supplementing Medicare for bc issues

Hi, Tina,

Sorry I can't address your question directly, but I do know that at present, should you develop lymphedema (which is a life-long risk for literally all of us who have been treated for breast cancer) Medicare will NOT presently cover ANY compression garments, and out-of-pocket these are very expensive. (Typically, a custom measured day-time glove and sleeve will be over $300, night-time garments closer to $600. The day garments need to be replaced every 6 months on average, and you need two sets in order to have one to wash and one to wear.)

Medicare does cover therapy for lymphedema, but only if the therapy is done by a PT or OT. In many areas the only trained lymphedema therapists are RNs or MTs, and if so, you're out of luck.

Needless to say, those of us who know we will eventually be affected by this non-pay nonsense are busy advocating for changes, but the wheels of bureaucracy move mighty slow.

Any of you sharp gals who'd like to help with advocacy to make the necessary changes in Medicare policy, please PM me and I'll direct you to advocacy information. Thanks!

Binney 

I'm not anywhere near Medicare age either but due to RSD I am on SSD

and after waiting the 2 years went on Medicare June 1st.

I am trying to keep Medicare as my primary since I am a medically complicated patient---

As a result I elected Medigap  secondary insurance which leaves Medicare my primary.  It is very expensive but, I feel it is necessary right now.

I am welcomed with open arms by all Doctors everywhere- LOL.  As long as the Doctor is a Medicare participant --I'm safe. --And I don't have to go through the horror of referrals.

You have to consider Medigap very carefully because if you change to a HMO managed Medicare plan --you can never switch back to a Medigap plan again.

You have to be aware that many Doctors won't take certain M/C HMO's

--Many Psycologists, Podiatrists, on and on.  And if you need something like Dialysis you are limited to certain places as well.

It is a very big decision to consider.---It is up to you to make sure your

Doctors are participants in the plans you are considering.

I was eligible for Medicare just a few months before my diagnosis.  I joined a Medicare HMO (Oxford) and, for me, it's been wonderful.  My first year of treatment: surgeon, chemotherapy, radiation, and herceptin (very expensive) were all covered.  The plan I elected had a deductiible, which cost me $750 for that year.  This is beyond what is deducted from SS, and the $20 out-of-pocket for specialists visits.  My costs for my first year were well over $100,000, so I find it incredible that I only spent $750.  However, I live in New York City, so I have access to many, many doctors. And I'm treated at a well regarded cancer center.

If I had gone with straight Medicare my expenses, I believe, would have been about $20,000.  I don't have an in-between plan.  This is not to say I don't worry, as Oxford was recently purchased by United Health, not as highly regarded as Oxford, and things could change. Before deciding on any plan you should read all the literature very carefully, check out the doctors who participate in an HMO and which doctors in your area accept Medicare, and make sure they are doctors you can work with.  My friend from HS, who lives in Colorado, is having an awful time finding doctors there to accept Medicare.  Each area is different!  And New York State has enacted certain laws that some of the other states have not, on what must be covered for cancer patients. So it's a good idea to also find out what the laws are in your state.  You can do this by calling the State Insurance Department, probably located in the state capital.

Dotti:  Something weird is happening out there in health care.  Here in Illinois, now there is a problem with BCBS - private insurance.  In the past, always known as the best, now hospitals and doctors are dropping BCBS like its a hot potato!

It concerns me that our physicians are having to practice medicine based on what medicare and insurance companies are telling them.

Nicki (aka chemosabi)