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Old 03-03-2014, 10:44 PM   #1
Join Date: Feb 2014
Posts: 15
Does medicaid help pay for chemotherapy fees?

My sister, the HER2 breast cancer patient, is disabled and is on medicaid/medicare. She receives SSI.

She received a bill for $300 from the hospital saying that it was her co-pay for the testings she had done. This hospital was the hospital that diagnosed her.

Her care was moved to another hospital which is a better cancer research hospital. Her testing for the staging, MRIs, CT SCAN, doctors, but has not received a bill from medicare from her current hospital. The billing department said that all the bills would be paid by medicare/medicaid. The first hospital is my husband's hospital. We've had issues were they bill us incorrectly.

Should we turn this bill over to medicaid/medicare or have a social worker handle this for us? She's concerned that her upcoming chemotherapy treatments won't be covered. I'm under the impression that they will pay for them. Thanks.
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Old 03-08-2014, 01:22 PM   #2
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Re: Does medicaid help pay for chemotherapy fees?


I'm not familiar with Medicaid, but I do know Medicare doesn't cover a lot of the stuff. That's why there are Medicare Advantage Plans available through most insurance companies. You might be able to get things clarified by contacting http://www.cms.gov/

Sending you and your sister good vibes.

Erythema Nodosum 85
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Old 04-02-2014, 08:47 AM   #3
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Re: Does medicaid help pay for chemotherapy fees?

I'm on Medicaid and all my bills are paid for. I recently received a letter stating that I also no longer have co - pays. But some states may differ concerning co- pays. Yes, have your Social Worker check this out for you. There are also lots of places to get financial help for co-pays, transportation etc. and the social worker can help you with this. This is not the time to have to worry about finances. Good Luck!
Paula T. (saygoon means dog, yes I am Native)
DX March 2012
Stage IV w/ 5 bone mets to spine 2 on ribs
Herceptin, Zometa, Taxotere and Anasterole and of course radiation
2/14/2014 2 mets on pelvic bone
Stop Anasterole continue on Herceptin and Zometa start radiation (again)
2/24/2014 start T-DM1 continue Herceptin and Zometa
4/28 more radiation that brings total to 5 (10 days ea) - I think I will soon glow in the dark....
6/01/2014 Great news! Rib mets gone, 4 of 5 spine mets showing new bone growth and pelvic mets shrinking.
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Old 04-02-2014, 11:14 AM   #4
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Posts: 436
Re: Does medicaid help pay for chemotherapy fees?

My oncology center met with me prior to treatment to go over what insurance covered and what would be my respondsibility. That way there are no surprises.
dx: DCIS 6/8/10, HER 2+ 7/26/10; Stage I Age 41
Double mast w reconstruction
6 TCH w 1yr herceptin
25 radiation tx
Removal of expander on L due to infection. Tried to save it had 3 bouts of antibiotics and went to see plastic surgeon 2-3x wk to get drained. Saving it was my idea not his. But lost it anyway.
Reconstruction set for December 21st,2011
Finished chemo 12/2010
Finished Herceptin 8/26/11
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Nipple reconstruction 5/18/12
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11/22/12-Went back to get scar tissue stretched to even the outside of breast, didn't work due to it being radiated skin.
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Old 04-02-2014, 09:34 PM   #5
Join Date: Feb 2014
Posts: 15
Re: Does medicaid help pay for chemotherapy fees?

My sister's insurance (medicaid and medicare part D) is paying for all of her chemotherapy, surgery including mastectomy after chemo and reconstruction.

We had to battle medicare to pay for her Zofran which is about $300 for a 30 day supply. The onocologist's nurse had to fax the requests several times but were eventually approved. She received a 60 day supply of the Zofran and other meds needed to help her through chemo.

She battled nausea, loss of appetite, fatigue for about 5 days but is eating and drinking well again. She has 5 more chemo treatments and will have herceptin every 3 weeks for one year. No radiation is expected since she is having a double mastectomy after chemo. She is stage 2B.

Thank you for your answers.

(The breast surgeon and oncologist both suggested a lumpectomy instead of the mastectomy. Our mother died from complications of cancer in 1989. She had cervical cancer and the only treatment was surgery to remove the tumor and lymph nodes affected and radiation. Chemotherapy was not used because we lived in a small community with a small hospital. She died from radiation destroying her kidneys and kidney failure. The treatment was basically 1960s cancer treatment. It was outdated and chemo would have saved her life.

My sister knows the risks and is being proactive in her care. She calls it "The Jolie". In regards in Angelina Jolie's choice to have a double mastectomy as a preventive measure because of her high risk for breast cancer."

Last edited by cjjhero; 04-02-2014 at 09:42 PM.. Reason: more information
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