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Old 12-10-2014, 08:53 PM   #1
LaDonna28
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Join Date: Aug 2014
Posts: 78
medicaid anyone???

I was fortunate that I still had my health insurance through my previous employer for a period of time after I was released due to a worker comp issue. Now they are offering COBRA for 1100.00 a month. My insurance was 240. which was being paid by my boyfriend, as I have been unemployed since the worker comp issue. I found out that I qualify for Medicaid ( my boyfriend can't afford 1100. For me - I am grateful for him taking care of me as he does); however,Medicaid scares the crap out of me. I am in Colorado. Does anyone have Medicaid? Will it cover all my future herceptin treatments? Hormone therapy? What about doctors? Are they scarce like I hear? Thanks for any feedback.
__________________
Steriactic biopsy July 2011 for microcalicificarions - negative
Mammogram 2012, 2013 no change
Mammogram July 8, 2014, more microcalcifications and mass (10mm per radiologist)
Diagnostic Mammogram July 10, 2014
Steriactic Biopsy July 15, 2014
July 21 given diagnosis DCIS and IDC upper, Outer quadrant of right breast
ER Pos >95%. PR Pos 90%, HER-2-neu positive (score +3) Grade 3
Breast surgeon on July 29, 2014 says 2 cm
MRI states only mild to moderate bilateral physiologic background parenchymal enhancement with uptake on intermammary nodes
BRCA tests all negative :)
August 8 port placement. Lung partially collapsed. On oxygen until further notice
August 9, '14 started TCPH therapy with nuelasta shots. 6 cycles @ 3 weeks
5th treatment T and C dosages lowered due to bad neuropathy
6th and last TCPH changed to PH only for Dec 1st
Lumpectomy and node biopsy Dec 2
100% complete response from TCPH neoadjuvent therapy: tumor completely gone-dead cells only. Node completely free of ANY cells. Staged at 0! Margins clear from 4mm-10mm from dead cells.
2 week period following surgery went in for draining of Hematoma that filled surgery void area in breast 3 times
Continued with Herceptin only December 22, 2014 @ 3 weeks until ???
Started radiation Jan. 7, 2015 plan is for 16-20 rads
january 25th 2015 last radiation completed. Stopped at 16 due to Seroma (void in breast is filled with fluid)
January 30 Tamoxifan started
Still on oxygen, tamoxifen side effects kicking my butt. Seeing a gastro dr. due to a lot of stomach issues.
July 2015 - 3D mammogram nervous as all hell - but came back clean!!!! YEAAH
March 2016 - only using oxygen at night! Stomach issues better and trying to wean off the heartburn meds. Am hoping to get reconstructive done Jan 2017.
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Old 12-11-2014, 12:13 AM   #2
dsv
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Join Date: Nov 2011
Posts: 8
Re: medicaid anyone???

I'm in Colorado too. I don't have Medicaid, I have private insurance but there was a program through the drug company that makes Herceptin that covered all my Herceptin treatments. My oncologists took care of applying for me. My husband wants to retire early next year and the thought of how much we will have to pay for insurance scares me! Good luck
__________________
2006 ductal carcinoma, Stage 1, grade 2, ER+ PR-, Her2- lumpectomy, No lymph node involvement, 4 A/C treatments, clinical trial of radiation
7/2011 New breast cancer in left breast, Stage1c, grade 3, ER+ PR- Her2+, no lymph involvement;
Bilateral mastectomy, tram flap reconstruction
6 Taxatere, carboplatin, herceptin completed 1/25/12 with herceptin to continue.
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Old 12-11-2014, 04:09 AM   #3
LeahM
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Join Date: May 2012
Location: Bethlehem PA
Posts: 395
Re: medicaid anyone???

Hi,
Towards the end of my treatments my husband lost his job, and with it my medical insurance. After talking with the financial dept. at my hospital I signed up for Medicaid, or is it Medicare? Here in PA there is a special state sponsored program for women like me, women who have been diagnosed with cancer of either breast, cervix or ovaries. I was immediately accepted into this program and there is minimal (as in $21 is the most I will ever pay and that is for 7 days of inpatient treatment. My out of pocket expense maxes out at $21) expense on my part. As long as I am being treated, and Tamoxifen counts as treatment, I can keep this insurance.

