Topic: Stage IV and Medicare

Forum: Employment, Insurance, and Other Financial Issues — Employment, insurance, and financial concerns are common. Meet others here to discuss and for support.

Posted on: Jun 14, 2011 03:07PM - edited Jun 14, 2011 10:30PM by MaryNY

Posted on: Jun 14, 2011 03:07PM - edited Jun 14, 2011 10:30PM by MaryNY

MaryNY wrote:

My friend was diagnosed with triple-negative breast cancer three years ago. She lost her job about a year later. Her unemployment benefits have run out at around the same time she had surgery for mets to the lungs. As she was recovering from that, she was diagnosed with brain mets, for which she has also had surgery. She is fortunate in that she still has insurance but has no income and her savings are depleted. She needs to pay rent, utlities, doctors co-pays, transporation to and from frequent doctor/hospital appts and doesn't know where to turn.

I thought I read somewhere that Stage IV breast cancer patients automatically qualify for Medicare. Is that true? Or is there something about qualifying for social security disability first? Not sure if the process varies from state to state but this is in NY.

I'm not sure how she is managing to cover her rent payments at the moment, I think her family may be helping. I was wondering if anyone of have any suggestions on that end too. Like how difficult is it to qualify for Section 8 housing. 

Mary ~~ lumpectomy 8/10/2009, Oncotype DX 18, Chemo 10/28/09--2/1/10 AC*4, CMF*4 Dx 5/19/2009, IDC, 1cm, Stage IIA, Grade 2, 2/6 nodes, ER+/PR+, HER2-
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Jun 14, 2011 03:12PM MaryNY wrote:

I posted this topic earlier but then realized that the subject line made it look like a begging letter, but couldn't figure out how to revise that so deleted the post instead.

Mary ~~ lumpectomy 8/10/2009, Oncotype DX 18, Chemo 10/28/09--2/1/10 AC*4, CMF*4 Dx 5/19/2009, IDC, 1cm, Stage IIA, Grade 2, 2/6 nodes, ER+/PR+, HER2-
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Jun 14, 2011 04:27PM reesie wrote:

I don't know about the Medicare wait without SSDI but I understand qualification is 24 months from qualifying for SSDI It sounds like she would qualify immediately for SSDI and be eligible for retroactive benefits. If you go to www.SSA.gov you should be able to get some info.

Marie - It's A Great Day To Be Alive. Dx 10/29/2010 ER+/PR+, HER2- Stage IV mets to bones, liver, lungs, skin, pleural effusions
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Jun 14, 2011 04:44PM - edited Jun 14, 2011 04:48PM by nurse-ann

Hi:

I can only tell you how it worked for me.  I became disable (by SSA's definition) two years ago - May 1st.  They contacted me around the end of 2010 to ask if I wanted part b deducted from my benefits.  The same happened with my brother.  You are eligible for Medicare 2 years after becoming disabled.

I edited the post to add that my reason for disability is stage IV.

Dx 11/18/2006, ILC, 5cm, Stage IV, Grade 2, 15/16 nodes, mets, ER+/PR+, HER2-
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Jun 14, 2011 06:04PM MaryNY wrote:

My friend's lesions in her lungs showed up about a year ago, I think. But Stage IV was probably confirmed more recently when they did the lung surgery. I did look at the SSA.gov site earlier but found it hard to figure out.

So she has to qualify for disability first, right? and that might or might not be retroactive. And she would only be eligible for Medicare two years after the date established for the date of disability?

Mary ~~ lumpectomy 8/10/2009, Oncotype DX 18, Chemo 10/28/09--2/1/10 AC*4, CMF*4 Dx 5/19/2009, IDC, 1cm, Stage IIA, Grade 2, 2/6 nodes, ER+/PR+, HER2-
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Jun 14, 2011 06:13PM blondiex46 wrote:

Tell her to apply and you have to wait 6 months from the diagnoses before you can collect.  As far as insurance she might qualify for MA now but I am a part of the Healthy women Breast cancer and cervical program

http://www.familyplanningplus.org/services/healthy-woman/

that is the one for New York, I am in PA and get it.....any questions let me know!!

