Cost of SRT (in Holland)

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English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2217
   Posted 11/7/2010 3:12 AM (GMT -6)   
Well I finally got sent something by my insurer relating to the costs of my treatment (in 2009 they sent me nothing about the cost of my surgery, hospital stay etc they just told me on the phone that they had covered everything.)

Anyway I had SRT this year between April and June (33 sessions) and the insurer says they were sent a bill for 7,971.01 Euros (and they paid 7,872.40 of it)

That translates to $11,212.81 at this morning's rate.

Any thoughts or observations?

Alf
Born Jun ‘60
Apr 09 PSA 8.6
DRE neg
Biop 2 of 12 pos
Gleason 3+3
29 Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
17 Nov 09 PSA 0.1
17 Mar 10 PSA 0.4 sent to RT
13 Apr 10 CT
28 Apr 10 start RT 66Gy
11 Jun 10 end RT
Tired
BMs weird
14 Sep 10 PSA <0.1
Erections OK

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 11/7/2010 11:21 AM (GMT -6)   
Alf,
That does seem resonable. I remember being amazed at the difference between what thye billed for SRT and what they got paid due to the contract with the insurance company.
Michael

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 11/7/2010 11:50 AM (GMT -6)   
One of the big problems with our healthcare system is there are two or three different prices for everything..The providers try for a "list price" from their cash customers, they can charge anything they want....Or they agree to accept a negotiated price from private insurance companies or a flat rate from Medicare. Those of us on Medicare do receive a statement stating how much Medicare paid for any given service...

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7080
   Posted 11/7/2010 11:53 AM (GMT -6)   
I don't have the numbers in front of me, but mine was substantially more. The difference between billed and paid was dramatic.
 
Just had a look, and the per day charge for the treatment days was just at $2000 USD per day. Run that out for 39 days -
 
The weekly X-ray and review added just at $1000 USD to the bill each week.
 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/7/2010 12:50 PM (GMT -6)   
Gee, Alf, that is so cheap. Mine was finished last November, and the "list" price per treatment was close to 5,000, multiplied times 39 days and thas close to 200,000 USD. Not sure how much they settled for, its all arbitrated here between the treatment center and the insurance company via a third party. So far, I haven't been asked to pay a cent.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7080
   Posted 11/7/2010 1:12 PM (GMT -6)   
David,
Isn't our insurance system "wonderful" - I had to pay $3,000 out out pocket before they started IGRT, and am still getting bills for stuff that isn't "covered".
 
There are lots of things to pick at in the European models, but this is obviously not one of them.
 
By the way - saw your note about retiring as the resident catheter expert - good for you. Glad things are improving - I can see from the posts that your spirit is coming back!
 
Alf,
I think you got the pre-profit cost smilewinkgrin

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/7/2010 2:32 PM (GMT -6)   
142, i never even had to pay a co-pay with the radiation clinic, they never asked for a cent up front.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7080
   Posted 11/7/2010 2:36 PM (GMT -6)   
My DaVinci and IGRT were in two different calendar years, so I got hit with two deductibles and two out-of-pocket maximums. It was "perfect" timing.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/7/2010 2:44 PM (GMT -6)   
My open Surgery and the IMRT were in 2 diff years, but, the same year that I had the IMRT, I also had 3 corrective day surgeries, so that ate up any money due
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2217
   Posted 11/8/2010 5:24 AM (GMT -6)   
I'm still not sure how the US payment/insurance system works, so glad for the replies so far.
I'm not evern sure how the Dutch system works either. We have had to pay our insurance premiums ourselves (not paid by an employer). My individual premium is currently about 115 euros per month (or 160 USD). Each year I also have to 365 euros of the costs myself (500 USD). This policy also covers dentistry.

Interestingly when I answered a survey about PCa for the hospital a few months back as well as the questions about pain/bowels/pads/ED etc there was also one about whether or not you were having any financial problems due to your situation. (So I'm guessing not everyone is fully covered and for some it will also be hard to pay their own part)

And as for the UK system where your SRT would all be paid by the National Health Service!!!

Alf

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 11/8/2010 8:32 AM (GMT -6)   
Hi Alf,

I am uninsured and the cost of my treatment for 45 sessions was about $45,000 U.S. That was the discounted amount after some hard bargaining. A little known fact about U.S. insurers is that they not only negotiate what they will pay with the hospital but they also negotiate what the hospital will charge other insurers and uninsured patients. The patient price can be 2 to 4 times higher than the insurance. Typically if the patient is insured and the hospital is a preferred provider there will be no copay from the patient. (That was the case for me a few years back when I had open heart surgery... billed $46,000, paid $27,000 insurance, me $0)

Don
Diagnosed 04/10/08 Age 58
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
IGRT/IMRT with adjuvant HT (lupron) 2yrs
PSA:
02/08 21.5
07/08 0.82
10/08 .642
09/09 0.32
03/10 0.32
06/10 0.32
07/10 0.10

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7080
   Posted 11/8/2010 10:41 AM (GMT -6)   
Don,
 
Yeah, a few years ago was the "good old days" for insurance.
 
Just the last two years I've been pushed into the new Ultra-high deductible plans they dreamed up some years ago.
 
Out of pocket maximun has gone from $500 to $6000 in that time.
 
I asked about the "real" costs, as it was in the middle of our new depression with all in fear of being unemployed, and the doc also said about $45,000 "cash" price for RT.

clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2680
   Posted 11/8/2010 12:11 PM (GMT -6)   
I turned 65 exactly one week before surgery, but had not signed up for Medicare.  I have Blue Cross insurance under the Federal Employee Health Benefit Plan (FEHB), and it includes the following statement directed at those who have turned 65 but who are not enrolled in Medicare: "Under the FEHB law, we must limit our payments for inpatient hospital care and physician care to those payments you would be entitled to if you had Medicare. Your physician and hospital must follow Medicare rules and cannot bill you for more than they could bill you if you had Medicare."  I'm pretty sure my uro/surgeon and the hospital were disappointed once they realized they would have been paid a lot more if the surgery had taken place 8 days earlier, while I was still 64.  Still, he hospital billed $51k (but were paid only a little over 7K).

pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 447
   Posted 11/8/2010 1:51 PM (GMT -6)   
I had SRT in the January-March time frame...   32 sessions of 2 gys each for 64 gys.  My medical plan has a $5000 catastrophic limit per year...  With all the pre-scans, setups, and treatments copays,  I hit the limit,  but since then my wife and I planned to get every other little thing fixed...   lol...    bee sting allergy shots,  old shoulder injury,  old knee injury...   all for "free" thru Dec 2010...   lol..
 
Anyway,   "list price" of the SRT  was around $64,000....    Negotiated insurance paid around $34,000...   Blue Cross/ Blue Shield/ Regency federal program.
 
paayten   
3/2007 - Dx 59 y/o - 12 point biopsy - Left 0/6 Right 1/6 Gleason 3+3 T1c
4/2007 - DaVinci RRP performed - Gleason 6 T2c Nx Mx
PSA 7/07 0.01, 6/08 0.02, 12/08 0.03, 10/09 0.13
11/09 Consult BCR and recommendation for SRT
1/2010 IMRT SRT started 32 sessions at 2 gys for 64 gys total.
6/2010 3 mth PSA post SRT = 0.02 :-)
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