The down side is a need a referral for every MD I visit other then my OBGYN. So every follow up with every onc needs a referral. Luckily my PCP has been great with that.

Also, check to see if your hospital/treatment center has a reduced cost of care program. Mine did/does. They based it on my salary alone and since I was physically unable to perform my job after BMX and during chemo. They reduced the amount I would have to pay after insurance did their part. This was a big help.

Now, every time I have a question regarding my insurance I call the 800# on my card and I speak to a lovely person. Not scary at all. I feel like for the first time I have an insurance co that really has MY best interest at heart. My calls are answered quickly, my questions are answered thoroughly and I am always pleased with their support.

I did, at first, take issue with (and was embarrassed by) having a state funded ins co but the truth is I have been working all my adult life, I worked as a teen. I worked during college and pregnancy. I have worked for a very long time and I deserve the help I get now. And so do you. Don't be scared.

Best
Leah
__________________
39 year old wife, mother of one and nurse.
April 20, 2012: Dx Invasive Ductal Carcinoma
April 25, 2012: ER+(5%), PR-, HER2+++
May 10, 2012: BRCA 1,2 Negative
May 23, 2012: MUGA Scan EF 70%
May 31, 2012: B/L Mastectomy. 2/2 nodes removed and CLEAR!! Power Port placed. 2 Drains. 2 Expanders placed
June 5, 2012: Drains OUT! Ahhhh..
June 12, 2012: Final Pathology Report, .8x.3cm tumor. Micromets to 1 node .35mm under cytokeratin staining. Stage 2A. Onc says "you are lucky to have found this early"
July 10, 2012: Started 6 rounds of TCH with weekly H
Sept 5, 2012: MUGA 65%
Sept 20, 2012: CAT scan of brain clear!
Oct 23, 2012: LAST TC! AMEN! Continue Herceptin every three weeks until July 2013.
Nov 19, 2012: Port out!
Dec 5, 2012: Started radiation
Dec. 10, 2012: MUGA 65%
Dec. 13, 2012: Turned 40. BEST BIRTHDAY EVER!
Jan 23, 2013: Last radiation. Told I am NED. Continue Herceptin every three weeks till July 2013.
Jan 29, 2013: Begin 5 years of Tamoxifen.
Feb 28, 2013: CT Scan with Contrast of lungs. 5mm and 4mm nodules of unknown origin. Rescan in 3 months.
Mar 6, 2013: EF 60%
May 8, 2013: Exanders out, implants implanted...abd. lipo and fat moved up. Girls are looking good!
June 3, 2013: CT Scan with Contrast of lungs. Previous nodules gone. New nodules (2mm and 3mm) found. Rescan in 3 months. So sorry I opened this can of worms...
June 11, 2013: EF 60%
June 25, 2013: Last Herceptin. wow...
Aug 20, 2013: Tumor markers within normal limits. Xray to sore left ribs shows no disease or fractures.
Sept 9, 2013: CT of lungs shows no disease. Closing this can of worms and moving on.
Nov 20, 2013: Tumor markers within normal limits. Severe Vit D deficiency, started on prescription Vit. D. Blaming chemo for this.
Feb 2014: Tumor markers within normal limits.
May 2014: Tumor markers within normal limits. Graduated to twice yearly onc appts.
Oct 2014: Tumor markers within normal limits.
May 2015: Tumor markers WNL. Bone density scan fine. Bone scan and xray of ribs shows "something" 4th right rib. Could be healed fracture but if it is healed why does it hurt?
Nov 2015: Tumor markers WNL. Follow up bone scan clear.
Feb 2016: Syncope! WTF? Dizzy too. Brain scan clear, ECHO EF 60%, Halter Monitor shows heart is fine. Viral? I will never know.
June 2016: Tumor markers WNL.
Oct 2016: Stabbing pain right eye. Long story short, trigeminal neuralgia.
Nov 2016 Brain MRI clear.
Jan 2017: Tumor markers WNL, still getting weird pain right rib area, and sometimes right upper chest. Xray x2, Bone Scan, Breast MRI all clear. Scar tissue? Rads. I may never know.
www.onmywaytosurvivorhood.blogspot.com
www.thechemobag.com
www.facebook.com/thechemobag
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Old 12-11-2014, 05:04 AM   #4
rhondalea
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Join Date: Jun 2011
Location: Somerset, NJ
Posts: 487
Re: medicaid anyone???

