Topic: Medicare and liver transplant

Does anyone have up to date info about medicare paying for Liver transplant when the person has cholangiocarinoma? I would like to hear from  others about this. It seems that we are waiting for Medicares clearance in order for my husband to be put on the list for a liver.  Thanks in advance Brenda

Re: Medicare and liver transplant

Brenda...as far as I know, liver transplantations for intrahepatic CC are covered by Medicare in the State of Texas only.  In fact, we supported an attorney who handled the matter.  Don't know if any other States have followed suit.  Hope this helped.
Hugs,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

Re: Medicare and liver transplant

Hi!  Anybody have any further info on this?  Medicare in CA will cover liver transplant for CC, but Medicare in Indiana won't.  WTH???  tongue
Thanks!
Sis

Re: Medicare and liver transplant

Sis -
Medicare can be quite frustrating and quite often the system works backwards from what it should. Each state is handled differently so what Medicare will pay for in one state is not necessarily what you will get in another. Just as Medicare reimbursement rates are different from state to state.....Medicare actually punishes states that use their Medicare dollars wisely by giving them less money and states that don't manage get more. They also won't pay for a lot of preventative stuff that would save millions of dollars in the long run......an example is a quadraplegic who has an extremely high risk of pressure ulcers, they will not pay for a pressure relieving mattress until the person has bed sores. So let's close the barn door after then horse ran off.
It very frustrating and I battle it every day. One thing I will say though, is if you are denied something because it is not covered in your state then contact your Representatives and Senators, that can sometimes get those rulings changed.

KrisV

Any advice given is based on my experiences and should not be substituted for any medical recommendations. Please speak with your provider before making any changes.

Re: Medicare and liver transplant

Marksis......I was not aware of CA Medicare carrying liver transplantations for CC patients. I only recall a Texas attorney reaching out to the foundation 7 years ago asking for support in fighting the State of Texas and the case was won.
Hugs,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

6 (edited by jathy1125 Sat, 26 Jul 2014 06:40:04)

Re: Medicare and liver transplant

Crazy to read Brenda's original  post because less than a year later Kenny got his liver!!!
Apparently Medicare pays!!
Lots of prayers for all the battles our CC family faces
Cathy

Re: Medicare and liver transplant

Yes Cathy it is crazy, I thought the day would not come for Kenny to get his transplant.  It's a new life now, you know really living ! He is doing great and we have so many to thank, you, Dr Chapman, all the Drs And cordinators and GOD  for giving him this second chance. 2 young men in our area have lost their life just since we returned from the transplant, I so wish that we will see a better way to catch this disease so they can have earlier treatments.
Kenny is preparing for Fall harvest, feeling better every day. Who would have thought that?
As for Medicare , they paid their part, our insurance, BC BS paid theirs and we are just so glad.
By the way, even medicaid pays for transplants in Illinois for those that need it, it's only right that everyone be able to get medical care. In my view that is.
So yes, Kenny is doing great.
Hugs
Brenda

Re: Medicare and liver transplant

My brother is meeting with Dr. Chapman tomorrow!  I can't wait to meet him.
Re: Medicare--it's my understanding now that the country is divided into Medicare zones.  Each zone has it's own insurance provider/administrator.  Each zone has discretion as to whether it wants to cover liver transplant for CC.  If a medical center wants Medicare to cover liver transplant for CC, then they have to work with the Medicare provider and get them to approve the  medical center's liver transplant for CC protocol.  Once Medicare approves their protocol, anyone who successfully completes the protocol will be covered. 
Re: California--the UCLA protocol is accepted by Medicare.

So happy that Kenny is doing great! 

Sis

Re: Medicare and liver transplant

Sis, I hope that your Brother Mark is able to get help with Dr Chapman, if it is possible I am sure that he will be in good hands with a very caring and able dr. We have alot of respect for the whole team at Barnes. Please let us know how Marks appt. goes.
   Lots of prayers
Brenda

10

Re: Medicare and liver transplant

Healthcare in general is a very sensitive issue for me. I do not understand how we are the number 1 country in the world, our government spends BILLIONS of our TAX PAYERS dollars on WARS AND OTHER BS but yet, one of us has to worry about the financials when dealing with something major as liver transplant. This is JUST UNACCEPTABLE.

Diane, I hope the issue of Medicare will be solved soon so you brother can get the treatment he deserves. Mark is blessed to have the option of LT, I wish our politicians will be blessed one day with some humanity in them.. I wish him the best luck in his meeting with Dr Chapman, we are all praying for him.

Brenda, glad to hear that Kenny is doing well. You are both harvesting the results of the hope you planted along this journey.

Emad

"For as it goes through fire, passioned with a rebirth desire; it burns to ashes, and a new life dashes; for the Phoenix shall rise"  As I am the Phoenix and i will hold your hands  ...
I will always make you proud
My Angels "SEEK"

Re: Medicare and liver transplant

SEEK, I do think a person has to have alot of hope everyday. It was a long process but Oh so rewarding. The transplant changed our lives  in so many ways. Kenny at least has a second chance at life. He is positive to the point I have to keep an eye on him so he won't over do !He actually has the energy to do thigs that have been impossible for the last 3 yrs.
   Here in the USA  we are pretty lucky to have Insurance that allows all to have great medical care.That is why it is so important to get that 2nd and third or more opinions.If we would have stopped at the  first diagnosis and plan that was nothing, we wouldn't be having this conversation. God has a Plan for all of us BUT we  have to promote ourselves for the care'
I have met several transplant people who had just medicaid and got wonderful care no matter their insurance.  Can you tell how happy we are about this chance at life? lol But it really is somethin that we are so thankfull for.
Brenda

Re: Medicare and liver transplant

Sis, So excited that you are going to see our HERO Dr. Chapman!! Brenda and I are life time members of the Dr. Chapman fan club!! LOL!!
I sent you an email but there was conflicting messages when sent so please contact me if you don't receive it and would like to talk or if I can help I live in St. Louis area ! 618-567-3247
Lots of prayers-Cathy

Re: Medicare and liver transplant

Sis.... Fantastic news on the upcoming visit.  Good luck and please keep us posted.
On another note:  the Medicare information is very important for others to read and I am concerned that it may become lost.  Would you please be so kind and repeat the info in the Insurance thread? 
http://www.cholangiocarcinoma.org/punbb/post.php?fid=22
Let me know if you need help or if you prefer not to do so.  Gladly I will do it for you, but it is so much nicer for each member to post his/her own thoughts and information. 
Thanks for considering.
Hugs,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

14

Re: Medicare and liver transplant

Hope that your brother's meeting with Dr Chapman goes well Sis. Please let us know how that goes.

Best wishes to you and your brother,

Gavin

Any advice or comments I give are based on personal experiences and knowledge and are my opinions only, they are not to be substituted for professional medical advice. Please seek professional advice from a qualified doctor or medical professional.