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Kurious asked a questionBreast Cancer
Anyone else losing their adult child to cancer?
21 answers-
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Ohbruff
2 months agoKurious I am so sorry for your heart breaking situation. I am a two year survivor of breast cancer. Last year while finishing treatment, my 40 year old son was diagnosed with Multiple Myeloma. Rare blood cancer...especially in a. Young person. I struggled daily with the reality of this incurable disease. 6 months into his treatment, the chemo caused a blood clot and he suffered a massive stroke. Now, he is attempting to relearn walking and some talking. I would give anything for this to happen to me instead of him. It is heart wrenching but we do laugh and try to find the beauty in each day. I try and accept that I can’t control this but I can appreciate and love our time together. Sending you and your daughter prayers. God bless your family
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Kurious started following
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Kurious asked a questionBreast Cancer
Medicare Coverage
5 answers-
BuckeyeShelby
9 months agoWrong info on the phone is why most insurance companies have disclaimer. "Benefits are an overview of coverage not a guarantee of pymt and may not be interpreted as a modification to the terms and conditions in the membership booklet." Yeah, that's the one our company uses... And people are human and give wrong info. Some of y'all know that I audit customer service phone calls for my company, so yeah, there is wrong info. Not major scads of it, but more than I'd like. But if it came down to it, our calls are ALL recorded, so it can be proven what a rep did or didn't say.
That being said, good luck, Kurious. My own cancer is farther south, so no breast reconstructions needed for me. I hope you find your answer.
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ChicagoSandy
9 months agoIt is current Federal law that surgery &/or reconstruction of the opposite breast to achieve symmetry MUST be covered by Medicare and ACA-compliant private or employer plans (which is to say darn near all of them). Most Medicare Part B supplements pick up the co-pay. And per my lymphedema specialist, here's what else must be covered--for both mastectomy and lumpectomy patients, as by Federal law a lumpectomy is considered a "partial mastectomy:" One prosthesis per affected breast every two years, and two "mastectomy bras" (i.e., containing a pocket) per year. (Nope--you can't apply for reimbursement for regular bras unless they have pockets for prostheses--those slender pockets in Coobie and Genie bras containing removable pads don't count).
But what ISN'T covered by Medicare (and is optional for other insurance)? Lymphedema compression wear--sleeves, gloves, gauntlets, donning/doffing aids, wraps, pumps (though some creative doctors find workarounds for the latter, such as coding them for prevention or treatment of DVTs rather than LE). And some compression stockings are covered--again, not for LE but for vein health & safety.
Why isn't lymphedema treatment wear covered? Because the regulations were written in consultation with physicians; and the average doctor (even breast cancer surgeons) receives no more than 30 minutes of instruction about the lymphatic system (and even less about what could go wrong with it) in medical school. There are even breast cancer surgeons who don't really know about it (my BFF's, when asked about alternatives to arms for blood pressure & needles after a bilateral mastectomy & sentinel node biopsy, scoffed and said "They treat lymphedema with compression sleeves, so why wouldn't a blood pressure cuff be safe?"
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Kurious
9 months agoChicagoSandy- Wow, that was allot of info. I know Medicare will cover for silcone implant, but I'm not interested in any type of prosthesis. If I'm going to need a mastectomy followed by reconstruction, I want the reconstruction to be a DIEP lap procedure(using my own skin), and not some silicone implant that brings it's own set of problems. So far I've had no lymphedema problems, but the info you gave on it is helpful should I need to know in future. I guess my doctor will eventually let me know if the DIEP lap procedure is covered. If anyone has had that procedure, I'd like to hear from them. Maybe I should put that in a seperate question. Thank you for responding.
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Question: Medicare Coverage
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Kurious asked a questionBreast Cancer
Have you had a Breast Cancer Recurrance after lumpectomy?
22 answers-
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BarbarainBham
9 months agoYour welcome. (Not sure what to say about it being called a "Welcome Kit"----maybe I imagined that!!)
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rebajo160
5 months agoI had a lumpectomy, along with chemo, radiation and Herceptin 5 years ago left breast. I just found a pretty good sized lump right below my collar bone. I go to see my oncologist, on Tuesday. Has anybody had an experience or heard of someone having cancer return in that area? Just a little worried. If it is cancer, it sure grew quickly. I had a clear PET scan last year. Thanks for any input.
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