Have you heard this? Treatment question

PatchAdams
PatchAdams Member Posts: 271
in Colorectal Cancer #1

My mother's best friend is an RN at a hospital here in Mobile. She's 63.  She told mother that the hospital had a seminar last week that explained, with the new insurance rules, that treatment for seroius illness, like CANCER, will not be offered to Medicare patients who do not have another primary insurance carrier even if the cancer might be curable. They will offer pain relief and treat symptoms but nothing expensive like chemo will be offered. They did say surgery might be done if the cost would be less than palative care. 

I didn't think this sounded right so I was talking to a retired guy at church who is 72. He said he and his wife have opted to keep her insurance (former bank VP who is 71) because he went to a seminar on Medicaid and they were told people their age would not be treated for cancer nor would certain things, like colonoscopies, mammograms, be paid for by Medicaid within the next two years. 

I don't know what to think about all this.  My mother is looking into getting cancer insurance for herself now.  Her RN friend bought 'catastrophic insurance'. 

I don't know what this means for people who are on state insurances, like a 40 something cousin who has many illnesses and is on state Medicaid in Alabama. 

 

Patch

Comments

  • Lovekitties
    Lovekitties Member Posts: 3,364 Member
    #2
    Confusing for sure

    I can't speak to Medicaid, as that varies by state, but here is an official government site about medicare and cancer treatments.  Please note there this no mention about age cutoff:

    http://www.medicare.gov/coverage/chemotherapy.html

    Since this seminar was held at a hospital, it may be the hospital's choice to no longer accept Medicare for any or all treatments.  The hospital and doctors have the choice to participate or not.   That is why it is important for the patient to always check to see what their hospitals and doctor's take in the way of insurance.  Many choose not to accept it because of the "cap" put on facilities and services.

    Never assume that Medicare or Medicaid is accepted by all...it isn't.

    Marie who loves kitties

  • geotina
    geotina Member Posts: 2,111 Member
    #3
    Medicare:

    Just took out my 2014 benefits book.  Colonoscopy - Test covered every 120 months, high risk 24 months, etc. etc. "You pay nothing for the test if the doctor or other qualified helalth care provider accepts assignment.", etc. etc.  Pg. 39.  Chemotherapy is also covered in hospital or free standing  clinic.  You have to pay your deductibe after payment of the medicare approvied amount and supplement. Mammograms are covered.  I have Medicare Parts A and B and also a Blue Cross/Blue Shield Medicare Plus Blue PPO plan.  My doctors are at the University of Michigan and they accept just about every plan out there.

    I can't imagine a hospital and the doctors associated with that hospital not accepting Medicare for cancer care when it is clearly a paid benefit.   Still sounds not quite right.  

    Perhaps the hospital they are talking about opted out of Medicare. 

    Take care - Tina

     

     

  • annalexandria
    annalexandria Member Posts: 2,571 Member
    #4
    hospitals can indeed opt out of Medicare,

    as can private doctors.  Medicare and Medicaid have built-in cost controls that mean the sky is not the limit when it comes to fees.  Obviously for-profit entities may make this decision as part of their bottom line, which unfortunately is profits more than patients, even in health care.

     

    As for the rest of those concerns, Idk...all I can say is that there is a vast amount of misinformation being spread to senior citizens in this country, and virtually everything I've read has been fear-based speading of rumors for political ends.   I don't take anything anecdotal as reality until I see some actual proof.

     

     

  • PatchAdams
    PatchAdams Member Posts: 271
    #5
    Agree with all of you.....

    The man from church did say this was going to be in two years which would be 2017 or 2018.  I didn't ask who held the seminar.  Hospital or Tea Party! LOL 

    I haven't spoken with Paulette myself about the seminar.  My mother feels like she was told in confidence and doesn't want me to mention it unless Paulette mentions it to me. 

    I didn't keep the link, but while searching I found a report that said colonoscopies will no longer be ordered for those over 70, mammograms after a certain age or pap smears over 65. Those would be self pay.  

    However..... my husband uses the VA. He rec'd a letter saying the VA will no longer pay for certain immunizations and other tests are being spaced out.  

    It's upsetting if any of it is true because long term survivors can and will be affected at some point. 

     

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