UC San Fran: So we are tossing around... - Advanced Prostate...

Advanced Prostate Cancer

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UC San Fran

JWPMP profile image
75 Replies

So we are tossing around the idea of moving to Nevada from California due to high cost of living. I contacted UCSF and told them we can be in California for Zoom calls and of course treatment. But could Jim get his Lupron and bloodwork out of state. We were told you have to be a permanent California resident to be treated at UCSF. I thought a person could travel to any hospital for treatment as long as they were willing to travel and had the insurance. I cannot find a prostate center of excellence in Nevada. They have prostate center in Las Vegas, but no psma scan available. Do all cancer centers require that you be a state resident? It seems I read people traveling a lot. Maybe they'd be too overwhelmed if they accepted out of state patients? Feeling perplexed and disappointed. Thank you as always.

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JWPMP profile image
JWPMP
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75 Replies
6357axbz profile image
6357axbz

I live in Florida but travel regularly to MD Anderson in Texas. No problem at all.

JWPMP profile image
JWPMP in reply to 6357axbz

Thank you very much! I'm sure puzzled by this.

6357axbz profile image
6357axbz in reply to JWPMP

Could be because USCF is a state funded school, not a private institution.

JWPMP profile image
JWPMP in reply to 6357axbz

Hadn't thought of that.

Grandpa4 profile image
Grandpa4 in reply to 6357axbz

Yes it is

JWPMP profile image
JWPMP in reply to Grandpa4

Good to know. Thank you

edwards304 profile image
edwards304 in reply to 6357axbz

Also, maybe an insurance issue.

I have treatments in Miami and Vail, no issues; both are private centers

JWPMP profile image
JWPMP in reply to edwards304

Thank you.Jim has original Medicare, not a regional advantage or supplemental insurance. So it's not an insurance issue.

Tall_Allen profile image
Tall_Allen

It’s a foolish state law that they can’t have out of state telemedicine. There’s a bill in Congress to change it. But who knows if our gridlocked Congress will pass it.

JWPMP profile image
JWPMP in reply to Tall_Allen

I'm shocked that even if we go in person, they won't treat him if we're not residents. Is UCLA the same? Do you know of any excellent centers in Nevada? I couldn't find one just searching.

Tall_Allen profile image
Tall_Allen in reply to JWPMP

That surprises me too.

JWPMP profile image
JWPMP in reply to Tall_Allen

Here are the messages. I asked for clarification about traveling in person.

Hi Linda

Not sure who to check with. We are tossing around the idea of moving out of California. We understand that zoom appointments have to be instate and of course scans, treatment etc. Thats no problem we can make that work. My question is, can you all authorize Lupron shots and bloodwork at out of state centers? Our number one priority in all of our decisions is Jim's continued care at UCSF.

Thank you for your time.

Hi Jim and Paula,

Thank you for looping me in on your plans. We unfortunately are unable to provide care to patients whose permanent residence is outside of California and are no longer California residents. We also cannot place orders such as Lupron to a facility that is out-of-state.

I hope this information is helpful. Keep us posted! As always, take care and be well.

Best,

Linda

--

Linda McMullen, FNP-C, AOCNP

Oncology Nurse Practitioner

Genitourinary Medical Oncology

UCSF Helen Diller Comprehensive Cancer Center

SongofFred profile image
SongofFred in reply to JWPMP

I received Brachyboost therapy and year long Orgovyx/Nubeqa prescription from UCLA last August and I live in Seattle. My labs are done in Seattle. Don’t know if it’s a recent ruling or if the person you’re corresponding with is clear on the guidelines. Maybe try someone else there?

Or maybe they reinstated rules they relaxed during Covid. I did have one doc in Chicago last June who wouldn’t televisit with me anymore because the rules had apparently reverted back to in-state only. But then UCLA had no problem so I don’t know what to think.

JWPMP profile image
JWPMP in reply to SongofFred

Thank you. I'm thinking a phone call might be in order.

garyjp9 profile image
garyjp9 in reply to SongofFred

It is true that many hospitals have tightened up their out of state care since Covid.

Tall_Allen profile image
Tall_Allen in reply to JWPMP

It sounds fishy to me. Why would the rules be so different for UCSF than for UCLA since they are both part of the UC system? Is there any way you can communicate directly with the doctor, without going through Linda? I know a patient who lives in NM and visits an RO at UCLA. The UC hospitals take many out-of-state patients -- they are regional centers of excellence.

JWPMP profile image
JWPMP in reply to Tall_Allen

Thank you. I will go ahead and contact Dr Borno. Should have gone to her first, but Jim's last two FU appointments have been with Linda, so I contacted her. It sounded off to me also, and now even more so since hearing UCLA is not restrictive like that. I got to wondering if it's an attempt to discourage more moves out of California, but why would you turn down revenue. Makes no sense. Appreciate your time a great deal.