This was in my Slate feed yesterday:

http://www.slate.com/blogs/the_slate...52b8870b00b18f

The report is here:

http://oig.hhs.gov/oei/reports/oei-02-13-00670.pdf

Although they've cast this in the worst light possible (in the article), I've experienced similar problems obtaining appointments even though I have very good private insurance.

One of my neighbors had Medicaid coverage throughout her breast cancer treatment, and she received comparable care, except in a couple of situations where she didn't know she needed to jump up and down to get attention for certain comfort issues. But that was her, not Medicaid.

If you can, change your doctors before you switch. Practices keep existing patients even when they switch to Medicaid, even if they have a cap on acceptance of new Medicaid patients.
__________________

2/6/09 Core needle biopsy: negative; Mammos through 2010: no change
3/30/11 Pea-sized lump in left breast at site of prior biopsy; mammo negative, sonogram not so much
4/14/11 Core needle biopsy: negative for cancer
5/18/11 Excisional biopsy 1.2 cm tumor, LVI, positive margin; ER+60%,PR+20%,HER2/CEP17 5
6/15/11 BMX: Left DCIS & LH; Right ADH; SNB: 2/3 nodes: 1.4 cm and 1 mm; ALND L1&2: 0/10; Stage IIa, Grade 3
7/14/11 CT/Bone scans NED; MUGA 66%
7/19/11 Biweekly dd AC w/Neulasta; done 8/30/11
9/13/11 Transfusion (Hemoglobin 8.6); MUGA 64%
9/20/11 Start Taxol + Herceptin; Taxol done 12/6/2011; continue Herceptin until 9/4/2012
12/27/11 Radiation - 6 weeks; 2/27/2012 - DONE! Yayyyy!
2/29/12 Start Tamoxifen 20 mg/day; continue until 2/28/17
5/16/12 Start five-years Metformin trial
6/19/12 MUGA 61%
8/21/12 Brain MRI NED (head still hurts, brain still fogged)
9/4/12 Herceptin done!
9/6/12 Port out!
7/11/13 Aricept 5mg for cognitive impairment; increased to 10mg as of 8/23/13; back to 5mg 12/2013
5/2014 Add Namenda 7mg
9/2014 Stop Aricept and Namenda; Neuropsychological evaluation
10/24/14 Start cognitive rehabilitation therapy
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Old 12-13-2014, 09:05 PM   #5
LaDonna28
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Join Date: Aug 2014
Posts: 78
Re: medicaid anyone???

Thanks rhondalea and everyone for the words of wisdom. I did find out my GP/Obgyn will accept Medicaid, same with radiation doctor. The plastic surgeon I saw once on regular insurance takes it too. I will check and swap if need be for oncologist and surgeon.
You are right.....I do deserve to have it and not feel guilty. I have worked for 40 years....payed taxes every year.
__________________
Steriactic biopsy July 2011 for microcalicificarions - negative
Mammogram 2012, 2013 no change
Mammogram July 8, 2014, more microcalcifications and mass (10mm per radiologist)
Diagnostic Mammogram July 10, 2014
Steriactic Biopsy July 15, 2014
July 21 given diagnosis DCIS and IDC upper, Outer quadrant of right breast
ER Pos >95%. PR Pos 90%, HER-2-neu positive (score +3) Grade 3
Breast surgeon on July 29, 2014 says 2 cm
MRI states only mild to moderate bilateral physiologic background parenchymal enhancement with uptake on intermammary nodes
BRCA tests all negative :)
August 8 port placement. Lung partially collapsed. On oxygen until further notice
August 9, '14 started TCPH therapy with nuelasta shots. 6 cycles @ 3 weeks
5th treatment T and C dosages lowered due to bad neuropathy
6th and last TCPH changed to PH only for Dec 1st
Lumpectomy and node biopsy Dec 2
100% complete response from TCPH neoadjuvent therapy: tumor completely gone-dead cells only. Node completely free of ANY cells. Staged at 0! Margins clear from 4mm-10mm from dead cells.
2 week period following surgery went in for draining of Hematoma that filled surgery void area in breast 3 times
Continued with Herceptin only December 22, 2014 @ 3 weeks until ???
Started radiation Jan. 7, 2015 plan is for 16-20 rads
january 25th 2015 last radiation completed. Stopped at 16 due to Seroma (void in breast is filled with fluid)
January 30 Tamoxifan started
Still on oxygen, tamoxifen side effects kicking my butt. Seeing a gastro dr. due to a lot of stomach issues.
July 2015 - 3D mammogram nervous as all hell - but came back clean!!!! YEAAH
March 2016 - only using oxygen at night! Stomach issues better and trying to wean off the heartburn meds. Am hoping to get reconstructive done Jan 2017.
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Old 12-14-2014, 06:46 AM   #6
LeahM
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Join Date: May 2012
Location: Bethlehem PA
Posts: 395
Re: medicaid anyone???

