Medicare, and scared to find out how much this will cost.

brend
brend Member Posts: 66
edited January 2015 in Employment, Insurance, and Other Financial Issues
Medicare, and scared to find out how much this will cost.
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  • brend
    brend Member Posts: 66
    edited December 2014

    I've been on Medicare since 2006. I've recently been diagnosed with IDC possibly stage 2. Yesterday (yea, Christmas Eve), I started getting bills for the tests (oh frigging Merry Christmas). After 2 bills so far, I'm not sure I want to know what the rest of this will cost.

    My surgeon wants me to do chemo first, before surgery. I can't find anywhere, what Medicare pays on chemo. I won't even meet my oncologist till Dec 31st. I've had 3 visits with the surgeon.

    This has pretty much ruined my Christmas. And I have to go visit relatives???

    Anyone with a guesstimate on what I'm looking at out of pocket?

    Medicare D stinks....with that huge GAPING donut hole that I've hit with other medications in the past.

    Needless to say I'm scared to death to find out how much this will cost. Starting to wonder if my surgeon will do surgery without the chemo first.

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  • jenjenl
    jenjenl Member Posts: 948
    edited December 2014

    I'm not familiar with that plan but mine sucked too, 10k OOP each year since 2012. BUT I was able to get financial assistance (see link below) - they retro paid 5k for my chemo. It's a one time thing but it helped a lot when those bills kept piling in. It was a very easy and fast process, looks like it's still open. I was surprised I was approved based on my income to be honest. Try to look for other programs in addition to this.

    http://www.copays.org/resources/breast.php

    I am sorry you found out on xmas eve. Try to not focus on the bills right now and figure out the best treatment plan.

    Here for you. xo

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  • proudtospin
    proudtospin Member Posts: 5,972
    edited December 2014

    sorry for all this at this time of year. I did my treatment while on my employer plan 6 years ago and remember how scared I was at the start.  My insurance worked out with a not high max out of pocket at the time.  Now I am only just learning about Medicare as I am now retired. 

    One place I had called was the hospital where my surgery was as they sent me a big bill.  We worked out a payment plan to ease the initial shock!

    Now on medicare, I have had issues on medications and on tests and find my docs are a good source of help.  They have to code things properly so I do not get hit.  Like Medicare will not pay for a Wellness visit but will pay for check/blood tests regarding my high BP and cholesteral.  It is tough but do not give up.  Check with your docs for help

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  • pajim
    pajim Member Posts: 2,785
    edited January 2015

    brend, I can think of several places to look for help with this question. 

    The first is your cancer center.  They have billing specialists and social workers who will know all the billing tips and tricks.  And if cost is an issue, they can provide ideas on how to hold down costs.

    Second is your local social security office or the medicare help line.  That wouldn't be my first choice, but if you find the right person they can help.  Some of their answers will depend on your state.  MA requires some things that other states don't.  Not sure if Medicare regulations supercede state regulations.

    Third is CancerCare.org.  They have counselors who know the ins and outs of this sort of thing.  http://www.cancercare.org/financial  They can also help find some assistance if you need it.

    Fourth is CancerSupportCommunity.org  http://www.cancersupportcommunity.org/  

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  • jdlott74
    jdlott74 Member Posts: 6
    edited January 2015

    Being in the medical insurance and seeing this on a daily basis, Medicare has a set fee schedule across the board depending on where you live.  The CMS website  I think have the fee schedules.  Medicare only pays 80% and the pt is responsible for 20%.  If you have the CPT codes then you can find out what the allowable is.

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