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re: I have never felt more powerless in all of my life
Posted on 5/22/14 at 3:14 pm to asurob1
Posted on 5/22/14 at 3:14 pm to asurob1
As I was trying to say, asurob1, before I was interrupted:
The new law under ACA is an annual out-of-pocket maximum for individuals of $6350, including for prescriptions.
Someone posted that there's no OOP limit for prescriptions under ACA, and posted a link to an article that only said that pre-2014 policies where prescription limits are segregated from treatment limits wouldn't have an OOP limit for 2014.
If your mother buys a policy NOW, which she can't be denied because of her cancer, she doesn't have to worry about that pre-2014 policy exception because it wouldn't apply to her. She WOULD have a $6350 oop maximum that WOULD include her prescription... as long as the prescription is approved for her particular cancer, I guess.
I, personally, had major surgery earlier this year and now pay zero for all my prescriptions because I've reached my annual OOP maximum.
I'm sorry if you thought by my wording that I was being callous about your mother's condition. Nothing could be further from the truth. Anybody who had bothered to check the post to which I was responding would have known what I was saying.
I've done much hospice volunteering, for heavens sake. I hope your mother recovers and doesn't need such a thing.
The new law under ACA is an annual out-of-pocket maximum for individuals of $6350, including for prescriptions.
Someone posted that there's no OOP limit for prescriptions under ACA, and posted a link to an article that only said that pre-2014 policies where prescription limits are segregated from treatment limits wouldn't have an OOP limit for 2014.
If your mother buys a policy NOW, which she can't be denied because of her cancer, she doesn't have to worry about that pre-2014 policy exception because it wouldn't apply to her. She WOULD have a $6350 oop maximum that WOULD include her prescription... as long as the prescription is approved for her particular cancer, I guess.
I, personally, had major surgery earlier this year and now pay zero for all my prescriptions because I've reached my annual OOP maximum.
I'm sorry if you thought by my wording that I was being callous about your mother's condition. Nothing could be further from the truth. Anybody who had bothered to check the post to which I was responding would have known what I was saying.
I've done much hospice volunteering, for heavens sake. I hope your mother recovers and doesn't need such a thing.
This post was edited on 5/22/14 at 3:16 pm
3
Posted on 5/22/14 at 3:25 pm to Rex
Guys...thanks...I have taken some down time today as I process all the new information. I will go through the thread soon and try to answer what questions you guys posed and ask a few more of mine.
Mostly, Im just looking for a way to help her extend her life as much as we can. The money is the issue and honestly I was just surprised at how much the drugs cost.
Thanks again for the information you guys have provided.
Mostly, Im just looking for a way to help her extend her life as much as we can. The money is the issue and honestly I was just surprised at how much the drugs cost.
Thanks again for the information you guys have provided.
Posted on 5/22/14 at 3:25 pm to Rex
quote:Isn't it too late to sign up for ACA coverage for year 2014? You're not able to just sign up the week you break your leg and get coverage.
If your mother buys a policy NOW, which she can't be denied because of her cancer, she doesn't have to worry about that pre-2014 policy exception because it wouldn't apply to her. She WOULD have a $6350 oop maximum that WOULD include her prescription... as long as the prescription is approved for her particular cancer, I guess.
There may be an exemption since this is basically a transition period for the ACA, but in the future, I'm pretty sure you have to sign up for the next year by sometime in the late fall or you won't be eligible for coverage for the entire year.
Posted on 5/22/14 at 3:27 pm to Hog on the Hill
Yep, it's too late.
If you miss the Open Enrollment period, you can't sign up unless you qualify under very specific exemptions: LINK
For the OP, here's the link to the Special Enrollment Period guidelines, just in case your mom might qualify and ACA coverage might be better than what she has now: LINK
quote:
March 31, 2014: 2014 Open Enrollment ended
November 15, 2014: 2015 Open Enrollment starts
December 31, 2014: Coverage ends for Marketplace plans bought in 2014
February 15, 2015: 2015 Open Enrollment ends
If you miss the Open Enrollment period, you can't sign up unless you qualify under very specific exemptions: LINK
For the OP, here's the link to the Special Enrollment Period guidelines, just in case your mom might qualify and ACA coverage might be better than what she has now: LINK
This post was edited on 5/22/14 at 3:30 pm
Posted on 5/22/14 at 3:31 pm to Hog on the Hill
quote:
Isn't it too late to sign up for ACA coverage for year 2014?
I think it's too late for the premium subsidies. But it still sounds like she'd come out ahead if she enrolled in a new policy directly with an insurance company and pay the premiums... the OOP limit is still the law whether she receives subsidies or not.
This post was edited on 5/22/14 at 3:33 pm
Posted on 5/22/14 at 3:34 pm to thetempleowl
quote:
If you don't mind me asking, what region of the country is this thing happening?
My mom lives in colorado. When she got the diagnosis we moved her to Michigan with my brother who happens to married to a nurse who works at a cancer research facility. I felt like having someone on the inside could stream the process a bit (and it has) as far as getting pointed to the right direction for the treatment.
I believe however, that they have somewhat written her off as they are not actually combating the cancer, but rather trying to simply stop it where it's at due to the fact that it has spread from her kidney into her lungs.
Trying to come up with 3K a month is the issue at the moment. I certainly don't have that which is why I thought to post this here, because you guys are actually collectively a huge wealth of information.
I will be checking out every link you guys have put up. I am fairly certain my mom isn't going to beat this, but I want her to have whatever days she has left as stress free as we can make them.
Posted on 5/22/14 at 3:35 pm to BlackHelicopterPilot
quote:
am terribly sorry to read this.
