Latest Insurance Questions discussions http://www.cancercompass.com/message-board/cancer-treatments/insurance-questions/1,0,129,83.htm Thu, 24 Jul 2008 00:00:00 GMT Thu, 24 Jul 2008 00:00:00 GMT http://backend.userland.com/rss RSS.NET: http://www.rssdotnet.com/ For all of you who are considering voting for our presumptive Republican candidate - if for no other reason than to save on taxes - think again.What we need is more more social conscience.  If we don't begin to chip in for some of the services that we ourselves may depend on in the future, we will end up reaching our "maximums", being denied proper medical care and ultimately dying while the marvels of modern medicine will only be available to very few.  Judging from the subject matter, we are almost there. My husband had an "on the job accident" and ended up in the clutches of the Workers Comp system.  Once that happens, you can no longer use your regular insurance coverage to treat the condition that caused the need for Workers Comp coverage.  The system is, at best, flawed and certainly not set up to benefit the workers.  My husband injured his knee.  He had to hire an attorney to force Crumb & Forester (the coverage administrator) to approve basic tests and doctor visits.  Crumb & Forester tortured my husband and his doctors.  We became characters in a John Grisham novel.  After 18 months of excruciating pain the first corrective surgery was approved.  It was "too little too late".  What could have been one simple procedure ended up in a complicated knee replacement.  The next battle was with Prudential.  Another attorney had to be hired to "persuade" Purdential to pay the long term disability benefit on which they collected premiums for over 6 years.  We learned.  Our legal representatives told us that the Bush administration implemented laws that have allowed insurance companies to get away with more acts of overt, unreasonable and improper behavior than ever before.  Many people cannot afford insurance.  Those who do have it (often at a great financial sacrifice) may not get what they pay for.We cannot continue to be ignorant.  The information is out there.  Unless we vote for change, we will get what we deserve:  continuation of 8 years of trigger happy, violent, uncaring, elitist and conniving government.DBDB   http://www.cancercompass.com/message-board/message/all,26236,0.htm Danka b. Fri, 18 Jul 2008 00:00:00 GMT My husband just switched jobs and i have to change all my doctors, is there anyone that could recommend a good oncologist at the UW Hospital in Madison, WI??? Please help, Kristi http://www.cancercompass.com/message-board/message/all,26172,0.htm kayleighnicole Thu, 17 Jul 2008 00:00:00 GMT Do you are a loved one need help in paying for the high cost of prescription medications required in treating your cancer? If so, I may be of service. I represent "MedWise" , a firm which provides patient assistance programs. For qualifing individuals, those without prescription drug insurance who have to pay "out of pocket", we normally can work thru the pharmacutical companies to get you yout medications at greatly reduced cost.You must be a U.S. citizen to qualify. For additional information, you may contact me at --Message edited by CancerCompass staff. For personal protection, email address and phone number removed. Consider private reply. Please review CancerCompass Member Guidelines at http://www.cancercompass.com/common/guidelines.html-- http://www.cancercompass.com/message-board/message/all,25386,0.htm Ralph0920 Wed, 25 Jun 2008 00:00:00 GMT i have stage 4 colon cancer. undergoing chemotherapy at a university hospital. my employer is switching insurance to kaiser next month. is anyone familiar with getting treatments at kaiser? are they less aggressive with treatment? are their doctors equally competent? is their standard of care the same or inferior? do you have success stories while getting treatment at one of kaiser centers? http://www.cancercompass.com/message-board/message/all,24954,0.htm sara.47 Thu, 12 Jun 2008 00:00:00 GMT .....and won!  Sometimes this is set in place to delay payment on expensive treatments such as cancer.  My husband and I have recently experienced this and succeeded in getting every bill paid.The trick is to have each doctor fax their first medical notes on you to the insurance company.  Plus, have every pathology report faxed as you receive it.  This gives them an undeniable path of treatment.  I also typed an outline of doctors, dates of treatment, dates of path reports etc for them to follow.  