The cost of cancer care can cause financial stress, especially in patients with private insurance. Most patients with Medicare have a supplement and therefore have 100% coverage, and patients who qualify for MediCal do not have to pay anything towards the cost of their care. However, patients with private insurance will incur some kind of cost and may have high deductibles and co-pays.
The physicians, nurses and staff at Gene Upshaw Memorial Tahoe Forest Cancer Center all work together as a team, so when the Nurse Navigator, Karen Aaron, saw that a patient who was scheduling appointments for surgery, medical oncology and radiation oncology was visibly distressed over the potential cost of all this medical care, she immediately brought her across the hall to talk to Ashley Vigano, Financial Counselor and Patient Liaison.
The patient seemed overwhelmed, believing that she would owe 40% of all medical costs, including the doctors and the hospital charges, possibly amounting to $400,000. Ashley explained how insurance benefits work. The patient is responsible for the deductible amount. Charges above that amount are lowered by a contractual agreement with the insurance company and the patient is responsible for a certain percentage of those remainder fees—but only up to the annual maximum, which is capped.
|Patient Responsibility = Deductible + Remainder Fees|
BUT only up to the annual maximum
Then, Ashley called the insurance company and put them on speaker phone with the patient in the room. Together, they addressed all the patient’s questions and concerns. Yes, the patient with private insurance will incur some costs, but not the frightening total she once feared.
Type of Insurance
Medicare with Supplement
Depends on Deductible & Maximum Out of Pocket for the Year
What does Ashley Vigano love most about her job? “I can share my knowledge and make patients feel better emotionally. Seeing their relief and appreciation makes it worth the effort.”