What’s going on here? I’m talking about insurance companies.

Some people think nothing of it.  You have a doctor’s appointment, a prescription and if your insurance is covering the costs, chances are you’re no thinking twice about it.  I’m talking about, how much the appointment or prescription actually is costing.  How much are you paying for that doctor’s appointment or that prescription?  I think it’s time that we all ask, what’s going on here? I say this because our money is, in my opinion, being mismanaged by vendors who are submitting their fees to our insurance companies.  Who profits from it?  You may think you do , because after all, “it’s covered by my insurance”.  I think it can cost you in the long run, if you don’t pay attention to the details.

This topic gets under my skin because of an experience I had last year.  In my analytical way of thinking, even under duress as I was going through a series of surgeries.  I was making note of how much this experience was costing. And unfortunately, still is costing me.

We may find that we’re fine at strategizing and organizing our personal or business finances.  How many of us actually look at how our finances are being managed by our medical vendors submitting to our insurance companies.

I’ll give you an example that shocked me.  After, I believe, my fifth reconstruction surgery that my doctor could not seem to get right, the decision was made that I just could not go through another surgery.  I certainly didn’t want the current surgeon to be performing any additional surgeries.  Being raw with emotional and dealing with the massive disfigurement of my body, it was recommended that I get prosthetic.  So one last prescription from my doctor was to get a prosthetic fitting and she recommended another local hospital volunteer Health-center boutique for the needs of cancer patients, including wigs, scarves & skincare products. I say volunteer because of the lack of professionalism with the retail store clerks that I experienced.  They did have a “professional fitter”, who I assume was on payroll.

The experience was cold and what I felt lacking the sensitivity for a young, single woman, wanting to have a fashionable alternative to her new silhouette.  The options for the special bras and the choice of prosthetic was limited .. but what do I know, I’ve never been through this shopping experience before.  The big disappointment was the lack of fashion and when I voiced my frustration, their response was, “but aren’t you glad you don’t have cancer anymore?”.  What a lousy response was my thought. It just felt like adding fuel to the fire of my kindling pile of emotions.  The resources were so limited, but again, I didn’t know any better.

The staff was very quick to make sure that my insurance would cover their recommendations and were sure to provide adequate prosthetic and special post mastectomy bras that incorporated the prosthetic.  After my reluctant decision on one or two bras and a set of prosthetic, I went up to the check out cashier.  The bill was over $1,200.  I was stunned and quickly was assured not to worry about it, as my insurance was covering the cost, 100%.

I was torn, but somewhat happy to have an option to wear what made me have a little more familiar silhouette of my previous figure.

Within a couple of hours after leaving the hospital boutique I was horrified with the fit of the new bra.  The prosthetic were heavy, causing shoulder pain, and they ended up sliding toward the middle of my body, making it completely unrealistic to wear any blouse or shirt that had any view of my chest area.  On top of the shock of the bill, I was just, for lack of better word, pissed.

When I had my next follow-up appointment with my doctor, I told her about my new purchase and threw open my blouse and said, “see how ridiculous this looks and for over $1,100”.  She was very defensive.  My frustration was about the outrageous cost.  To my surprise she said that she had no idea , that she had never had to recommend prosthetic to anyone else.  I think that was my last appointment with her.

The PTSD that I  dealt with dealing with all the surgeries, the disfigurement and dealing with the muscle spasms of scar tissue are an entirely other story.  What I did dwell on though was the cost and how high it was.  My point is that just because my insurance paid for it didn’t mean I could, or should, accept it. Neither should you.  I did some research and have since found out that you can purchase the same prosthetic for under $200 — and there are options for other bras, some even cute and sexy, other than what I was presented and begrudgingly wearing for at the time nine months.

You may be asking yourself, why do  I care what the cost is because the insurance company is paying.  Well the reason is that, at the time, my insurance paid 100% of my prescriptions after my deductible so no big deal right?  But what if you had an insurance policy that only covered 80%?  Do you want to pay 20% of $1,200 or 20% of $200?  The answer is now obvious.

If you were, or currently are in the place where I was faced with making this prescription purchase, no doubt, you’re vulnerable.  If you’re like me, you’ll do anything just to make this wardrobe challenge go away.  The problem is that when you’re in that state of shock, possibly drug induced, or under heavy medications to manage your emotions, you are probably not aware of the financial implications that you may be facing once you become conscious.

My purpose of sharing this story with you is to create the awareness that we need to be savvy shoppers with our expenses when we shop for healthcare providers, as well as, where we fill our prescriptions.  It’s hard if you’re single, like me.  Without an advocate to protect you, your financial health can take a serious downturn prolonging your recovery back to a healthy life.

I have since, it took about nine months to venture out shopping,  found new resources to get me back into beautiful, feminine lingerie and even a swimsuit!!!  With my new prosthetic and bras, I am feeling better with the body I’ve been dealing with and have hope of being more mainstream with my wardrobe choices.

You don’t have to be alone or settle for less than you deserve through your mastectomy recovery.  Let me know if you want my help and support as you transition back to a healthier, happier, and even more fashionable life.