They could no longer deny claims as the information was sent prior to the bills!So, while they will try the ol' pre-existing clause delay tactic, there is a way around it.  Keep good notes and enundate them with information.Hope this helps someone else.Good luck.   http://www.cancercompass.com/message-board/message/all,24871,0.htm Mediator Tue, 10 Jun 2008 00:00:00 GMT   I want to move out of state, and I am actually thinking about quitting my job and starting over. How long will my insurance cover me before I must pay out of my pocket, and does it carry over like that? Does it depend on the company and the type of insurance I have? I have never done this before, so I am unsure. It is hard for companies to take me seriously out of state, when I am looking for jobs......They are pretty much hiring people that are already in the area so I don't really know what to do. The area I want to live does not have facilities even close to where I want to move too for transfer. Or should I just look for the closest facility? Which would mean more than one move!! I am nearing 50, single/no children with avg health so I am taking a huge risk relocating w/o anything, can anyone help? I have BC/BS right now. THANK YOU SO MUCH http://www.cancercompass.com/message-board/message/all,24257,0.htm jeckram Wed, 21 May 2008 00:00:00 GMT I have multiple myeloma and collecting SSD and group disability insurance. I need to know if my myeloma becomes stable (as it has before but returned) will the insurance company stop my payments? Has anyone collected disability ins and their cancer gone into remission? I am in pain with bone lesions because of the myeloma. http://www.cancercompass.com/message-board/message/all,23306,0.htm tech58 Tue, 22 Apr 2008 00:00:00 GMT I did not think to persue any aid but I did and qualified. Check with Carecare.org  and  Patientadvocate.org.or copays.org it does not help with a cure but it does relieve some other stresses.It is good if you have a lot of copays for doctors visits and prescription drugs. Good Luck. http://www.cancercompass.com/message-board/message/all,21588,0.htm Heartbrokehusband Mon, 03 Mar 2008 00:00:00 GMT It amazes me not only that some private insurance carriers don't like to pay for cell culture assay tests but that they don't emphatically mandate it as a requirement for obtaining chemotherapy reimbursement against ill-directed treatments.The validation standard that private insurance companies is accepting from "molecular" profiling tests is "accuracy" and not "efficacy." The "bar" has been instantly lowered. No longer will it be essential to prove that the use of a diagnostic test improves clinical outcomes, all they have to do for these "molecular" profiling tests is prove that the test has a useful degree of "accuracy." However, at the same time, the validation standard they want for "cell-based" profiling tests is "efficacy."The "cell-based" profiling tests have the same entitlement to be judged by the same validation standard as "molecular" profiling tests. The combination of measuring morphologic (structural) effects and metabolic (cell metabolism) effects constitutes measuring the "profile" at the whole cell level. It must be noted that both types of dignostic tests are just that, "tests" and not treatment.Profit, as we have seen, is a powerful motivating force. Among the private payors, at least, the profit motive is entirely consistent with the goal of the test, which is to identify efficacious therapies irrespective of drug mark-up rates.The evidence in support of these assays is more than sufficient to justify the funding of validation trials, if any more truly are needed, as claimed - speciously and self-servingly - by the medical establishment.Everyone is scared to death - and rightly so - at what is going to happen to the healthcare economic system with the introduction of increasingly expensive new drugs that benefit only a small percentage of patients who receive them, hence the headlong rush to develop tests to identify molecular predisposing mechanisms whose presence still does not guarantee that a drug will be effective for an individual patient.Nor can they, for any patient or even large group of patients, discriminate the potential for clinical activity among different agents of the same class, such as Sutent, Tarceva, Iressa, and Nexavar.The FDA could benefit too, as they find themselves under increasing pressure to allow new drugs into marketplace while at the same time protecting the safety of potential recipients of those drugs as well as the financial interests of those who will have to pay for them.It