Story on FB about major cancer centers denying treatments

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JDinNC
Posts: 771
Joined: Fri Jul 05, 2013 9:49 pm
Location: Murphy, N.C.

Story on FB about major cancer centers denying treatments

Postby JDinNC » Mon Nov 09, 2015 10:10 am

I'm sorry...I read an article about how major cancer centers will be denying some patient cancer care in 2016. I do not know how to link these stories from FB to this forum so I'm hoping someone here with better computer skills could look into this. The article talked about Anderson cancer center refusing to take PPO and HMO with BSBC being the last denied..so far.. I have BCBS PPO and this now has me worried since I need to renew my policy by the end of this year. And you know if this is true, BCBS is not going to inform me this which means I could be blindsided with huge expenses out of my pocket. I don't know others that might be in this same situation or if these are the real facts but it's something to investigate.....thank to anyone who help look into this for me

Jan
61 y/o female @ DX...........
T3N0M1
6/13 DX- stage 4
Sigmoid colon cancer.
One met to lung
7/13 colon resection
8/13 lung resection
7/17 four years....NED
8/18 five years....NED
MELANOMA
63 y/o @ DX
6/15 stage 2a
7/15 surgery on arm
7/15 NED
4/16 recurrance
5/16 remove metastasis from back
5/16. Started immunotherapy
8/16 discontinue treatment
7/18...PET scan...NED

Deb m
Posts: 558
Joined: Tue Jan 14, 2014 10:08 am

Re: Story on FB about major cancer centers denying treatments

Postby Deb m » Mon Nov 09, 2015 10:43 am

When you say "Anderson center", do you mean MDA cancer center? We have been patients at MDA for about 5 years now and have never be denied treatment or anything our oncologist thought needed such as ct,'s pet's mri's ect. We also have BCBS PPO thru my husbands employer. I've never heard of them refusing treatment to patients. There are some insurances they don't except, but they will still treat you as a patient pay.

deb m

fwilkins
Posts: 12
Joined: Tue May 13, 2014 9:08 pm

Re: Story on FB about major cancer centers denying treatments

Postby fwilkins » Mon Nov 09, 2015 12:03 pm

I spoke with MDA in Houston and was informed that they will not be taking ANY HMO plans through the Affordable Care Act. Blue Cross Blue Shield is not offering any PPO's in Texas through the Affordable Act, so anyone having BCBS PPO through the Affordable Care Act in 2015 and is going to MDA, it will be discontinued in 2016. BCBS will continue to offer PPO's through employers and MDA will accept that in 2016. MDA will continue to accept Medicare (not Advantage Plan) and Medicaid in 2016.

sjring
Posts: 181
Joined: Mon Jun 30, 2014 3:16 pm
Location: Philadelphia, PA

Re: Story on FB about major cancer centers denying treatments

Postby sjring » Mon Nov 09, 2015 12:04 pm

Jan,

Was this the article you were referring to?

http://www.texasstandard.org/stories/ca ... are-plans/
50 YO Husband & father of 2 teenagers.
DX 9/9/13 Stage 4 cc (at age 48)
16 Rounds FOLFOX + Avastin (Oct-13 to May-14)
Maintenance chemo - Avastin & 5-FU infusions (Jun-14 to Jul-15)
Jul-15: Mets to lymph nodes, resuming FOLFOX
Sep-15: MRI showed stability, back to maintenance chemo.

Deb m
Posts: 558
Joined: Tue Jan 14, 2014 10:08 am

Re: Story on FB about major cancer centers denying treatments

Postby Deb m » Mon Nov 09, 2015 1:30 pm

I just read the article. I feel very bad for all those who have a PPO thru the affordable care act, but on the other hand, if ACA won't pay the providers and hospitals a decent rate, how can they stay competitive and except it? I heard that their pay rate is worse than medicare and medicaid. Our health care system did need changes made to it, but I feel that the affordable care act has just made it worse and is much more expensive for most people and offers much less!

