Thanks medicare

hutchibk · 05-11-2009, 12:00 PM

So, here's a nugget for all of us. Apparently being a 49 year old breast cancer patient gets you very little consideration from medicare for annual GYN check-ups. I learned today that my annual GYN check-up will now be covered only every 2 years, as medicare does not believe it is medically necessary for 50 year old women to see a GYN every year (even if she is a cancer patient). I learned this because I am fighting with them right now over last October's annual visit to my GYN. They paid my doctor for seeing me and doing the pap, but they refuse to pay the lab for running the smear, because it has been deemed "no medical necessity to substantiate the claim." I will have to pay the $96 lab cost.

Lovely how govt insurance works. Just a sign of things to come. As PJ O'Rourke so eloquently mused...""If you think health care is expensive now, wait until you see what it costs when it's free."

Believe51 · 05-12-2009, 12:08 AM

I shutter Brenda. I just want you to know that the foundation that Rose (RexinG) has started is going to be aimed at situations like this. Her goal is to reach 52 million dollars per year to get cancer patients whatever a doctor 'deems' medical necessary, be it that or finance a clinical trial to come to town. She has been endorsed by Medicaid and the Tomorrow Fund to name a few and is planning on taking me aboard next month. This is a non-profit foundation geared on filling in these gaps. There will always be gaps with this system yet to come but we will there as one more outlet for that cancer patient.

Now I go, too many secrets, you have a vay of making me talk.....Believe51

Mary Anne in TX · 05-12-2009, 07:22 AM

I do wonder sometimes why they require medical school, if they're not going to listen to them! Insane, really insane! ma

WomanofSteel · 05-13-2009, 07:50 AM

Brenda, why does this not suprise me at all. I still can't fathom what makes these stupid, pencil pushing doctors come to these decisions. Don't you also find that healthcare seems to be sexist also? Seems funny what they will cover for men and what they won't for women. Maybe we need to infiltrate this system somehow with some breast cancer survivors who know what we are going through. I wish I were an MD. I would be willing to play I SPY!

Laurel · 05-13-2009, 07:27 PM

Problem is it is not the M.D.'s calling the shots or determining what treatments are covered. It is in fact the pencil pushers who are eyeballing the bottom line who decide. God help us all if national health care gets rushed through by August as Obama promised today. I guess we may as well start driving on the left side of the road, because we are going to be England in a very brief time.