Medicare and Herceptin
 

Hi everyone,
This is my first post on this board. My question is; I will be going on Medicare in June and I have been offered by my Doctor to take the Herceptin treatments.
Will Medicare cover this treatment. I called Medicare but didn't get a direct answer.
Also my doctor is prescribing every week for one year. I noticed it seams that everyone else takes it on a three week tour. My Doctor says he would rather give it every week in lower dosage to help prevent side effects.

Miriam

I don't know the Medicare questions but getting Herceptin weekly or the triple dose every 3 weeks are both standard ways to receive Herceptin.

You will find people on this board who receive it either way.

Best regards

Becky

Hi Miriam; Welcome to the group :)

Yes, Medicare will pay for Herceptin. If you sign up for a Medicare supplemental, don't be worried if their formulary list indicates you would have a larger co-pay because I'm pretty sure it bounces back to Medicare Part D during the billing process and when all the dust settles it's covered. Check on this aspect carefully however. I believe your doctor has to be listed as a provider in order to get the full benefits provided by the supplemental, so be sure and ask about which providers are on a particular plan's list. The customer service at a particular plan can help on this, and also your doctor's billing staff may be able to help. Several at my treatment center are on Medicare and getting Herceptin, and they've told me it's covered.

I've had both the weekly and 3 weekly dosing schedule, and haven't noticed any difference in side effects, but that's just me. Each person seems to be different, so if your doctor wants to play it safe you could always switch to the 3 weekly down the road if you tolerate the weekly ok.

Again, welcome!

<3 Lolly

Thank you Lolly and Becky for your help. You have answered both questions. Miriam

Dear Lolly,
I just read this posting and when you say "Medicare supplemental" do you mean the new government program or a private outside insurance?
I am currently living in france but moving back to the USA. I am on Herceptin here and have been approved for disability with social security. As part of that they gave me Medicare hospitalization. I am trying to find out if I will be covered for Herceptin and exactly what I'll have to do to be covered. Hence my initial question. Thanks.
Sarah