Medicare- what to do??

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Emmy0212
Emmy0212 Member Posts: 2
edited March 2021 in Employment, Insurance, and Other Financial Issues

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

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  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited March 2021

    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

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  • Moderators
    Moderators Member Posts: 25,912
    edited March 2021

    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.


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  • AliceBastable
    AliceBastable Member Posts: 3,461
    edited March 2021

    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.

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  • Emmy0212
    Emmy0212 Member Posts: 2
    edited March 2021

    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?

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  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited March 2021

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

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  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited March 2021

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

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  • illimae
    illimae Member Posts: 5,710
    edited March 2021

    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.

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