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
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Billash
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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:
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
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.
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.
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
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.
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.
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.
Sorry for the delay, I just noticed your ?? I have basic medicare A&B with a great plan F supplement through State Farm. We studied all the advantage plans early on and thought all the "advantage" was with the companies selling them. They have only become worse IMHO.
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Medicare Part D coverages for APC Drugs (not covered by Part B administration).
Medicare Coverage for PSMA Scan
Medicare will pay for PSMA PET/CT Studies.
Is Medicare Coverage Any Good?
