CSN Login
Members Online: 2

You are here

Insurance Drops MD Anderson

NewHere's picture
NewHere
Posts: 1295
Joined: Feb 2015

For some reason I thought I saw this posted here, but looking at the date did not see the topic.  Apologies in advance.  And blame chemo brain Sealed

 

http://www.houstonchronicle.com/business/medical/article/Loss-of-insurance-plans-could-devastate-cancer-6603232.php

tanstaafl's picture
tanstaafl
Posts: 1299
Joined: Oct 2010

From above, rationing started with a bait and switch, from PPO to HMO.  PPO insurance in Houston was a victim of the total system cost of high tech/high cost treatments.  In essence so many going locally to MD Anderson (or other super specialists) broke the PPO insurance coverage around Houston:

BCBS of Tx,...decision to drop PPOs... was not made lightly....the company paid out $400 million more in claims than it collected in premiums...."Since the Affordable Care Act began, the market has changed. We found the individual PPO plan was no longer sustainable at the cost it was being offered," 

..."Being in Houston is good and bad. We have all of these wonderful medical facilities. People come from all over the world to be treated in Houston. But that kind of care comes with a very high price," 

My wife's only salvation, both technically and financially, has been through cheaper treatments based on generic drugs, experimental and alternative medicine, while not counting on insurance to pay it.   Much of her generic based treatment is not US available because of bad FDA rules.  

The FDA and state license monopolies are where much of the US medical and insurance crisis originates due to high prices and the unavailability of cheaper, superior competitors.    Basically, conventional US medicine couldn't touch my wife for survival or quality of life or cost.  They might put you or your doctor in jail, if you tried too hard.

-------

Btw, for those that think "single payer"is some magic answer, under medicine in the US controlled as rigidly as the Canadian system, we would just die.

Hugmoe
Posts: 9
Joined: Oct 2015

Try the link on this page called community resources. All they can tell you is no. If they can't help you maybe able to get you in contact with somebody that can. The main thing is DON'T give up by the word no. Hope it helps.

NewHere's picture
NewHere
Posts: 1295
Joined: Feb 2015

Just know of MD Anderson's rep.  And I am guessing there will be more stories like this.  Just found out my insurance is terminating the end of this month and hoping a new one can be put in place without breaking the bank.  Too much.

NewHere's picture
NewHere
Posts: 1295
Joined: Feb 2015

I am $%^&#*((0%@$%#.  Cry

Trubrit's picture
Trubrit
Posts: 5392
Joined: Jan 2013

I know the gut wrenching feeling where lack of financial help is concerned. I pray something comes up soon, that helps your situation. 

I hope all of your treatments have been covered and that other than the regular tests, you see NED for ever and ever. 

Sue - Trubrit

NewHere's picture
NewHere
Posts: 1295
Joined: Feb 2015

My health insurance went up a ton, just found out.  And other issues where it looks like I may not be covered.  Long story. 

Thankfully surgery and chemo is complete.  So it is scans and monitoring that is the issue. I will figure out a way as it comes up.  It just got dropped in my lap and after being a bit bummed and ticked, starting to plan.  As long as NED, everything else is relatively minor in the grand scheme of things.  

Trubrit's picture
Trubrit
Posts: 5392
Joined: Jan 2013

My deductable is $3,500 (Husbands is the same) which just kills us, as we're not rolling in the moola. 

Something will work out, my friend. Hang tight!

Sue - Trubrit

Daisy13's picture
Daisy13
Posts: 43
Joined: Nov 2014

are there treatments or procedures that you need that only M.D. Anderson provides? 

NewHere's picture
NewHere
Posts: 1295
Joined: Feb 2015

I saw the article about MD Anderson before I just the news yesterday.   As to treatments/procedures, when I got the initial diagnosis I immediately though "MSK" since I am right there.  But I did meet with other doctors before my MSK appointment.  Was not impressed, and there seemed to be some guessing and not really "being on top of it."  My surgery turned out to be more complicated compared to what the scans and colonoscopy showed.  I really believe that if I had gone with some of the other doctors I would not be in the shape I am in now.  

At this point I am hoping it is just scans and monitoring, will figure out a way.  If there is future surgery or chemo or the rest, that will be a big issue.

lizard44's picture
lizard44
Posts: 409
Joined: Apr 2015

That is  infuriating- and wrong. Meanwhile, a lot of  insurance  companies are pleading poverty and losses and  dropping  customers or  increasing their premiums while paying their executives  exorbitant salaries and bonuses.

Before retirement, we were self-employed and had  issues with insurance companies for years.  Sometimes it seemed we needed a letter from God before they would cover  some medically necessary procedures. It seemed like we were paying very high premiums for  very little coverage.  I am thankful I have Medicare with a  supplemental  policy now.  We switched private insurers last year, dropping the  major insurer in our state and going with  a company  affiliated with the  major medical research university  here. It was a good move.  We have  a high annual out-of-pocket expense of   just over $6700-- not exactly   an easy amount to cover  on a  very limited income  consisting mostly of  Social Security, but  since the insurance company has already been billed over $100,00 this year, I can't really complain too much, and they have not balked at covering any tests or treatments my doctors have requested coverage for.

I hope you can find another policy that is affordable. Does MSK  have a department that  helps patients with  insurance and financial issues?

Hang in there.

Grace

 

NewHere's picture
NewHere
Posts: 1295
Joined: Feb 2015

, We were self-employed 

That is my issue.  And in the last three years it has become remarkably difficult and expensive.  It is exteremly difficult to find insurance now and the exchange plans in my State have some serious weaknesses.  The one I just discovered - though the insurance companies do cover MSK, and MSK accepts, their various plans, including their HMOs - the insurance companies do not cover MSK if purchased on the exchange.  If I worked for someone and got the same plan through a company, then it is covered.  

abrub's picture
abrub
Posts: 2155
Joined: Mar 2010

for residents of NY are the off-exchange Oxford plans, which starting in 2016 will still cover MSK, but not include NYU.

Send me a PM if you need more information, and I can help you.  I'm a broker, with strong ties to MSK (I go there for my cancer care) and am very attuned to the issues of the Individual plans.

Alice

NewHere's picture
NewHere
Posts: 1295
Joined: Feb 2015

Appreciate the information.  That is even worse than I thought in terms of Individual Plan.  Been looking all weekend trying to find my doctors in the off-exhange plans.  Now I know why it was so problematic. Cry  I may be stuck paying the outrageous premium if the plan still covers MSK.  (Just looked at the Oxford Rateson their site.  Premiums  a ton less a month than my new bill.  Just concerned about switching due to the wonderful C word.)    

Subscribe to Comments for "Insurance Drops MD Anderson"