Who takes Medicare ?

Is there a chart or info anywhere on which of the major cancer treatment centers will bill medicare. Many on the cite talk about going to Mayo or MD Anderson or Sloan Kettering for 2nd opinions. These are large profit centers and do not generally accept medicare. I am using a local cancer center here in Idaho Falls and am generally satisfied. However, if I wanted a second opinion down the road where can someone like me on SS go without going broke. A friend mentioned that the university centers will accept medicare, is this true? Thanks for any suggestions.

Bill

26 Replies

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  • The OHSU Knight Cancer Institute in Portland, OR takes Medicare patients. Dr. Tomasz M. Beer is a nationally-known prostate cancer physician and researcher there. See also:

    ohsu.edu/xd/health/services...

    ohsu.edu/xd/health/for-pati...

    I consulted with Dr Beer in May 2016. He was listed as a Preferred Provider for my version of the Blue Cross Blue Shield network for my secondary insurance, with Medicare primary. The submitted Outpatient Physician charge was only $85. ("Your Health Care Provider has agreed to accept assignment of Medicare Benefits"). The Plan Allowance was $78.15. Medicare paid $62.27. My Secondary Insurance picked-up the remaining $15.88.

    UCSF also accepts Medicare assignment for the bulk of costs for consultations. Travel and other costs to get there may be higher than going to Portland, though. Dr. Eric Small is the counterpart there to Dr. Beer at OHSU. I'm currently under his care, along with my local Oncologist, etc.

    UCSF Helen Diller Family Comprehensive Cancer Center

    Genitourinary Medical Oncology

    Ron Conway Family Gateway Medical Building

    1825 Fourth St., Fourth Floor

    San Francisco, CA 94158

    Medical Oncology Phone:

    (415) 476-4616

    See also:

    ucsfhealth.org/clinics/pros...

    Charles

  • Sounds like you have the dream team for Doctors

  • Charles:

    Are you on ADT at UCSF? If so, is it ADT1, or ADT2, ADT3?

    I am looking for more than ADT only. What about OHSU Portland?

    Thanks,

    Craig

  • I was diagnosed 3 1/2 years ago with very widespread mets to bones and lymph nodes and a very high PSA around 5,006. I went straight to the care of a hometown oncologist for systemic treatment only. I had temporary bicalutamide to prevent a testosterone "flare", followed immediately by Lupron Depot 3 mo. , plus Zometa IVs for the bone mets. My PSA dropped as low as 1.0. When it went up into the 3-4 range my local onc. tried a rechallenge addition of bicalutamide, to minor effect, but stopped it again after a few months as PSA progressed. After about 2 years my PSA response went well into the castrate resistant phase, rising from 5.0 to around 95 during the third year, while I did some other consulting at OHSU and UCSF. Both offered me clinical trials involving Yervoy, which I declined, due to my hesitations about potential side effects of the CTLA-4 inhibitor. UCSF then arranged for me some familial genetic testing, a PSMA PET scan, and Provenge, of which I completed 2 of 3 cycles. At the approx. 3 year point, UCSF added Xtandi (enzalutamide), which has taken my PSA down from 94.8 to 5.0 within four months. I still see my local oncologist for less frequent Zometa (3 months), and Lupron "for life". My local oncologist could have added either Zytiga or Xtandi, but I decided to go with added Xtandi via UCSF for continuity of advanced care into the future.

  • Thanks, Charles. Another question- did you get a referral from your local Oncologist for UCSF and OHSU or did you self refer?

  • A little of both. I wanted to drive the train. And my insurance was OK with looking elsewhere. And my local Oncologist was being pretty passive about it.