LongevityAT profile image
LongevityAT in reply to JWPMP

I live in Georgia and was treated at UCLA. After treatment, I've had quarterly, and now semi annual, calls with the doctor or his PA. This wasn't raised as an issue at any time.

JWPMP profile image
JWPMP in reply to LongevityAT

Thank you.

Don_1213 profile image
Don_1213 in reply to Tall_Allen

You can go in person and be treated. The law (and I've been going around and around with it) prohibits MD's from doing Telemedicine to a patient in a state they aren't licensed to practice in. This law was exempted during Covid, so MD's could do zoom visits with patients anywhere.

It has caused issues requiring me to travel into NYC for visits with my medical practitioners there. Some of the staff doing scheduling seem to enforce it much more rigidly than others. I had my last visit with my MO done by cell-phone, there wasn't any real reason that video would be needed.

TA - would you happen to know the bill# in Congress - I think our representative in Congress isn't currently in court for theft and corruption like our Senator is. Our congressional representative does live in VA despite claiming to be a NJ resident. We won't go into the reasons that hoax has been allowed to continue, but I will approach him and see what he has to say about the bill.

JWPMP profile image
JWPMP in reply to Don_1213

Thank you for the information!

Still_in_shock profile image
Still_in_shock

Call Renown Institute for Cancer in Reno, ask them about their affiliation with UCSF

renown.org/cancer

JWPMP profile image
JWPMP in reply to Still_in_shock

Thank you! I just called them and the girl answering the phone said they have no affiliation with UCSF. She may not know. But they do treat prostate cancer there, and Jim said he's fine with that. It's his decision. He said people in Nevada have cancer too, so they must know how to treat it.

Still_in_shock profile image
Still_in_shock in reply to JWPMP

My MIL lived in Reno had lung cancer, and Renown was using UCSF for procedures they could not do. Albeit 10 years ago. It's the biggest facility there. I also remember they were aligned with University hospital at UNR. (My daughter graduated from UNR) Needless to say I spent a lot of time in Reno. (Living in LA) It wasn't a 3rd world city back then!!

Hope it work out for you. Reno might ne my next residence.

JWPMP profile image
JWPMP in reply to Still_in_shock

Thank you so much again! I called them again with more questions and they were so nice and helpful. Wow. Looks like a great facility. Really appreciate the info.

JolleySprings profile image
JolleySprings

We live in TX and my husband’s oncologist is Dr. Rahul Aggarwal. We have monthly Zoom calls. My husband is given his ADT shots here in Dallas. We had to go out once to establish a patient/doc relation. Otherwise it is all virtual.

JWPMP profile image
JWPMP in reply to JolleySprings

Great to know! Wow. I'm calling tomorrow. I wish we had Dr Aggarwal, I've heard very good things about him. Thank you.

Mcrpca profile image
Mcrpca

Try Stanford

P3Nav profile image
P3Nav

I left Sunnyvale CA for Oklahoma for the same reasons. I was blessed with Veterans Admin coverage though. Any chance either of you were prior military?

JWPMP profile image
JWPMP in reply to P3Nav

Wow, wonderful! My Dad was a veteran, thank you. Neither of us were military.

Kaliber profile image
Kaliber

Hi JWPMP….

My wife worked for UCSF S.F. , for decades, as a field Physicians Liasion and problems like this are something she handled many times on a daily basis. She’s asleep right now but I’ll ask her to help if possible and possibly give you any direct contact information if available. I’ll have her read this and let you know.

I’ll get back to you as soon as possible.

❤️❤️❤️

Kaliber profile image
Kaliber

hello again jwpmp … my wife woke up and says to tell you she will call her contacts tomorrow morning and we’ll P.M you.

It sounds odd for UCSF to say that because part of her territory was northern Nevada and UCSF has transplant clinics and patients all over her territory in Northern Nevada. It’s not impossible that some clinics may have special qualifying rules tho.

We’ll get back to you after business hours open up this morning.

❤️❤️❤️

JWPMP profile image
JWPMP in reply to Kaliber

You all are awesome. Thank you!

JWPMP profile image
JWPMP in reply to Kaliber

I'm so overwhelmed by the generous outpouring of help here. It is remarkable and brings me to tears. Thank you!

Kaliber profile image
Kaliber in reply to JWPMP

We’re waiting for the liaison group to return our call. It would have been minutes back in the day when the hammer was senior field liaison…. But nowadays it’ll be longer lol.

