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What You Don’t Know Won’t Hurt You…Will It? October 11, 2010

Posted by Admin in Health Insurance, Money.
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In late September, I consulted a sleep doctor. It’s a newer specialty, which evolved out of pulmonology and internal medicine. Newer meaning late 20th century. I have some level of sleep apnea and was  interested [finally] in learning how I sleep. (Someone told me that I was ceasing to breathe, waking up and then breathing again).  Or not sleep. To sleep or not to sleep? Mine is probably more like:

To snore, or to snore some more?

This week, I will learn more about my sleep and the connection to my eating habits, how much I weigh and my age.

The not knowing part, (bet you thought it was the condition, didn’t you?) is that I don’t know how much it cost me to spend the night in the hospital and

  • be observed by a technician (caseload-two patients) for eight hours. I asked if they called my insurance company and trusted that it was
  • pre-authorized.
  • I wonder what the 20% cost-share will be;
  • if I will max out for the year;
  • if it was a 4 figure number; and
  • if it was deemed “medically necessary”.

I will let you know. Please don’t wait nine months, as I did,to investigate this potentially hazardous condition of sleep apnea.


Thanks to GINA-Testing Day is Now September 26, 2009

Posted by Admin in Diary, Health Insurance, Women.
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Double Helix

After eleven years of waiting, I have finally submitted my blood for a DNA test. Even now, this was not an easy decision to make. However, in 2008, legislation which limits the opportunities for discrimination in employment and health insurance. http://www.ornl.gov/sci/techresources/Human_Genome/publicat/GINAMay2008.pdf. The law is called GINA-Genetic Information Non-Discrimination Act of 2008. http://rarediseases.info.nih.gov/GARD/GINA/ is also a good source for specifics.

[picapp src=”a/3/2/0/The_Genetic_Information_5235.jpg?adImageId=6139126&imageId=965196″ width=”234″ height=”158″ /]

Title One went into effect this past May and covers discrimination by insurance companies. Title Two goes into effect this November. This one has to do with employment discrimination.
Normally, I love tests. I even took the Foreign Service exam for fun-twice. Since I became a cancer survivor, my attitude towards these tests is different. There isn’t any way to study to do better. Responding to the outcome is always what is at stake. And do you really want to know the answers? One of my friends once told me that she would never do the test for the BRCA gene mutations. I asked why and her response was  that she probably wouldn’t do anything different when she had this new knowledge.  This test is to see if I have the BRCA1 or the BRCA2 gene mutations. These are known as the ”breast cancer genes”. Ironically, the researcher who is the pioneer in this field works at the UW-just down the road.

Her name is Dr. Mary-Claire King. “Mary-Claire King, Ph.D., is American Cancer Society Research Professor of Medicine and Genome Sciences at the University of Washington in Seattle. She was the first to prove that breast cancer is inherited in some families and the characterization of inherited breast cancer remains her primary research focus.” From her  web page

In a couple of weeks, I will know whether I have either one of those mutations or not. My vial of blood is at the only lab in the country which does this work. The reason this test was approved as “medically necessary” is that both I and my maternal grandmother had “early-onset” breast cancer (pre-menopausal). This means that there is a higher chance than normal of my family having this gene mutation but not the highest. The real reason to have this test then, is to eliminate a risk factor; not just for me, but for other family members. What GINA will do for me is not allow my insurance provider to see the results unless I disclose them and also they cannot use the results to deny me coverage.

If I do have the gene, then other decisions will present themselves. One will be to decide on a prophylactic surgery for me. More on that in a couple of weeks.

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