    I searched around for some researchers of note on my own as my disease progression definitely was going "castrate resistant". Then I checked to see if there were Preferred Providers in my nation-wide retiree version of Blue Cross Blue Shield (FEP Blue). I am also Medicare primary. The first consultation to OHSU began with my phone call to Dr Beer's office coordinator, which eventually morphed into a de facto Referral from my local Oncologist's office and his staff. I hand carried prior scans & reports, myself. The second consultation to UCSF Dr Small I initiated via an email directly to his email at UCSF, dropping the name of his counterpart at OHSU. He referred me to his office coordinator, who facilitated the appointment, which I had to help along a little as a de facto Referral from my local Oncologist's office, and, again, I hand carried prior scans and reports myself. (As an aside, the local Oncologist would have also been quite willing to do a referral to UCSF Dr Ryan, with whom he had a previous history, and who is in the same group as Dr Small at UCSF.) I do not have HMO-like restrictions on my doctors, but can incur extra charges if I go to Non-Preferred providers, or go outside my Drug Formulary or Prior Approval coverage restrictions.

  • Thanks for the information. It seems awkward to ask for a referral from a Oncologist that isn't on the course one wants to be on. Come to think of it, I did ask my radio-oncologist if he would refer me to a Medical Oncologist. He was OK with it, but it was "in house" at Stanford. I'm on Medicare, with Blue Shield medigap.

    Regards,

    Craig

  • Dana Farber and Sloan Kettering both take medicare. I've had chemo..doc visits...blood tests...other treatments...etc through both...no issues.

  • Oh..DF is in Boston MA and SK is in NYC. You can find the both on the web...Genitourinary Oncology.

    doctors.dana-farber.org/dir...

    mskcc.org/cancer-care/docto...

  • You might want to call each our those centers directly. MD Anderson Houston did for me. I have Traditional Medcare part A& B and BCBS medical supplement policy Plan F. A & B pays 80 % and Plan F covers the 20% of anything Medicare covers. Ask their office if if they accept assignment of Medicare for the coverage you have fax them copies of your coverage cards to be sure.

  • We have what you have - problem is the drugs / going into the donut hole which we are in - medications are 3 to 7,000 $ a month - for your co-pay - for zytiga & Xtandi - call Medicare & they will explain it

    Good luck

  • Guys, Each year when I go looking (on the Medicare site) for the most cost effective Medicare "D" drug plan, two of the scenarios I run are Zytiga or Xtandi. The result has usually been that my ANNUAL cost goes from about $2000 to about $7000--give a few bucks :-). The main reason is that once you come thru the donut pit, cost is capped at about 5%. Donut hole is also getting better, I understand.

    Herb

  • If you are a veteran, check with VA you may be able to get Zytiga or Xtandi through VA for only a $7 or $8 copay

  • I am a vet, however no need for Zuniga or Xtandi yet, thanks

    Bill

  • If you are a veteran, check with VA you may be able to get Zytiga or Xtandi through VA for only a $7 or $8 copay

  • You can only make around $27 or $28 thousand a yr to get VA to qualify for zytiga or Xtandi

  • It's a crying shame.

  • Thanks to all for the quick responses, Portland is close enough for an RV trip.

    Bill

  • I go to both University of Washington and Duke, and both take Medicare.

  • Several prostate researchers at UW/Fred Hutch/Seattle Cancer Care

  • Stanford

  • Again, thanks for all these responses, I do not have drug coverage but only on Eligard & casodex, Eligard is covered as it must be administered by Dr, Casodex inexpensive using Good RX , $30.00 at Sams for 90 count.

    Bill

  • MEMORIAL SLOAN KETTERING CANCER CENTER in New York City takes medicare patients.

    good luck!

    j-o-h-n Tuesday 04/18/2017 6:15 PM EST

  • You just gave to ask the provider what insurance they accept. It's also on their websites if they have one. No centralized list that I'm aware of. Asking here as you've done is also a good source of information.

    Bob

  • It's better to have the medicare supplement plan - lots of doctors do not take the advantage plan

    Penny and Mike

  • Do you have medicare with a supplement or medicare advantage plan? Lots of doctors/facilities will not take the medicare advantage plan

    Penny and Mike

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