1 Topic by cyjcho (edited by cyjcho Wed, 08 Dec 2010 00:40:26)

  • Registered: Mon, 06 Dec 2010
  • Posts: 9

Topic: No insurance and not old enough for Medicare

Hello. My mother was initially diagnosed with CC in March and received Whipple Procedure out of country. It was a successful surgery however, the tumor has returned only six months later and has metastasized to her liver. My family decided that it would be best if our mother stayed home in Texas and receive chemotherapy. But she has no insurance with only pending SSD. My brother and I have been actively looking into insurance companies, expedited process for SSD and medicare but were unsuccessful and was told that medicare is out of the question at this point since our mother is 63. I wanted to ask if anyone might be in a similar situation? Any thoughts would be greatly appreciated.

Thanks,
Christie

2 Reply by slittle1127 (edited by slittle1127 Wed, 08 Dec 2010 10:27:01)

  • Registered: Sun, 01 Aug 2010
  • Posts: 493

Re: No insurance and not old enough for Medicare

Christine - We were in your same position. We ended up paying out of pocket for the chemo. Due to the expense, this was not something we could continue for a long period of time but we did complete 3 cycles (6 treatments). Then our state (CA) implemented one of the new health care requirements and established a state insurance program - it is expensive at $567 a month - but is a good, comprehensive PPO plan. This is not required until 2014, but checking with your state can't hurt. Another option is to call the American Cancer Society and see if they have any help they can provide. Some of the drug companies will also help supplement payments so a check with them can't hurt. The only other thing we did was to negotiate cash prices for doctor appointments and tests.

Hope this helps some. It is so hard to need care and have no insurance. My husband is also too young for Medicare and we don't qualify for any public programs. There are non-profit hospice programs that can't charge either. When you are ready, you might look into that.

It takes a tremendous amount of patience to do the legwork. We contacted insurance brokers, but of course were denied. Denial from an insurance company, no insurance for 6 months were conditions of qualifying for our state insurance which is called PCIP - Pre-existing Condition Insurance Program.

Please keep us posted as you may come up with some great options that we need to know about as well.

Blessings, Susan

  • Registered: Thu, 09 Sep 2010
  • Posts: 533

Re: No insurance and not old enough for Medicare

Christine- CC has taught me to never "bitch" about insurance premiums. I was lucky that we had private insurance. I qualified with in weeks for SSD. You have to wait 6 months from  diagnose to apply. I was diagnosed July 2008, applied Dec,2008 rec'd yes answer Dec 2008 and got my first check Feb 2009. You don't get medicare until you have been on SSD for 2 years. I just reached 2 years and am finding out my medicare, supplement and drug coverage will be more than private insurance!! This is the most eye openning expierence. Good luck and lots of prayers- Cathy

  • Registered: Fri, 12 May 2006
  • Posts: 8,174

Re: No insurance and not old enough for Medicare

Christine...additionally, drug companies offer medications under the compassionate use program.  As far as I know the patient's income has to be less than 75 thousand per year.  Definitely, check into this.  Generally, the oncologist's office will have this information. 
Good luck and best wishes,
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
  • Registered: Mon, 06 Dec 2010
  • Posts: 9

Re: No insurance and not old enough for Medicare

Thanks everyone! I will definitely check with my state for health programs and drug companies. We are currently trying to decide on what type of chemo to chose and when. I will keep everyone posted if I come across other options.

Thank you, Christie