Please Pray. Medicaid suddenly decides not to cover women with stage 4 breast cancer

[tiggger1]

Please pray for my friend Connie, who I went to high school with. She has stage 4 breast cancer that has spread. Medicaid suddenly decided to not cover her treatments. So she is going without treatment because she cannot afford the 12 chemo sessions ( at over 12, 000 a piece) that she desperately needs.
here is the full story...
http://www.click2houston.com/video/22222742/index.html

 

[Darsa]

I wish I could hear the story, but no sound on the computer. Sounds terrible, I am so sorry! Does Medicaid give some kind of reason for not treating the cancer???

 

[tiggger1]

I wish I could hear the story, but no sound on the computer. Sounds terrible, I am so sorry! Does Medicaid give some kind of reason for not treating the cancer???

When she called to ask why they told her there there was no reason and that they didnt need one.

 

[tiggger1]

here is the article

http://www.click2houston.com/news/22225021/detail.html

 

[SDFgirl]

That's horrible for your friend and her kids. I'll be praying for them daily. My amazing MIL is in the process of fighting Stage 3 breast cancer and I can't imagine her having to deal with all of this stress on top of her treatments.

Hopefully the bad press will get Medicaid moving - at least to give her some REAL answers.

Again, I'm praying hard.

 

[Tuffcookie]

Can she get her state representives involved in this case?

Would the hospital deny her treatments without Medicaid approval?

My heart goes out to this poor woman!

TC

 

[clarabelle]

Oh I feel terrible for this woman. It doesn't sound like she has gotten valid answers.

But ....
What if the treatments will not help? Maybe that is why they are refusing to pay for them?

 

[golfgal]

It sounds like there is some kind of clerical error. The article doesn't offer much information.

 

[gottaluvPluto]

Oh I feel terrible for this woman. It doesn't sound like she has gotten valid answers.

But ....
What if the treatments will not help? Maybe that is why they are refusing to pay for them?

Just because a doctor says it won't work doesn't mean the treatment won't work. I have a friend who was considered to have terminal cancer and had at the most 3 months to live. Well, he is alive today because of treatment. In fact, he has been cancer free for 5 years!!!

 

[robinb]

Oh I feel terrible for this woman. It doesn't sound like she has gotten valid answers.

But ....
What if the treatments will not help? Maybe that is why they are refusing to pay for them?

You may be onto something. I don't know much about breast cancer, so I just looked up Stage IV breast cancer over at cancer.org and stage IV is the worst. In addition, it has already moved into her lymph nodes and that can't be good. Maybe her cancer is terminal . We just don't know from that little article. OP, do you keep in touch with your ex-classmate? Did the doctors say that her cancer is treatable? I hope she gets some answers.

 

[madmom1030]

You may be onto something. I don't know much about breast cancer, so I just looked up Stage IV breast cancer over at cancer.org and stage IV is the worst. In addition, it has already moved into her lymph nodes and that can't be good. Maybe her cancer is terminal . We just don't know from that little article. OP, do you keep in touch with your ex-classmate? Did the doctors say that her cancer is treatable? I hope she gets some answers.

I have a friend living with stage 4 breast cancer. It isn't curable but is treatable. This woman may be in the same situation.

 

[hedgehog2owl]

Does she have a advocate? I am crying just thinking about this

 

[4nana]

Thx you for bringing this to our attention, as it is every woman's nightmare and anyone of us could find ourselves in same situation.

Such a very sad story . My heart and prayers go out to your friend, Connie, and her sweet children, for quick resolutitions as she fights for her life.

My dear Mom is a 16 yr breast cancer survivor, so I am very familiar with the frightful journey.



The above article link had these additional facts off Facebook:

Connie was on Medicaid and was encouraged by her social worker to apply for Social Security Disability. As soon as she was approved for that (and what we were not advised of ahead of time) she qualified for Medicare and therefore Medicaid dropped her as soon as they could. The issue here is that Medicare has a mandatory 2 YEAR waiting period before benefits are paid. THIS is the situation Connie and many, many other critically ill or disabled people are now stuck in. The state will not tell you about this situation in advanced so that they can get you off of their books. Medicaid is supposed to pick up the slack during the 2 year Medicare wait but giving someone like Connie the run around encourages people to give up. We are just now finding all of this out and so took the story public to raise awareness. The 2 year Medicare wait should be fixed. The Medicaid scam to not cover qualified people needs to be fixed. But it all costs money and I don't know how to fix it. Right now I just know that my sister Connie qualifies for Medicaid and therefore someone needs to step up and push it through. And I want all those out there getting the same exact run around to know their rights as well. Connie worked for years and paid into the system so she wouldn't be in this situation.

 

[tiggger1]

Does she have a advocate? I am crying just thinking about this

Im not sure about the advocate. she has 4 sister's plus a ton of friends that are helping her out. I havent seen her since HS because she moved away and has been living in Texas every since but she is one facebook and I have been following her on her caringbridge site.

I dont know if she is terminal. she was really sick in the hospital a month ago ( I dont think they thought she was going to make it ) but they took a ton of fluid out of her lungs but it wasn't cancerous.

 

[wvjules]

Oh I feel terrible for this woman. It doesn't sound like she has gotten valid answers.

But ....
What if the treatments will not help? Maybe that is why they are refusing to pay for them?

Since when does some social worker sitting in an office get to decide if a treatment will help or not?

 

[wvjules]

You may be onto something. I don't know much about breast cancer, so I just looked up Stage IV breast cancer over at cancer.org and stage IV is the worst. In addition, it has already moved into her lymph nodes and that can't be good. Maybe her cancer is terminal . We just don't know from that little article. OP, do you keep in touch with your ex-classmate? Did the doctors say that her cancer is treatable? I hope she gets some answers.

It might not work so let her die? Frightening!

 

[Muushka]

This is such a sad story.
I hope that your friend receives the care that she needs. And she and her beautiful children are in my prayers.

 

[abdmom]

It might not work so let her die? Frightening!

This is how insurance companies in the U.S work.

This is why I don't live there anymore.

 

[kellyg403]

In 1982 my dm was diagnosed with Stage IV Ovarian Cancer. Her prognosis at the time was 6 months. My mother is alive today and was 17 years cancer free when she was diagnosed with Stage 1 Breast Cancer last year.

I, for one, do not believe that a person sitting behind a desk should make the determination of what will or will not help, treat or cure. If the drs had taken the position that my mother was terminal and didn't rate the care that she received, she would not have had the 17 years she had. This is one of those higher power things.

I would rather, as a taxpayer, see this woman, and any other person on Medicaid, receive the treatment they so desire than see other wastes. They are out there everyday and this just makes me SICK. I think I will write her Congressman and Senator MYSELF!

Kelly

 

[Pakey]

My insurance would only cover part of my chemo but I was fortunate compared to other women who were going to the same cancer center as I was. I only had to pay $4220 OOP for each of my chemo treatments and we were financially able to do it. I talked with one woman who was paying for all of hers OOP and I met with another woman who was unable to do chemo because of no coverage.

In my situation (with advanced stage breast cancer), I was told that the chemo would only improve my "odds" by +/- 6%. Perhaps insurance companies feel that isn't good enough odds? Because of our situation, my husband and I also debated whether the 6% was going to be worth what we were going to have to spend.

Under any circumstance, it's very sad.