I feel that hospitals do charge way too much money, it's insane! I also feel that the more government is involved, the more say they will have as to who gets what and how much ect. when it comes to healthcare . I don't want have them having this control!!!!! Our whole healthcare system is a mess!

deb m

User avatar
H is for Hawk
Posts: 103
Joined: Wed May 20, 2015 4:51 pm
Location: eastern Pennsylvania

Re: Story on FB about major cancer centers denying treatments

Postby H is for Hawk » Mon Nov 09, 2015 1:59 pm

For those who are disabled or over 65, Memorial Sloan Kettering only accepts standard Medicare, they do not accept any Medicare Advantage plans. This policy is printed on every statement, so they are quite upfront about it. It is seems justified as the Medicare Advantage reimbursement rates are very low; that is what you get with a low monthly premium - a limited choice of hospitals and doctors.
H is for Hawk (57)
10/14 L. hemi-colectomy 3 x 4 x 1 cm tumor, 13/14 lymph nodes pos. pT4a N2B M0 stage 3 MSS
11/14 - 4/15 12x FOLFOX
5/15 PET scan: 2.5 x 1.5 cm l. colon lesion, peri surface lesion SUV 2.4, adenocar., KRAS wd, BRAF V600E mut
6/15 HIPEC
9/15 Pleural lining & liver mets, CA 19-9: 6000
10/15 Vectibix Tafinlar Mekinist
11/15 1500
1/16 200
2/16 100, add Lentinan
3/16 122
6/16 4500
7/16 20,000, CT scan - three new liver mets
8/16 6700, FOLFIRI
9/16 4900, CT scan - two new liver mets
10/16 2255 vinorelbine

JDinNC
Posts: 771
Joined: Fri Jul 05, 2013 9:49 pm
Location: Murphy, N.C.

Re: Story on FB about major cancer centers denying treatments

Postby JDinNC » Mon Nov 09, 2015 4:41 pm

Yes...that was the article. I was worried because I do have BCBS ..HMO but I pay privately for my insurance, i'm not on Obamacare. It did say starting in 2016....so I wanted to let others know about it, in case they might fall into this category. I have one more year until I'm on Medicare ....so I guess Obamacare is completely worthless....if we had switched over, our premium would have gone up over $1,000. a month. In 2016, our privately paid premium when up to $500.per month. So glad we never switched....

Thanks again for everyone input...
61 y/o female @ DX...........
T3N0M1
6/13 DX- stage 4
Sigmoid colon cancer.
One met to lung
7/13 colon resection
8/13 lung resection
7/17 four years....NED
8/18 five years....NED
MELANOMA
63 y/o @ DX
6/15 stage 2a
7/15 surgery on arm
7/15 NED
4/16 recurrance
5/16 remove metastasis from back
5/16. Started immunotherapy
8/16 discontinue treatment
7/18...PET scan...NED

Sams wife
Posts: 749
Joined: Sun Jan 11, 2015 2:49 pm

Re: Story on FB about major cancer centers denying treatments

Postby Sams wife » Mon Nov 09, 2015 7:37 pm

Yay. I have a PPO!! I still don't get it. I will have to read some. We went & got healthcare thru agent. But they did give us the O-care discount.
They did send us a letter to get Medicare. I guess they want us on it. Does it take forever to get Medicare too or does someone know?
Husband dx 1/13/15 St.2 CEA 7.1
Chemo/25rad 2/15 till 4/24/15
5FU/leucovorin
Surgery 6/8/2015 Stage IIa T3N0MX microscopic cancer left
Watching 4 lung spots
0/5 lymph nodes. Lap. APR
25% less 5FU/leucovorin 7/14/2015 x 26 CEA 3.4
25% more 5fu 9/2015
9/16/15 CEA 7.7
1/16/16 @ 9.2 during allergy?
3/16 New lung spot 4x4 mm
6/16 CEA 6.9 spot 5x5


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