explains the new paradigm of requiring a companion diagnostic as a condition for approval of new targeted therapies. The pressure, in fact, is so great that the companion diagnostics they've approved often have been mostly or totally ineffective at identifying clinical responders (durable and otherwise) to the various therapies.I think that in both of these areas - private insurance carriers and the FDA - there is a very real opportunity to make a substantial impact and contribution, an interest in saving the healthcare system perhaps billions of dollars a year (and thereby the healthcare system itself) by ensuring that expensive treatments are used appropriately.Committee chairpersons, committee members and persons in congress who may have personal interests not only in discovering new cancer treatments - everybody wants that - but also, in the "here and now," using currently-available cell culture assay technologies to improve the effectiveness of existing drugs and save lives today by administering the right drug to the right patient at the right time. http://www.cancercompass.com/message-board/message/all,21281,0.htm Gdpawel Sun, 24 Feb 2008 00:00:00 GMT I am 74 yrs. old. And to find out now that I have Kidney Cancer and Cancerous Nodules in my Lungs caused by the Kidney. The Oncologist is going nto put me on Sutent.. 4 weeks on, then 2 weeks off. .The Pharmacist told me that the pill is very expensive. That is would be $1,400.00 for a months supply. That would take almost my whole Social Security. Which is my only income.l How can people afford this ?.  I am not on it yet because of the expense. http://www.cancercompass.com/message-board/message/all,21260,0.htm Yeoldmom Sat, 23 Feb 2008 00:00:00 GMT I had the HIFU  treatment on Feb. 7 with Dr. Suarez in Cancun.  Has anyone dealt with MDabroad or Insurance Claims Filing Service for the processing of their claims to a US insurance company? http://www.cancercompass.com/message-board/message/all,20946,0.htm RicardoB Thu, 14 Feb 2008 00:00:00 GMT My husband was diagnosed with pancreatic cancer August of 07.  Since then his insurance co. has paid for everything.  Now our doctor wants him to start Cisplatin and cpt-11, and even with a lettter to the folks at PBC, he has not heard one word from them about coverage.  We have since started Xeloda as a back up.  What Can I do to encourage the insurance co. to ok the coverage for the Cisplatin and cpt-11?Terry's wife http://www.cancercompass.com/message-board/message/all,19931,0.htm terryswife Sun, 20 Jan 2008 00:00:00 GMT My late husband was diagnosed with stage 4 stomach cancer. We applied immediately for his social security disability, he was deemed qualified BUT had to wait five months before receiving, even though he had been given six months to live.  Does anyone know of any person who did receive their disability benefits before this five month waiting period was met?  I am appealing Social Security decision that I (for the benefit of my late husband) should receive one month's disability for my late husband.  My late husband should have received all that was due him.  Legislation has been introduced to do away with this five month waiting period (HR2713) but it STILL sits.  I am planning on taking this all the way up to the highest level to have this changed.  Any info could be helpful.   http://www.cancercompass.com/message-board/message/all,19638,0.htm joeswife Sat, 12 Jan 2008 00:00:00 GMT Where does a person go, when they have health insurance, but it does not pay 100 percent of medical bills, but only 80 percent. I am one year cancer free now, and owe thousands upon thousands of dollars in medical bills that insurance refused to pay. It seems I am not eligible for any moneys,  from other sources because my husband makes to much money. We are not rich, we are barely getting by on his salary, and because he makes more then 15 thousand dollars a year, I am not eligible for any aid from the state, county, federal, or any other orangizations that offer help. Cancer is not cheap, insurance companies are, they want their premiums but when it comes time for them to pay, they don't  pay or they agree to pay a small percentage after you fight with them, threaten law suit, etc.... So where do people like me turn to for financial help? http://www.cancercompass.com/message-board/message/all,19570,0.htm seadawn Thu, 10 Jan 2008 00:00:00 GMT my father is 56 years old , he has stomach cancer  and  they just mowed from Russia and I am looking for health insurance for him , does anyone out there knows  if  insurance company that will cover