Medicare Question

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BonnieR
BonnieR Member Posts: 1,526 Member
edited March 2014 in Ovarian Cancer #1
Hi Everyone, I found many of the things that were in my Docs barrel are not FDA approved for Ovarian cancer. Has anyone had luck appealing Medicare, I know it is different in each state but just curious. If you have what did you do and how long did it take?

I am scheduled to start back on the carboplatin in two weeks, if my body and me feel up to it. Not sure it will work again but my Doc said let's give it a try as it worked for 13 months before the transplant. Still tired and anemic so not sure where my body will be at in 2weeks.

Anyway, just wanted to check with all of you about the medicare, such a wise and diverse group figure someone may know. I just maxed my insurance and Medicare is now my primary.

Hugs N Prayers Bonnie

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  • saundra
    saundra Member Posts: 1,370 Member
    #2
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    I don't know since I am behind you in treatment. I have not had a refusal to pay in the 20 months of treatment that I have had. No experience in the appeal process. Medicare is my primary. I do know that sometimes drug mfg's will waive the expense if the right researcher appeals to them. This happened with my son's arthritis medication for the rare type he has once in Chicago area. Similar problem with his insurance...refusing his type of arthritis when it was given for others on the same gene marker. The doctor contacted the mfg. directly in his behalf and they shipped directly to him for injections. Might be worth a try if appeals don't work. ((Hugs and prayers)) Saundra
  • kris43
    kris43 Member Posts: 275
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    Bonnie - do you have access to a social worker or case manager where you doctor? Or at the local hospital? They would be an invaluable source of information and know which way to proceed.

    I hope you are trying to get some rest - your body has been through so much.

    I think of you often and you are close in my thoughts. Please let us know what you find out.

    Take care!
    Kris
  • green50
    green50 Member Posts: 312
    #4
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    Hi Bonnie,
    I am doing the
    Hi Bonnie,
    I am doing the slow drip carbo and have since May every three weeks. I only have Medicaid but will be getting Medicare 2010,the 2 year wait. I give them 20 a month since I do the slow drip on the actual hosp. floor outpatient. The carbo is making me weak but I am plugging along. I was given the red blood cell shot last month and the month before and it made me weaker plus my count didn't come down last month and not as much the month before. I think I will tell them no more shots if I get too low just give me blood. And sometimes I have to go with 4 weeks in between instead of 3. I would rather take this then taxitiere though. Least I get to keep my hair. I have lost it 4 times in 6 years. Mine is not quite as long as your picture. I hope you can hang in there and take the carbo. My CA125 was 14,000 and now is 6554. As long as it keeps going down maybe I will be done by Thanksgiving or Christmas. I wait until it goes down below 100. Hope my body can handle it. I am on social security disability I am 50 years old and they said I had to wait 2 years for Medicare so have Medicaid in the mean time. I live in Indiana. My doctor and the woman who sent my records to SSA were good and sent everything and I got disability in 2 months. I hope all works for you and prayers to you.
    Sandy Green
  • BonnieR
    BonnieR Member Posts: 1,526 Member
    #5
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    green50 said:

    Hi Bonnie,
    I am doing the
    Hi Bonnie,
    I am doing the slow drip carbo and have since May every three weeks. I only have Medicaid but will be getting Medicare 2010,the 2 year wait. I give them 20 a month since I do the slow drip on the actual hosp. floor outpatient. The carbo is making me weak but I am plugging along. I was given the red blood cell shot last month and the month before and it made me weaker plus my count didn't come down last month and not as much the month before. I think I will tell them no more shots if I get too low just give me blood. And sometimes I have to go with 4 weeks in between instead of 3. I would rather take this then taxitiere though. Least I get to keep my hair. I have lost it 4 times in 6 years. Mine is not quite as long as your picture. I hope you can hang in there and take the carbo. My CA125 was 14,000 and now is 6554. As long as it keeps going down maybe I will be done by Thanksgiving or Christmas. I wait until it goes down below 100. Hope my body can handle it. I am on social security disability I am 50 years old and they said I had to wait 2 years for Medicare so have Medicaid in the mean time. I live in Indiana. My doctor and the woman who sent my records to SSA were good and sent everything and I got disability in 2 months. I hope all works for you and prayers to you.
    Sandy Green

    Thank you everyone
    First thank you each for responding, Medicare is so different in each state. You would think it had fed regs.

    Saundra, thanks for making sure I know about compassionate use. I have the information saved that I found online, but I think assets play into it. Anyway never hurts to try it.

    Kris, ditto ~ I know the docs and nurses would connect me with a worker if needed. :-)

    Sandy, I have been on disability since Aug 26, 2004, and like yourself qualified for ssdi right away. I think ovarian cancer is automatic as most people don't survive or never seem to get off chemo. Some do though so if you are a newbie don't let that sentence frighten you. Anyway I was on Carbo for 13months and it did keep my cancer from growing, didn't make it shrink but kept it from growing. I am allergic so get the 24 hour drip too and didn't lose my hair. Right now I am bald again and not sure how well it'll grow back, but that isn't as important as a chemo working. I know it made me very sick, I got fluids the day after I got out of the hospital - along with neulasta, and sometimes arenesp for rbc. I tried getting treatments further apart ~ to let my body come back on its own ~ but when we did that the carbo stopped working for me. So we know I have to go every 3 weeks this time, with an occasional 4 weeks because of blood counts. Anyway thanks again everyone .. pray this finds you all doing well ~ or as well as can be ~ Sending lots of prayers your way, it sounds like the carbo is really kicking cancer's butt for you!! Hugs Bonnie

    PS And thanks everyone For being That Friend who helps lift each of us to our feet when our own wings have trouble flying, yes ~ you are all Earth Angels.

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