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Advanced Prostate Cancer
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Medicare and social security

I know there are a lot of you who have researched this. How are folks able to pay for treatments if they only have social security income and Medicare?

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Buy a Medicare Advantage Plan..most have little or no monthly premium and maximum out of pocket costs of around $6700

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my dad has that (a supplemental advantage plan) with out of pocket of 4500. HOWEVER zytiga is considered a specialty drug and falls under different rules. his cost for zytiga is 2800 a month.

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I have blue cross plan 65 supplement and the cost of Zytiga is 500 but the donut hole is another 2000. Total with premium is about 8500 a year. See if he can change before dec 7

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What Fairwind says has got me thinking. Military service might get the VA involved. Going to look into that one myself. When I was diagnosed at M D Anderson the first thing they told me was they had a group working to find money to help people pay for this drug. I have to assume all the big cancer centers do the same. Your dad would qualify for sure. There were no guarantees and I was still working full time so I did not qualify but call all of them.

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If you can demonstrate "boots on the ground" in Vietnam, your prostate cancer is "Agent Orange presumptive" and the VA will pick you up without further question. Your DD214 may show that. There are other means - I used an OER. Lists of units that were stationed"in country" and dates are commonly available and any medal citations you got. Your state may have Veterans Service Officers in each county and they are invaluable in assisting you. My experience with the Portland, OR VA has been very positive. Keep fighting.

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Well can’t say I was in the fighting. Spent my time in turkey italy and Germany. Probably won’t qualify for help but the one thing I might is the va home. Nice place near me.

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If you were discharged from the United States military under honorable conditions, you qualify for medical assistance through the VA. A member here named Gregg57 is currently receiving oncology care through a VA facility. Don't quote me but I think he mentioned he pays $50 a month for Zytiga co-pay. Take your discharge paper and go to a VA hospital. A volunteer will direct you to the "office" where you can sign up for health care. I have been through the VA process and it pays off. You really need to go and sign up for care. Good luck.

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Thanks I wonder if there is coverage just for the drugs? Cant see leaving my care team at this stage. if I have to spend my wife’s money she says it’s ok. Early in the treatment of stage 3/4 with tumor outside the prostate. Letting the drs worry about it until they tell me something for sure. Not sure why I’m not worried. Think I’m just so happy I quit work it hasn’t sunk in yet.

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You can keep the care team you currently have. You will be assigned a PCP and an oncologist. More times than not, a VA oncologist will work with an outside medical team, prescribing needed drugs. It isn't as difficult as one would think. The VA follows the "standard of care", I go to the Ann Arbor VA and the University of Michigan cancer center. They work together seamlessly. The only way to get a definite answer to your questions is to go to the VA. It's a very easy process.

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I’ll give it a shot

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I’ll start it Monday thanks

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Bill I went to the va with my papers and will not get in because of income. Since I’ve quit work in the middle of the year I can’t meet the 43000 ceiling. I make my wife work and refuse to let her quit. Next year i might make it. Especially if Zytiga heretic doesn’t show up.

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Just called my pharmacy and the generic by Mylan pharmaceutical will be 380.00 to me instead of 503.00 for Zytiga. Not a lot of difference. My dr. Did say it was ok

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The VA has changed..Just walk into any VA Medical Center, stop at the front desk, get a number, wait until they call your number, do the interview..Bring your DD-214..If you have served in the armed forces, were honorably or medically discharged and your annual income is less than $38K / year more or less, you probably qualify for most benefits, no service connected disability necessary..Your first appointment will be with your PCP, primary care physician, who will spend an hour with you going over your health history. he / she will then refer you to any needed specialists including an Oncologist who will write any scripts you may need including things like Zytiga and Xtandi, scans, labs, Lupron...Chemo..Your prescriptions all cost the same $8 each. There is no charge for doctor visits, injections or infusions..Usually they send your scripts in the mail (UPS) and you or somebody must be home to sign for them..

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Not true, please don't post false information.

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What part is not right. The income amount? Can’t get that low

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Please follow the link below for an official overview of VA health care eligibility.

va.gov/healthbenefits/resou...

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Thanks Bill

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Anytime. I have been "dealing" with the VA for many years. Feel free to ask a question. If I know the answer for certain, I will be happy to respond.

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Yes, look into a Medicare Advantage plan. There are many different ones, the HMO types are usually no cost..Also apply for "Extra Help". If your only income is SS then you should qualify . Extra Help greatly reduces drug costs..If you were ever in the Military, don't forget the VA....

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Where do you apply for “Extra Help”? Thanks

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Be careful of Medicare advantage plans, it is a private insurance plan and they can decide that a drug your taking is no longer covered if they choose to do so. Not so with Medicare. I picked up a high deductible supplemental plan and a Medicare drug plan where all my meds were included in the formulary. The donut hole is currently being phased out and Medicare cost is being shifted to higher income beneficiaries to make up for it.

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Most of the Drug Companies have special support assistance programs available, based on income, to moderate the cost of their drugs. Go to the drug company web page and search for assistance programs. They will have an 800 number attached which you can call.

Also, we all need to take action and make sure that the medicare rules don't change so that the Medicare providers are allowed to insist that we use drugs they decide we need as opposed to out doctors making the decisions. Cancer ABCs has just started a National Petition asking the President and Congress not remove the protection that Cancer Medications currently have. Changes, like the proposed ones, will negatively affect all of us.

Add your name to the petition at: bit.ly/2AznunU

We also need that signers reach out to all the members of their community, including their church and family and ask that they sign on to the petition.

Joel

CancerABCs.org

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I needed 42 radiations in 2007 and I had no insurance, but in a few years I could get medicare. The hospitals all wanted $130,000. but I found a urologist who had the same machine and charged me $30,000. for the same thing! Then I got medicare for 30 more radiations and they charged me $48.00. Medications are a problem with medicare because of the donut hole. My oncologist for 11 years charged me $50 a visit for 4 times a year, but he had charity that picked up the co-pay. They take $100. out of my medicare payment for having medicare advantage. My insulin was $110. a bottle and the company that makes it sent me 20 bottles for free 4 times last year, but this year it is only $34. for 4 bottles. So I check around and ask questions to lower prices.

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Do NOT enroll in a Medicare Advantage plan. If you want to re-enroll in traditional Medicare, when applying for a Medicare Supplement plan, you will be medically underwritten.

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True enough. But Kaiser Advantage plan (Northern Ca.) Costs me $20 mo. With only social security income I easily qualify for their Medical Assistance Plan (and they love cancer patients). They have pd. for Xtandi for almost 16 months now plus the lupron, xgeva and other assorted drugs, ct, bone-scans, everything. (Assets don't count in no. ca. plan, just income, easy to google). Sure, it's only standard of care, but that's all I can afford anyway so don't see me switching plans. I'm just careful not to hit a million dollar lottery ticket 'cause my bills are already closing in on that fast. What a racket.

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If you want a good medical care, you can try to loan some money for that. There is company plscashadvance.com/are-no-c... which may give you funds in such situation. It is really important!

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