Topic: Medicare- what to do??

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

Posted on: Mar 7, 2021 06:26AM - edited Mar 7, 2021 06:27AM by Emmy0212

Posted on: Mar 7, 2021 06:26AM - edited Mar 7, 2021 06:27AM by Emmy0212

Emmy0212 wrote:

Hi everyone,

My mom was recently diagnosed with stage 2 triple negative breast cancer. As if the emotional impact of the diagnosis wasn't enough, we have no idea how we are going to pay for the cost of treatment. My mom is 58 years old and is on disability. This being the case, her insurance is Medicare and they will cover 80% of her treatment, but she has to cover the remaining 20%. There is no out of pocket maximum. By my calculations, she is going to be in an ENORMOUS amount of debt by the time this is all over. As a family who lives paycheck to paycheck, there is no way we can afford this. Do we have any options? It looks like medigap isn't an option unless you are 65.

Thanks!

Emmy

Log in to post a reply

Page 1 of 1 (7 results)

Log in to post a reply

Mar 7, 2021 06:51AM melissadallas wrote:

Emmy0212, sorry about your Mom.

I would make an appointment with a social worker at the hospital. They are really good at helping line up assistance or discounted billing.

As far as Medigap policies, they are available in my state for people on disability but under regular Medicare age, but they are very expensive. My cousin had to drop his because he would have been spending almost all his disability payment for the insurance. These policies are priced very differently than “regular” Medigaps

LCIS, extensive sclerosing adenosis, TAH/BSO & partial omentectomy for mucinous borderline ovarian tumor. Dx 5/20/2012, LCIS, Stage 0, 0/0 nodes
Log in to post a reply

Mar 7, 2021 08:52AM moderators wrote:

Hi Emmy0212, MelissaDallas's suggestion to talk with the social worker is excellent. Please take a look at our section also on Paying for Your Care. For instance, most pharmaceutical companies have programs to help with costs. Please keep us posted, and let us know if we can help guide you or your mom.


To send a PM to the Mods: community.breastcancer.org/my/...
Log in to post a reply

Mar 7, 2021 10:57AM alicebastable wrote:

If your mother gets treatment at a teaching hospital or one affiliated with a religious organization, they may have sliding scale fees. MelissaDallas' suggestion is excellent.

Ignore treatment info (below) which is a BCO glitch. Do not enter personal information on this site since they grossly mishandled a data breach. Surgery 7/10/2018 Lumpectomy; Lumpectomy (Left); Lymph node removal Surgery 8/7/2018 Radiation Therapy 10/28/2018 Whole breast: Breast, Lymph nodes
Log in to post a reply

Mar 7, 2021 12:31PM Emmy0212 wrote:

Thanks for your responses everyone! I have reached out to the social worker and am waiting on a response. I really hope they can help in some way, or unfortunately we may not be able to continue with my moms treatment. Treatment is slated to include AC+T, lumpectomy and radiation.

Another question. My dad gets health insurance through his job and his open enrollment period is coming up. My parents were thinking of adding my mom to his plan, but could she be denied because of her pre-existing condition?

Log in to post a reply

Mar 7, 2021 02:54PM melissadallas wrote:

More than likely she cannot be declined for a group plan during open enrollment

LCIS, extensive sclerosing adenosis, TAH/BSO & partial omentectomy for mucinous borderline ovarian tumor. Dx 5/20/2012, LCIS, Stage 0, 0/0 nodes
Log in to post a reply

Mar 16, 2021 10:26PM sbelizabeth wrote:

I second MelissaDallas. I would be very surprised if his employer was allowed to deny her enrollment based on her pre-existing condition.

pinkribbonandwheels.wordpress.... Dx 10/20/2011, IDC/IBC, Left, 1cm, Stage IIIB, Grade 2, 6/28 nodes, ER+/PR+, HER2- Chemotherapy 12/15/2011 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/18/2012 Mastectomy; Mastectomy (Left) Radiation Therapy 5/21/2012 Breast, Lymph nodes Hormonal Therapy 7/19/2012 Femara (letrozole) Surgery 4/15/2013 Reconstruction (Left): DIEP flap; Reconstruction (Right): DIEP flap
Log in to post a reply

Mar 16, 2021 11:01PM illimae wrote:

Could you try an ACA plan for supplemental insurance? Perhaps they have a specific department that can provide assistance or other options? Also, check with her oncologist and hospital’s financial dept., they may have financial aide or prescription programs to help with those costs.

Diagnosed at 41 Stage IV De Novo Dx 11/16/2016, IDC, Left, 5cm, Stage IV, metastasized to bone, Grade 3, 3/13 nodes, ER+/PR-, HER2+ Chemotherapy 1/1/2017 Abraxane (albumin-bound or nab-paclitaxel) Targeted Therapy 1/1/2017 Herceptin (trastuzumab) Targeted Therapy 1/1/2017 Perjeta (pertuzumab) Surgery 6/26/2017 Lumpectomy; Lumpectomy (Left); Lymph node removal Radiation Therapy 8/10/2017 Breast, Lymph nodes Dx 10/5/2017, IDC, Left, 5cm, Stage IV, metastasized to brain, Grade 3, 3/13 nodes, ER+, HER2- Radiation Therapy 10/19/2017 External Local Metastases 10/19/2017 Brain Radiation Therapy 4/18/2018 External Local Metastases 4/18/2018 Brain Radiation Therapy 5/22/2019 External Local Metastases 5/22/2019 Brain Surgery 1/21/2020 Radiation Therapy 2/16/2020 External Local Metastases 2/16/2020 Brain Radiation Therapy 7/20/2020 External Local Metastases 7/20/2020 Radiation therapy: Bone Radiation Therapy 12/4/2020 External Local Metastases 12/4/2020 Brain Targeted Therapy Tukysa (tucatinib) Chemotherapy Xeloda (capecitabine) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)

Page 1 of 1 (7 results)

Scroll to top button