Original 8/96 - 1cm, chemo, rads. Recurr..9/09...Mets to lungs, chest wall, lymph nodes under arm & chest, cervical & lumbar spine, ribs, hip. Femera, Falsodex, Zometa, Xeloda, Gemzar,Taxotere, Adriamycin,Havalen.WENT OFF CHEMO 7/20/14 Dx 9/1/2009, 3cm, Stage IV, ER+/PR-, HER2-
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Jun 14, 2011 06:14PM scuttlers wrote:

Mary, there is a thread with lots of answers to your questions on the Stage IV forum, I just bumped it up so it should show in recent discussions.

Your friend can fill the request for SSDI in line. My whole process took less than two weeks from application to approval. Yes, there is a wait for Medicare, but in the wait there is also money coming in which really helps.

The SS office will also check to see if she qualifies for SSI in addition to the SSDI, which could qualify her for Medicaid possibly (or the low income need based which applies in her state).

My favorite side effect of treatments is BEING ALIVE! Dx 2/4/2009, IBC, 6cm+, Stage IV, Grade 3, 11/17 nodes, mets, ER+/PR-, HER2+
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Jun 14, 2011 06:15PM nurse-ann wrote:

That's my experience but also look at the financial requirements for Medicaid in her state.  My brother was able to be on Medicaid until Medicare was available to him two years after becoming disabled - now he has both. 

Dx 11/18/2006, ILC, 5cm, Stage IV, Grade 2, 15/16 nodes, mets, ER+/PR+, HER2-
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Jun 14, 2011 06:33PM 37antiques wrote:

Hi Mary! 

Your friend needs to apply for SSDI, she can do it online, and then they will call her.  If you need help with this, I am very good at this whole process and can try to guide you if you need it.  It does take time, the sooner you get everything together the quicker it goes.  It would be best if she told her doctors that she is doing this, so they will be prepared and have all of the documents on hand to submit for her.

After 2 years of SSDI, Medicare kicks in.  Yes, there is a premium they deduct.  However, since you are in NY, if she has SSDI and goes to the office of the Aging (no matter the age, she is now considered disabled), they will help her with that and become an advocate for anything she needs, and they can especailly help with the prescription plans, which can be a huge headache.

But it sounds like she needs immediate help, instead of waiting two years. If you need help or guidance, please feel free to PM me, I am in NY and am unfortunately, very familiar with what she can do right now.  There is housing assistance, medical care, a lot of things that she can qualify for easily since she has no income, but again, you have to have all of the paperwork ready to go.

I hope this helps, and if I can help you at all, please let me know.

IDC DCIS & Mets Dx 2/27/2007, DCIS/IDC, Left, 1cm, Stage IV, metastasized to bone, Grade 3, 0/1 nodes, mets, ER+/PR+, HER2-,
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Jun 14, 2011 08:34PM cycle-path wrote:

Regarding Section 8 housing: I don't know how difficult it is to qualify, but I do know the waiting list to actually GET the housing after you qualify can be rather long. So it's something to look into right away. I believe you have to apply through your local city or county housing authority.

I am an Uppity Woman. Don't like my posts? Put me on IGNORE. Dx 12/10/2010, DCIS, 1cm, Stage 0, Grade 2, 0/2 nodes, ER+/PR+
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Jun 14, 2011 08:38PM bcincolorado wrote:

I can tell you for many people with SSDI claims you are often denied to start off with.  I knew someone who applied and was approved right away but many have to get a lawyer and do an appeal.  For this person the SSDI payments did not start (they were not eligible) until they had not been able to work for a year.  Then it took 6 months more before they were eligible for Medicare payments.

Dx 8/2009, IDC, Left, 5cm, Stage IIA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Surgery 1/1/2010 Mastectomy (Left): Nipple Sparing; Reconstruction (Left): Tissue Expander Surgery 1/6/2010 Lumpectomy; Lumpectomy (Left); Lymph node removal; Lymph node removal (Left) Hormonal Therapy 1/14/2010 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 1/29/2016 Femara (letrozole) Hormonal Therapy 1/1/2020

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