Herceptin only ... no chemo ... Medicare won't cover it!
My wife is 83 and just had a mastectomy after finding a Stage 1A 4mm size tumor. All margins were clear as well as 3 lymph nodes. The oncologist offered a chemo & Herceptin treatment protocol … but my wife has decided she isn't up to the chemo. She is willing to accept the Herceptin on an every 3 week protocol lasting a year. She is banking on little in the way of side effects and will have her heart monitored during the period.
Now that she has come to peace with that decision … we've been told that Medicare WILL NOT COVER the Herceptin-only treatment. This has her back to thinking of no follow up treatment. We've been told that if chemo was started and then stopped because of the impact of side effects, the Herceptin would continue to be covered but she refuses the chemo. Yet bypassing chemo all together is a NO GO from Medicare's point of view.
Has anyone else encountered this? She accepted the Herceptin-only approach after reading this paper:
We are trying other avenues to get the Herceptin for free or at a significant discount but I'm wondering if anyone else had run into this Medicare road block.
Comments
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Hi @ptsintx and welcome to Breastcancer.org.
We're so very sorry to hear of your wife's diagnosis and the financial concerns that bring you here. We hope others will be by shortly to weigh in with their experiences.
You might find some help by reaching out directly to Genetech (the company that makes Herceptin) as they have a financial assitance program you may qualify for. You can find out more here:
Genentech Financial Support
Patient Resource Center:
1-877-436-3683Genentech Patient Foundation:
1-888-941-3331
*For people who don't have insurance coverage or have financial concernsWe hope this helps. Sending you and your wife good thoughts! Please let us know how else we can help!
—The Mods
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Thank you. We’ve already started that process with Genentech. I’m discussing this as an age discrimination issue and I’m using one of your research papers as justification for a herceptin only treatment protocol.
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