cancer treatments.please help Kristine http://www.cancercompass.com/message-board/message/all,19478,0.htm hayk56 Mon, 07 Jan 2008 00:00:00 GMT I have a 66 year old uncle with Glioblastoma multiforme. He is currently under going radiation an chemotherapy. In the hospital they had him on Temodar. They released him from the hospital about 4 days ago but now his medicare and medicaid don't want to pay for the Temodar, is there a reason for this? Is there something i can do to have them pay for the drug cause my family can't afford it? http://www.cancercompass.com/message-board/message/all,18712,0.htm HarleyQ Fri, 07 Dec 2007 00:00:00 GMT My uncle was just diagnosed with Stage 4 lung cancer and severe/widespread bone metastases.  It has spread everywhere in his body except his neck, toes and head.  For some reason, he didn't show or complain about the symptoms one would have expected, which is why they didn't detect it until now.  But the reality is he is in a country that is so upside down and backwards that in this day and age, we still suffer from such draconian access to medical services.They are giving him 30 to 60 days to live but it's possible that Tarceva will push that out to 6 to 9 months.   He is very late stage, unbearable and difficult to control pain, unable to eat, very difficult to breath, very weak and very little body weight left.  He is 59. I have been turning my life inside out trying to find a way to gain access to Tarceva.  It is impossibly expensive at $3,300 per month.  Genentech, the US distributor, has a foundation to assist the needy in the United States.Roche, the distributor for the rest of the world, does not have this type of charity foundation.I am desperate and so is my family and I don't know where else to turn but to those of you that have gone through this and understand what's happening.The United Nations states that access to critical, life sustaining medications is an inalienable human right for every person on this planet. What do I do?Is there any way to get access to even a small quantity of Tarceva?I mean, even if I sold every worldly posession I had, it would buy him only two months worth of Tarceva.I can't accept that our world is like this.  It just doesn't make any sense.Any advice would be very welcome.  Thanks in advance. Pej http://www.cancercompass.com/message-board/message/all,17465,0.htm marketwizard Sat, 27 Oct 2007 00:00:00 GMT Is there anyone out there covered by PPHA and has had cytoreduction and/or Intraperitoneal hyperthermic chemotherapy covered and paid for by PPHA (Progressive Personal Helathcare Advocates)? We have been denied coverage. :(Thanks for any help.M.F. http://www.cancercompass.com/message-board/message/all,17356,0.htm Maff62 Wed, 24 Oct 2007 00:00:00 GMT Medicare Modernization Act Did Not Change Chemotherapy As Feared DURHAM, N.C. -- Cancer patients receiving chemotherapy have not noticed a restriction in their access to treatment following the enactment of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA), despite the act's significant reduction in government reimbursement to oncologists, according to a new study led by researchers in the Duke Clinical Research Institute (DCRI). "Critics of the MMA often said that it would reduce patients' access to chemotherapy services, because doctors would receive 30 to 40 percent less reimbursement from the government for administering treatment," said Kevin Schulman, M.D., director of the DCRI's Center for Clinical and Genetic Economics, and senior investigator on the study. "Our study showed that patients actually do not perceive barriers to their access to chemotherapy and perceptions about access are really the same among patients who received treatment before the legislation went into effect, and those who received it afterwards." The team's findings will be published in the November 15, 2007 print edition of the journal Cancer, but also will appear earlier in the journal's October 8, 2007 online edition. The study was funded by a grant from the National Patient Advocate Foundation's Global Access Project, which brings together 42 national healthcare stakeholder groups -- such as pharmaceutical companies and advocacy groups -- to fund health research projects. The Project has focused on examining the MMA's consequences for patients, providers and healthcare systems. The Duke researchers examined the results of 1421 surveys completed via the internet by 684 patients who had received chemotherapy prior to the enactment of the MMA and 737 patients who were treated after it went into effect. Respondents answered