit card. Balance transfer cards are more difficult to get right now, so you’ll need a very good credit score to qualify.

Use a CareCredit card. This is a medical credit card, and you can apply for it at medical offices. You’ll get an interest-free period, and if you can pay the bill in full before it ends, this is a good option. Current terms include a 26.99% APR when the 0% rate ends. Yikes, right? A personal loan is usually a much better option than this.

Get a debt consolidation loan. If you can’t qualify for a balance transfer credit card, consider consolidating your medical debt on a personal loan. The interest rate you’ll get is likely to be much less than the APR on your credit cards. Be sure you compare offers so you get the best deal possible.

Do You Have a Medical Bill in Collections?

In the U.S. News survey, almost 39% say they had at least one medical bill in collections. The worst thing you can do is to ignore medical bills. If you don’t pay the bill within 90 days or so, your account is in danger of being sold to a debt collector.

The amount of time you’re given before it’s sold will vary among providers, but as soon as you know you can’t pay the bill, take action. Contact that health provider and negotiate for a payment plan. As long as you hold up your end of the deal, you’re protecting your credit.

You must do this before your bill is overdue. Once it lands on your credit report, it’s usually stuck there for seven years. The impact on your credit score depends on the amount of the debt and also on the credit score version that a lender requests when you apply for credit.

Just to stay on top of all this, get your free annual credit reports and make sure the data reported is accurate. I know it’s a lot to think about when you’re coping with a health crisis, but trust me, you’ll be glad you did when your life gets back to normal.

More from U.S. News

How to Get Help Paying Medical Bills

How to Negotiate Your Medical Bills

5 Bankruptcy Myths Debunked

What Breast Cancer Taught Me About Medical Debt originally appeared on usnews.com

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