• Cancelling chemo due to insurance not covering enough?

    Asked by sunshinemb on Monday, September 29, 2014

    Cancelling chemo due to insurance not covering enough?

    I have been fighting ovarian cancer for 5 years; it has now decided to attack my right kidney and urether tube; had a stent placed in to start chemo. Was notified by my cancer center that my chemo was cancelled due to medicare not covering enough of cost and I am on disability in poverty level. So I feel like I was handed a death sentence; after spending 300+ to get this stint in that they insisted I have. Should I call an attorney? What are my rights?

    17 Answers from the Community

    17 answers
    • cam32505's Avatar
      cam32505

      Do you qualify for Medicaid? It will usually pick up what Medicare doesn't cover. If you are on disability, that usually means your income is low enough to qualify. I know many people who receive both and Medicaid just pays the part that Medicare doesn't cover. Call you Social Security and welfare office to find out how to apply. You probably can apply online, but it sounds like you need emergency coverage.

      over 6 years ago
    • LiveWithCancer's Avatar
      LiveWithCancer

      Wow. How sad. I hope you can get some relief. Cam32505 has some good information that i hope will work for you. I wonder if a county hospital or state-funded facility would have to provide services? Hoping and praying that you find help.

      over 6 years ago
    • KancerKiller's Avatar
      KancerKiller

      There is help out there for you. It is a shame they had to wait right before your treatment to find this out! they could have gotten approval weeks ago. This kind of thing makes me mad! Ask the hospital or center about help, programs or even forgiven expenses. Lots of places have programs that will take care of your left over expenses, they just don't let it be known that they have these programs. I hope you get some help quick!

      over 6 years ago
    • sunshinemb's Avatar
      sunshinemb

      Well I have contacted every organization out there; including the governor. Medicaid does not cover OVARIAN CANCER, only breast and cervical. This needs to be changed. Due to having an incurable cancer in late stage I'm on a list of patients that they don't want to waste their precious drugs on or delay the inevitable. So Thank you Obama for taking away as of January 1, 2014 the option for financial assistance for hardships like mine. Oh your mom would NOT be so proud now.

      over 6 years ago
    • barryboomer's Avatar
      barryboomer

      Are you doing anything that YOU Can control like a vegan diet and special supplements?

      over 6 years ago
    • LiveWithCancer's Avatar
      LiveWithCancer

      @sunshinemb, this is the saddest thing ever. I have no words, just complete anger and frustration at the situation. I wish I knew something to suggest. Just sitting back and waiting to die should qualify as cruel and unusual punishment.

      over 6 years ago
    • LiveWithCancer's Avatar
      LiveWithCancer

      @sunshinemb ... are there are clinical trials that you could get into?

      over 6 years ago
    • lilymadeline's Avatar
      lilymadeline

      That is outrageous!!!! I am so sorry to hear this, it makes me so sick!!!! Hugs!!!! Hang in there because as far as I know this decision can be appealed.
      This is what I would do if I were you:
      I would call the oncologist tomorrow and insist on speaking to him or her! Tell him what happened! Ask for help! After all he can file an appeal for you, and in fact he should be already doing this because he should know what happened. If he refuses or won’t talk to you, then I am sorry to say but if he does that you definitely need a new oncologist...so get moving on finding one! But are you stage IV now? Ask your oncologist about that. Because if you are that will help, medicare rarely denies things for stage IV cancer patients. Your oncologist might have to restage you....I don’t know how it works exactly, but I know that stage IV cancer patients have more options, such as clinical trials. Also medicare even pays for monthly PET scans for stage IV’s, this doesn’t sound right if you are being refused chemo and stage IV. I have never hard of that, only stuff being denied for stage 1 and 2’s. But I’m here to learn, and what happened to you is beyond words!
      More thoughts-
      You probably already did this- but call the cancer centers patient support services ( or whatever they call it at your cancer center ) ask for financial assistance with the co-pays and whatever Medicare won’t pay for. Most cancer centers seem to have a charity care program, I applied for it at my hospital and was accepted because I was also underinsured, well who isn’t with cancer it is so darn expensive. Ask patient support services for a social worker as well, you should have one especially if you are low income because they are the the best help for any financial needs and services. Please get a social worker to help you!
      And do you have a medigap policy? If not, please get one ASAP. I would look into the one offered by AARP because you are under 65. Yes they are expensive, but they actually save a ton of $ medical bills! So they are cheaper in the long run for people with a lot of medical bills and doctors visits, they cost hundreds a month but pay thousands a month in medical bills!
      After throwing ideas at you- and I am grasping at straws because I want to help you so badly! The only other thing that I can do is to offer prayers! And please keep us posted! Good luck to you and God bless! Hugs!!!

      over 6 years ago
    • derbygirl's Avatar
      derbygirl

      I know that when I couldn't afford treatments and tests I called my local hospital that owns the doctors offices that I use and spoke with a social worker and financial counselor. They set me up for a year with 100% assistance so I don't have to pay anything on any tests or treatments that are done at one of their facilities. I also get disability and Medicare but I do get medical assistance through Medicaid. I know what it feels like to be dumped because when I got insurance through medical assistance, my oncologist didn't accept it and she refused to see me when I went in for my 5 year check. She wouldn't even come out and talk to me personally even though I was the only one in her office and she was sitting there looking at me from her personal office. She communicated through her front desk nurse and told her to have me see my OBGYN. I didn't mind seeing him since he has been taking care of me through everything but he even said he's not an oncologist so he's not trained in what to look for. It made me so mad because she always treated me so nice and said she was in this with me and then to not even talk to me was rude. He was angry too but he made an agreement with her that he will see me and order the tests but he will still forward everything to her and have her look it over and get her opinion since they are in the same building and he does still do surgeries with her. It's scary to think that oncologists know they are working with patients who are in a life and death situation and they still think nothing of showing that it's the money that means the most. I know they have to make a living but they also have to realize that cancer is the most expensive disease to treat. Take care

