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re: Help needed from the OT

Posted on 1/28/20 at 9:08 pm to
Posted by Teauxler
Baton Rouge
Member since Jan 2010
3851 posts
Posted on 1/28/20 at 9:08 pm to
what really gets me, if he was an illegal or didn't have a job and was a welfare critter, he'd be getting his chemo today
Posted by Cracker
in a box
Member since Nov 2009
19318 posts
Posted on 1/28/20 at 9:08 pm to
speak to the drs clinic/office that will be billing your insurance ask to speak for the case mgr if they have one or someone in billing reimbursement explain the insurance situation they deal with this daily. The drug companies will cover the drugs most onc drugs the cut off for the paitent income is pretty high for paitent assistance.
Posted by Tiger Prawn
Member since Dec 2016
26338 posts
Posted on 1/28/20 at 9:09 pm to
quote:

Appeal the insurance denial
I had looked into one of those Christian health medi-share type programs once before and it had no coverage for cancer diagnoses within the first year. Not sure if OP’s brother has something similar, but I came across it and ended up just going with BCBS for a little more a month
Posted by BrotherEsau
Member since Aug 2011
3601 posts
Posted on 1/28/20 at 9:13 pm to
First thing to do is get his policy and start with what they do and don’t pay. Force whoever said it’s not covered to explain specifically why. Make sure they are correct. It could be that the facility is not on the plan but another is.

frick cancer.

My father in law was diagnosed in ‘18 and chose not to fight. It got real ugly real fast. Fighting it is the way to go. If he at some point regrets fighting he can stop. But it doesn’t work the other way around. He was on a shitty Medicare ppo but chemo was fully covered.

Most hospitals and doctors have an insurance benefits coordinator. Go see that person, bring the policy. They will help. Some of the people we dealt with were so awesome and nice and you could tell they actually cared. Find those people and ask them for help.

Where is he located?
Posted by Teauxler
Baton Rouge
Member since Jan 2010
3851 posts
Posted on 1/28/20 at 9:16 pm to
he's in Baton Rouge. And let me say, he understands he made a huge mistake signing up for the cheapest lowest plan option that his company offered. So there is some personal responsibility. But it is what it is at this point and it's time to move forward and get him help.
Posted by BrotherEsau
Member since Aug 2011
3601 posts
Posted on 1/28/20 at 9:18 pm to
If you need help understanding the policy I can read it and try to help. Brotheresautd@yahoo.com - tell me here if you send it bc I don’t check that often.
Posted by 777Tiger
Member since Mar 2011
93541 posts
Posted on 1/28/20 at 9:19 pm to
quote:

speak to the drs clinic/office that will be billing your insurance ask to speak for the case mgr if they have one or someone in billing reimbursement explain the insurance situation they deal with this daily. The drug companies will cover the drugs most onc drugs the cut off for the paitent income is pretty high for paitent assistance.


this, everything is negotiable, my old lady had about a million dollars worth of treatment/care/medivac waived for her family because she speaks the lingo
Posted by LSUJML
Central
Member since May 2008
56850 posts
Posted on 1/28/20 at 9:22 pm to
The Patient Advocate Foundation (PAF) provides education, legal counseling, and referrals to cancer patients and survivors concerning managed care, insurance, financial issues, job discrimination, and debt management.
Visit www.copays.org or call 866-512-3861 for more information.

The Internet also has sites from the various drug companies but there are also some general sites that may be helpful such as:
www.needymeds.com,
www.cancersupportivecare.com/drug_assistance.html
www.themedicineprogram.com

Also try cancer.org (American Cancer Society)

But I think speaking with a social worker at the treatment center is the best place to start
Posted by Teauxler
Baton Rouge
Member since Jan 2010
3851 posts
Posted on 1/28/20 at 9:23 pm to
thank you so much. I have a copy of his insurance card. i'm trying to get his benefits package. His plan is a BRONZE MEC plan.
Posted by East Coast Band
Member since Nov 2010
67002 posts
Posted on 1/28/20 at 9:24 pm to
quote:

what really gets me, if he was an illegal or didn't have a job and was a welfare critter, he'd be getting his chemo today


I'm doubting this
Posted by BrotherEsau
Member since Aug 2011
3601 posts
Posted on 1/28/20 at 9:27 pm to
You’re welcome.

Check out Cancer.org page on insurance denials tons of resources on that page
Posted by Teauxler
Baton Rouge
Member since Jan 2010
3851 posts
Posted on 1/28/20 at 9:28 pm to
i apologize for that statement. just mad and frustrated right now
Posted by AUCE05
Member since Dec 2009
45424 posts
Posted on 1/28/20 at 9:30 pm to
I had RCC
Posted by Teauxler
Baton Rouge
Member since Jan 2010
3851 posts
Posted on 1/28/20 at 9:31 pm to
can you expand ?
Posted by AUCE05
Member since Dec 2009
45424 posts
Posted on 1/28/20 at 9:32 pm to
What do you wanna know? I had the same cancer.
Posted by Teauxler
Baton Rouge
Member since Jan 2010
3851 posts
Posted on 1/28/20 at 9:33 pm to
what was the treatment ? How are you doing ?
Posted by AUCE05
Member since Dec 2009
45424 posts
Posted on 1/28/20 at 9:35 pm to
They hooked me up to that robotic machine. Cut the cancer out. He flipped over every organ looking for cancer. Felt like a train hit me. I am 7 years out. I had to have an annual CT scan to check in the event it spread. I stopped at the 5 year mark with a clean bill of health.
Posted by Teauxler
Baton Rouge
Member since Jan 2010
3851 posts
Posted on 1/28/20 at 9:39 pm to
what stage ws it when they discovered it ?
Posted by AUCE05
Member since Dec 2009
45424 posts
Posted on 1/28/20 at 9:39 pm to
3.9 CM. I caught it very early.

ETA

Has he seen a urologist?
This post was edited on 1/28/20 at 9:41 pm
Posted by Teauxler
Baton Rouge
Member since Jan 2010
3851 posts
Posted on 1/28/20 at 9:40 pm to
man good for you. God is good !
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