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May is Skin Cancer Awareness Month, except at my HMO

I had a dermatology appointment today. I was pretty nervous, because last time I got a mole checked out, I checked out. I was also a bit concerned, because when I received my referral to the department, I was told the consult would be $75 with additional charges for other services. I was already skeptical that a painful cyst would count as "cosmetic" rather than "medical," but surely an abnormal mole was more on the "medical side." RIGHT?

May is Skin Cancer Awareness MonthThe message to get moles checked out is huge. Skin cancer if caught early can be treated. It is a no-brainer that HMOs would want to stop something before it escalates into something very serious (and potentially very costly.) RIGHT?

Just last week (or was it this week?) was "Melanoma Monday." As summer approaches, there are more and more campaigns reminding us to wear sunscreen and get abnormal moles checked. I have fair skin, so often wear sun-protective clothing. (My favs for "cute" UPF 50+ clothing are Coolibar and Mott 50, and then I have some generic T-s from SPFstore.com. For the boys and for my swimming needs, it is UV Skinz for the win.)

I'm fairly diligent about having abnormal moles checked, although since I'm a heavily-freckled person, I'm not 100% sure that I'm tracking everything well. Although the dermatologists themselves say a "mole check" every 6 months or so is advisable, the waiting list for dermatology at my HMO makes this difficult, and the expectation that preventative care is "cosmetic" and must therefore be billed at a higher rate, is ridiculous.

And so, I check my moles myself, and only speak up when I'm concerned about a particular one. (But what am I missing: on my back, or other place I cannot see?)

Today, I explained that the mole on my elbow bleeds frequently (that's one of those "triggers" I often see published about when a mole might be a concern.)

protective-clothing-skin-cancer-prevention.jpgThankfully, the doctor said she thought it wasn't anything, but remarked that I could have it excised and sent to pathology for $199.

UGH.

In the past, I've had moles removed from my arm, my outer thigh, my inner thigh, and my forehead. Every single time, they've come back abnormal and I've required further surgery to remove every last speck for fear it will become cancerous. But, aside from normal co-pays, all these procedures were "free."

Not $199.

I'd like to think that if the doctor did believe the mole looked suspicious, that I wouldn't have to shell out additional funds. But, I don't know.

Many years ago, I argued with a doctor who said he didn't think my questionable mole was an issue. I fought to have it tested. And it came back very abnormal. I had to endure another surgery, and have a very large scar on my leg to show for it. (In fact, I'm thinking about getting a tattoo to cover it. As it is, people gasp, "WHAT HAPPENED!" so I'd rather they think "Wow, cool tattoo.")

mole-removed-forehead-scar.jpgI don't know what would have happened if I hadn't fought to have that particular mole removed.

And so, I'm a bit nervous about not having this one removed. But, I don't really have $199 hanging around. If this mole changes in any way, I'll have it checked again, and push for an excision, even if it does cost me. (After all, I don't want something like this to cost my life.)

But - I can't help thinking how frustrating it is that I try to do the right thing, but it is so expensive to do a procedure because it is deemed "cosmetic." Other tests in my HMO are covered. Golly, my spinal surgery starring both an orthopedic surgeon and a neurosurgeon was free. FREE! But removing a mole that bleeds often is $199?

I wish my HMO would support its own message of "get yourself checked!" $75 for a check and $199 for an excision is pretty pricey. I wonder how many people who don't have $75 in their pocket will be unable to catch potential skin cancer.

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Other posts about skin cancer prevention:
- Don't Forget the Sunscreen! [a product review]
- Stylish UPF 50+ Clothing [a product review]
- I am not Smurfette
- Code Blue in Dermatology
- Decisions and Delays
- Not Again?!
- Where Everybody Knows Your Name
- Take These and Chill Out : Don't Bother to Call
- Blocking Pesky Betas
- Hearts Afflutter
- En Route to a Harry Potter Scar

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Disclaimer: I received no compensation or free product from any of the companies I list here. They are just the brands I happen to use for my sun-protective clothing needs.

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