      over 6 years ago
    • sunshinemb's Avatar
      sunshinemb

      Thank you for all your inputs; to barryboomer; I juice everyday; and other than this cancer I am very healthy. to the rest of you; I was on the phone all weekend with cancer places and finally found someone who gave me a care advocate to help me do this. Like they said when your sick and dying; being your own advocate is very tiring. Right now I"m in the process of doing everything to get SC help, not just me. I confirmed over the weekend that SC has the lowest financial assistance and help for ovarian cancer. I believe this my purpose for the future women to get this changed before I die.

      over 6 years ago
    • barryboomer's Avatar
      barryboomer

      Hey Derby Girl......I find your story about the Oncologist not even coming out to talk to you as absolutely AWFUL and Predictable. I think They pick the Specialty of Oncology because they are people who Don't like personal care. Oncology is mostly impersonal as they mostly just prescribe the poison and order some tests and scans.....They have an assembly line of patients and they sit there all day doing paper work. THEY have no hands on at administering this stuff and are just isolated......Just the way they MOSTLY are....of course not all.
      Different Personalities are drawn to different specialties.

      over 6 years ago
    • sunshinemb's Avatar
      sunshinemb

      Derby Girl, how do you get Medicaid coverage and what state are you in? SC does NOT cover ovarian cancer under Medicaid.

      over 6 years ago
    • kalindria's Avatar
      kalindria

      Please check to see if your medical center has a social worker who can help you navigate the financial services that may be available to you.

      over 6 years ago
    • lilymadeline's Avatar
      lilymadeline

      Hi Derby Girl, Your story makes me so angry!!! What a terrible oncologist!!! What a terrible doctor!!!! What a terrible human being!!! What a terrible story! But I had something similar happen once....I had an appointment with a new specialist, I told them over the phone what kind of insurance I had and that I was covered by the hospitals charity care program for the co-pays. I had already checked with the charity care office by the way to make sure that this doctor was part of the program. Anyway, I get there fill out all the paperwork and sat there for 2.5 hours....finally an assistant came out and told me that they couldn’t accept me unless I paid the co-pays upfront. Well I couldn’t do that and I said so, and I also told the girl that I had already discussed my insurance and financial situation with them when I made the appointment ( I had the name of the person that I made it as well ) Anyway she said that was wrong and asked me to leave the office if I couldn’t pay. Right in front of other patients!
      You know, in retrospect I was saved from a bad doctor and a bad staff!!!! They did me a favor although I went home sobbing I was so scared, humiliated and embarrassed. I started crying in the elevator in the building and didn’t stop until I got home and called my social worker. You were saved from a lousy oncologist as well! The ones I have seen were all wonderful and caring! My oncologist has fought for me against insurance companies and drug companies and even other doctors! He steps up to the plate constantly, and I don’t think that he is special. But I hope that you find another one very soon! The one you described falls into Barryboomers book of terrible doctors that get in it for the $ only! We don’t need those in our lives! Because they aren’t real healers, at least they aren’t in my book.
      And Sunshinemg, your oncologist should be in there pitching for you, making sure that you get the treatment you need! If he isn’t, please find another doctor! Yes it is a lot of work, but your life is worth it, also things will go more smooth once you get a better doctor because you will have less to worry about. I can’t tell you how many times mine has simply put his foot down with medicare or my insurance company prior to when I was on medicare, but he always gets things done and the is the thing, you need a doctor that takes care of you, that cares about you and gets things done. My insurance refused to pay for my targeted therapy drug at first but he appealed immediately and got it paid for. He didn’t even bother me with it, just said don’t worry we’ll get through. I think that is what your oncologist should have done with you, called you up and told you not to worry that he would have it taken care of and get them to approve more of the payment for the chemotherapy. Again I think that restating you might be the trick, at least ask about that for sure. Caring doctors do exist, I don’t think that my oncologist is special at all, because I know doctors socially that really care about their patients, they take their work home with them and figure out how to help and what to do....Good luck and God bless!

      over 6 years ago
    • barryboomer's Avatar
      barryboomer

      The Doc that is helping me with Scans a few minor surgeries, AND pretty much encouraging me and holding my hand is a Angel Sent from Heaven. He's one of the Greatest Human Beings I've ever met and he Prays with me every time I go to see him. He is a Surgeon but has lots of Patients like me who he sees as a GP and holds their hands and talks a lot about God.....Wonderful Guy.....SO they are out there just far and few between.....It's hard to become a Doctor but it should NOT be that hard to be a Good Human Being....What goes around comes around......

      over 6 years ago
    • sunshinemb's Avatar
      sunshinemb

      Well, my oncologist for the last five years just called and said that until my 11,000 bill was paid he could no longer treat me. REALLY? He said he could refer me to someone else; but I would have to make financial arrangements ahead of time to be seen. OMG.....I've really been given a death sentence with no remorse from anyone.

      over 6 years ago
    • barryboomer's Avatar
      barryboomer

      I DO understand that the Docs need to get paid and this guy only takes regular insurance.....There is Medicare and Medicaid etc......BUT it is an awful indictment of our Broken and Cruel System here in the good ole US of A....

      over 6 years ago

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