Topic: Medicare & prophylactic BMX

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Posted on: May 2, 2011 08:15PM

Posted on: May 2, 2011 08:15PM

certified wrote:

Does anybody know if Medicare will pay for a prophylactic mastectomy?  I want both breasts removed to avoid the worry and anxiety of more cancer appearing in the other breast.  Besides, I'd be balanced (which I think is important) and could be any size I wanted just by changing breast forms.   

certified Dx 11/12/2010, IDC, 3cm, Stage IIIA, Grade 3, ER-/PR-, HER2-
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May 3, 2011 07:57AM dlb823 wrote:

I don't know the answer, but thought I'd stop and bump your thread for you.

Deanna "The soul would have no rainbow if the eyes had no tears" Native American proverb Dx 2/1/2008, 1cm, Stage IIA, Grade 3, 1/16 nodes, ER+/PR+, HER2- Dx 1/3/2014, Stage IV
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May 3, 2011 08:21AM nurse-ann wrote:

I didn't answer your post earlier because I couldn't tell what you have already done.  It's seems from your bio that you have already had one done?  If that's the case that may be more difficult with Medicare or private insurance for that matter to go back and have the other done.  There's a website with an odd name that covers what medicare does and does not cover.  If you PM me, I can get it for you sometime today. 

If this becomes a complex question (one done one time then the other done later) you may need to discuss this with your surgeons office and their medical person who will have Medicare people they can contact.

I've noticed that there are either not very many Medicare people on this website or they don't post much just for your information in the future.    

Dx 11/18/2006, ILC, 5cm, Stage IV, Grade 2, 15/16 nodes, mets, ER+/PR+, HER2-
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May 11, 2011 10:22PM certified wrote:

nurse-ann, my dx comes ffrom radiological guided punch biopsies.  So far I've had neoadjunct chemo to shrink the tumor (4 A/C & 12 Taxol) and finish the chemo this Friday.  Also have first appointment with onocology radiologist too.  I don't know when I'll see the surgeon, possibly around the 1st of June.

I want to have both breasts done at once with no reconstruction although the cancer is only in the right breast.  Being a triple negative I want to be as proactive in my treatment as possible.

certified Dx 11/12/2010, IDC, 3cm, Stage IIIA, Grade 3, ER-/PR-, HER2-
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May 12, 2011 09:29AM nurse-ann wrote:

Certified:

Just read your post unfortunately after I sent you a PM - my search option has been down for several days and this hampered my ability to keep up on my posts.  I did include some contact info for Medicare but not the info I hoped to get.  I would be surprised if they do not cover this procedure especially with a big push from the surgeon.

Good Luck and let me know.

Dx 11/18/2006, ILC, 5cm, Stage IV, Grade 2, 15/16 nodes, mets, ER+/PR+, HER2-
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May 28, 2011 06:13AM TooManyCocktails wrote:

I'm on Medicare.  I,also, have a secondary insurance.  Medicare did pay for my prophylactic BMX.  In my case, it was my right breast that was removed prophylactically.  But, I did have them both removed at the same time.

Hope this helps.

"If you ever drop your keys into a river of molten lava, let 'em go, because, man, they're gone." Jack Handey Dx 10/8/2010, IDC, 3cm, Stage IIIC, Grade 3, 40/40 nodes, ER+/PR+, HER2-

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