questions related to issues including the amount of time they waited to start chemotherapy after their initial cancer diagnosis, and how far they had to travel to get their treatments. "When the act was passed in 2003, many doctors and patient advocates were concerned about the consolidation of services it might necessitate, such as the moving of chemotherapy services to hospital rather than outpatient settings and the elimination of staff positions," said Joelle Friedman, a DCRI researcher and lead author on the paper. "They were afraid these changes would affect patients' access to care, but our study showed that these concerns turned out to be largely unwarranted." About half of the patients surveyed in each group were under the age of 65 and half were over 65. The majority of patients in each group reported being either satisfied or very satisfied with the care they received from their oncologists, Friedman said. The researchers also found no difference in the amount of time from diagnosis to initiation of chemotherapy between the two groups; the median lapse in time was 22 days in both groups, Friedman said. Patients reported an average travel time of 30 minutes to the location of their chemotherapy appointments, both before and after the implementation of the act, she said. The speculation that treatment location would change -- that patients would either be forced to travel farther for therapy or switch treatment locations in the middle of therapy -- also proved to be unfounded, Friedman said. The MMA represented the largest overhaul of the Medicare system since it was created in 1965. Changes included a new prescription drug benefit, and a $25 billion allocation of funds to rural hospitals. One key provision, however, was a significant reduction in Medicare reimbursement to healthcare providers. Oncologists were strongly affected, due to a perception that they had been over-compensated in the past. Other researchers involved with this study were Lesley Curtis, Bradley Hammill, Jatinder Dhillon, Charles Weaver, Sugata Biswas and Amy Abernethy. http://www.cancercompass.com/message-board/message/all,16918,0.htm Gdpawel Tue, 09 Oct 2007 00:00:00 GMT My brother has surgery in March and has a recurrent malignant brain tunor Grade IV.  He has been denied for Avastin/CPT-11 treatment and we have a hearing tomorrow with Blue Cross/Blue Shield. He is progressively getting worse every day and we are looking for facts for tomorrow's hearing. Does anyone know what insurance companies will cover Avastin?  The doctor feels this is his best hope. Please let us know. Debbie  http://www.cancercompass.com/message-board/message/all,14220,0.htm suncat11 Tue, 10 Jul 2007 00:00:00 GMT We no longer have insurance and could not afford my husband's Temador. We found Schering's Commitment to Care Program. They are now mailing us his Temador free. There # is (800) 521-7157. I hope this helps someone. Diane http://www.cancercompass.com/message-board/message/all,14080,0.htm Dttmusic Fri, 06 Jul 2007 00:00:00 GMT Anyone familiar with this clinic and its protcols, please be kind enough to enlighten me.  Does Medicare cover this clinic and whatever fees (hospitalization). Thank you.  Please respond. http://www.cancercompass.com/message-board/message/all,13784,0.htm Zimexlady Mon, 25 Jun 2007 00:00:00 GMT If you are looking for a way to save money on Medical,RX,Vision and or dental please contact me. i will show you how me and my family save money on these services.ThankssandySandya1967@aol.com http://www.cancercompass.com/message-board/message/all,13154,0.htm Lasalp Tue, 12 Jun 2007 00:00:00 GMT Hello! My name is Megg.  I am a 30 yo female with a golf ball size lump just above my collar bone.  This started out as a pea sized lump in November.  I finally decided to seek the advice of my dr.  He sent me to get a CT scan with contrast and it came back inconclusive.  I am so confused and wondering if I should seek another opinion.  Has anyone else had inconclusive (i.e. didn;t show up on the scan) ct results?  Please, any advice , thoughts would be so greatly appreciated. all the best,megg http://www.cancercompass.com/message-board/message/all,12871,0.htm Meggan Mon, 04 Jun 2007 00:00:00 GMT As I am watchful waiting with a very high PSA (60), it is necessary to have a PSA test every three months. Medicare will only approve one test per year. Does anyone know how to gain approval for more than one PSA per year?Will appreciate your help.George http://www.cancercompass.com/message-board/message/all,12721,0.htm Georgealbert Sat, 02 Jun 2007 00:00:00 GMT