I wish her the best possible outcome and you (and your family) strength and peace.
Posted on 5/22/14 at 3:38 pm to idlewatcher
quote:
Hope your mom is at peace and not scared of what lies ahead
My mom is very religious and very faithful. But I know she is afraid. Hell I have been walking around in a fog for six weeks. The hardest thing in the world is always being upbeat every time she calls.
But I do it.
Posted on 5/22/14 at 3:42 pm to asurob1
How old is your mother?
Posted on 5/22/14 at 3:51 pm to asurob1
quote:
My mom is very religious and very faithful.
Does she get a kick about your constant jabs about her believing in "magic", or are we the only ones who get to be blessed by such witty banter?
Either way, I wish her well, and I hope for the best for you and your family in your trying times.
Posted on 5/22/14 at 3:52 pm to asurob1
quote:
My mom lives in colorado. When she got the diagnosis we moved her to Michigan with my brother who happens to married to a nurse who works at a cancer research facility
They have no resources to help out?
Michigan is outside my tiny little sphere of influence. I am sorry.
I am not sure about writing her off. Depending upon age and other comorbid factors, it may be better to just keep the cancer at bay for the time being. This is going to sound awful, but sometimes the goal of treatment is to let the patient live long enough to die from something else and not the cancer.
I do not know about all your mothers specifics, and that is more than a bit outside my specialty. I wish I could be more help.
Posted on 5/22/14 at 4:00 pm to Rex
quote:Did not come across that way. Everyone's trying to help here. Your point about possibly needing to change plans in the event of a pre2014 issue is a good one Rex. We don't have as much info as we should to make quality recs at this stage, but hopefully the litany of ideas here will at least help Rob out.
I'm sorry if you thought by my wording that I was being callous about your mother's condition.
Posted on 5/22/14 at 4:06 pm to asurob1
quote:That is probably accurate. Not so much "writing her off" btw, as simply understanding the prognosis. So sorry you're Mom is going thru this. Someday we'll beat Ca. Wish it were today.
I believe however, that they have somewhat written her off as they are not actually combating the cancer, but rather trying to simply stop it where it's at due to the fact that it has spread from her kidney into her lungs.
Posted on 5/22/14 at 4:09 pm to asurob1
Very sorry to hear about your Mother ASURob. I hope things work out for you so that your Mom's last days are as good as possible.
Posted on 5/22/14 at 4:09 pm to asurob1
quote:
asurob1
So sorry to hear about your mom. Lots of positive thoughts sent out your way.
A couple of things (I haven't read the thread so sorry if duplicates)
1. talk to the financial counselor at the hospital where she is receiving treatment. They should be able to help you find programs that he hospital offers including charity programs at the hospital
2. whatever her specific cancer is, contact the philanthropic society associate with that cancer; they may have financial aid available
3. contact the pre-eminent oncologist in that field. They may know of financial aid available or studies that your mother may qualify for
4. don't shy away from a benefit fundraiser or crowd funding service if that will help your mother and your family cover the costs of treatment.
Best to you and your family
Posted on 5/22/14 at 4:33 pm to Y.A. Tittle
quote:
Does she get a kick about your constant jabs about her believing in "magic", or are we the only ones who get to be blessed by such witty banter?
where do you think I get my debating skills from?
Posted on 5/22/14 at 4:35 pm to thetempleowl
quote:
I am not sure about writing her off. Depending upon age and other comorbid factors, it may be better to just keep the cancer at bay for the time being. This is going to sound awful, but sometimes the goal of treatment is to let the patient live long enough to die from something else and not the cancer.
My mom just turned 70. The thing is, she is damn healthy for her age. A few of the usual things for a 70 year old. But they only found this out by accident. She hurt her rib coughing so they were treating that when they discovered this. Otherwise we would have never known.
Posted on 5/22/14 at 4:35 pm to asurob1
quote:skills?
where do you think I get my debating skills from?
Posted on 5/22/14 at 5:26 pm to asurob1
LINK
I have linked a urologic oncologist at Michigan (UM), Todd Morgan, that you can consider for a 2nd opinion
I trained with him at Vandy
He trained at UW (Seattle)
Fellowship at Vanderbilt
Smart, personable guy. Created drawMD LINK
Will be plugged in to UM system (very reputable)
If your mom is in good health (good performance status) there may be more option available to her (if she has only been seen by a medical oncologist).
I have linked a urologic oncologist at Michigan (UM), Todd Morgan, that you can consider for a 2nd opinion
I trained with him at Vandy
He trained at UW (Seattle)
Fellowship at Vanderbilt
Smart, personable guy. Created drawMD LINK
Will be plugged in to UM system (very reputable)
If your mom is in good health (good performance status) there may be more option available to her (if she has only been seen by a medical oncologist).
Posted on 5/22/14 at 5:29 pm to asurob1
quote:
My mom is very religious and very faithful. But I know she is afraid. Hell I have been walking around in a fog for six weeks. The hardest thing in the world is always being upbeat every time she calls. But I do it.
Love and prayers, Rob...to you and your mom. It's things like this that bind us all together. We all face it sooner or later.
My mom laid in the bed on dialysis and an ventilator for months, not in pain...but scared of death. I once mentioned to her about "being tired of fighting", thinking that maybe she was waiting for one of the family to make a call....wow...she gave me 'the eyes' real quick. Some folk fight to live through all manner of suffering; makes me feel ashamed that I'd probably just go away if the cost/benefit balance went in the red.
My dad was afraid to go to sleep; figured he could fight better if awake, I reckon.
Love is the best thing in this World. And the saddest. Some day....'oh death...where is thy sting'!
Love you bro.
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