Make sure your primary care doc accepts the plan you want. Especially if you will need referrals
__________________
39 year old wife, mother of one and nurse.
April 20, 2012: Dx Invasive Ductal Carcinoma
April 25, 2012: ER+(5%), PR-, HER2+++
May 10, 2012: BRCA 1,2 Negative
May 23, 2012: MUGA Scan EF 70%
May 31, 2012: B/L Mastectomy. 2/2 nodes removed and CLEAR!! Power Port placed. 2 Drains. 2 Expanders placed
June 5, 2012: Drains OUT! Ahhhh..
June 12, 2012: Final Pathology Report, .8x.3cm tumor. Micromets to 1 node .35mm under cytokeratin staining. Stage 2A. Onc says "you are lucky to have found this early"
July 10, 2012: Started 6 rounds of TCH with weekly H
Sept 5, 2012: MUGA 65%
Sept 20, 2012: CAT scan of brain clear!
Oct 23, 2012: LAST TC! AMEN! Continue Herceptin every three weeks until July 2013.
Nov 19, 2012: Port out!
Dec 5, 2012: Started radiation
Dec. 10, 2012: MUGA 65%
Dec. 13, 2012: Turned 40. BEST BIRTHDAY EVER!
Jan 23, 2013: Last radiation. Told I am NED. Continue Herceptin every three weeks till July 2013.
Jan 29, 2013: Begin 5 years of Tamoxifen.
Feb 28, 2013: CT Scan with Contrast of lungs. 5mm and 4mm nodules of unknown origin. Rescan in 3 months.
Mar 6, 2013: EF 60%
May 8, 2013: Exanders out, implants implanted...abd. lipo and fat moved up. Girls are looking good!
June 3, 2013: CT Scan with Contrast of lungs. Previous nodules gone. New nodules (2mm and 3mm) found. Rescan in 3 months. So sorry I opened this can of worms...
June 11, 2013: EF 60%
June 25, 2013: Last Herceptin. wow...
Aug 20, 2013: Tumor markers within normal limits. Xray to sore left ribs shows no disease or fractures.
Sept 9, 2013: CT of lungs shows no disease. Closing this can of worms and moving on.
Nov 20, 2013: Tumor markers within normal limits. Severe Vit D deficiency, started on prescription Vit. D. Blaming chemo for this.
Feb 2014: Tumor markers within normal limits.
May 2014: Tumor markers within normal limits. Graduated to twice yearly onc appts.
Oct 2014: Tumor markers within normal limits.
May 2015: Tumor markers WNL. Bone density scan fine. Bone scan and xray of ribs shows "something" 4th right rib. Could be healed fracture but if it is healed why does it hurt?
Nov 2015: Tumor markers WNL. Follow up bone scan clear.
Feb 2016: Syncope! WTF? Dizzy too. Brain scan clear, ECHO EF 60%, Halter Monitor shows heart is fine. Viral? I will never know.
June 2016: Tumor markers WNL.
Oct 2016: Stabbing pain right eye. Long story short, trigeminal neuralgia.
Nov 2016 Brain MRI clear.
Jan 2017: Tumor markers WNL, still getting weird pain right rib area, and sometimes right upper chest. Xray x2, Bone Scan, Breast MRI all clear. Scar tissue? Rads. I may never know.
www.onmywaytosurvivorhood.blogspot.com
www.thechemobag.com
www.facebook.com/thechemobag
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