❤️❤️

JWPMP profile image
JWPMP in reply to Kaliber

Oh gosh, please don't spend too much time on this. You all are just too kind 🥲💙

Kaliber profile image
Kaliber in reply to JWPMP

The ladies are on it …. The clinic isn’t responding yet. No one messes with the liaison service, there must be big stuff happening in the clinic. ( staff missing, doctor off the grounds etc. ) there might be logistics reasons the clinic is functioning the way it is … this is kinda interesting.

They don’t want to get to the “ don’t make me come over there “ level rotflol.

❤️😁❤️

JWPMP profile image
JWPMP in reply to Kaliber

Lol... From my working days, I know that level well 😉I'm not familiar with liason services, although I know what they are.

It was interesting. I always get same day responses when I message (although it'sunderstood thats not required, but they always did). It took a little over 2 days for them to get back to me.

I kept telling Jim it was odd. Now I'm more curious...

Thank you !!

Kaliber profile image
Kaliber in reply to JWPMP

PM’ed you.

BruceSF profile image
BruceSF

i go to a support group that meets on zoom weekly, and many of the members are treated at ucsf and some of those are out of state. If you’d like to attend a meeting you can find contact info at mymarinhealth.org/programs-...

Stan Rosenfeld has been facilitating this weekly group for over 20 years, he would be happy to chat with you.

JWPMP profile image
JWPMP in reply to BruceSF

Thank you, This is great, I will check into this!

Las Vegas does have a medical facility that does perform PSMA testing. I live in LV and just had one performed.

JWPMP profile image
JWPMP in reply to packardlover1949

Thank you! When I looked on the website during my research it wasn't listed. Really appreciate it

fast_eddie profile image
fast_eddie in reply to packardlover1949

I've had my scans done at Simon Med imaging in the Phoenix area. I googled Simon Med in Las Vegas and got:

bing.com/search?q=simonmed+...

JWPMP profile image
JWPMP in reply to fast_eddie

Thank-you, really appreciate the info!

jtspitfire profile image
jtspitfire

If anyone ever wondered how helpful and caring the members of this site can be, this thread is a perfect example!

JWPMP profile image
JWPMP in reply to jtspitfire

Omg you just said it. Im amazed and overwhelmed with gratitude.

CousinGrandpa profile image
CousinGrandpa

is it an insurance issue? Medicare and Medicare supplements (medigap) cross state lines while many Medicare Advantage programs are PPO and you have to stay in your state or area for coverage.

Explorer08 profile image
Explorer08 in reply to CousinGrandpa

Medicare Advantage programs have a huge amount of variability. Ours is good anywhere in the US and does cover ER visits outside the US.

JWPMP profile image
JWPMP in reply to CousinGrandpa

He has original medicare and secondary is his union insurance, anthem blue cross. I checked and there's no issues with the insurance. Thank you

we live in Nevada and we are being treated at UC Davis with no issues.

JWPMP profile image
JWPMP in reply to Concerneddaughter123

Thank you. Where in Nevada do you live?

Concerneddaughter123 profile image
Concerneddaughter123 in reply to JWPMP

We are in Reno Tahoe area.

JWPMP profile image
JWPMP in reply to Concerneddaughter123

Oh beautiful, thank you. Jim's looking at a property in Fallon.

Concerneddaughter123 profile image
Concerneddaughter123 in reply to JWPMP

Oh that’s nice. It would be about a 5ish hour drive to San Fran, and about 3ish to UC Davis from there

JWPMP profile image
JWPMP in reply to Concerneddaughter123

Thank you.

I am not wanting to move away from my mom and friends. It's causing major anxiety. But I tell myself he has cancer, I don't, let him live his life.

mababa profile image
mababa

wow! Never heard of that before. If the hospital is receiving any federal funding, it cannot deny you medical care based on what state you live in. Same if they’re receiving any Medicare reimbursements. The Fred Hutchinson Cancer Center in Seattle takes people from all over the world.

JWPMP profile image
JWPMP in reply to mababa

Interesting! And makes sense. They do take International patients so I don't see the difference. Thank you!

Sagewiz profile image
Sagewiz

I live in OR and my insurance does not pay for treatment out of state.

JWPMP profile image
JWPMP in reply to Sagewiz

Is that original Medicare?

Sagewiz profile image
Sagewiz in reply to JWPMP

No, Providence.

JWPMP profile image
JWPMP in reply to Sagewiz

Thank you.

Jim has original Medicare.

Laun profile image
Laun

adventist health in Lodi CA. Has PSMA pet scan and may accept you. I go to UCSF but have PSMA done in Lodi

JWPMP profile image
JWPMP in reply to Laun

I didn't realize the scan was so widespread now, that's good news.

specialmatter profile image
specialmatter

5 years ago we lived in Florida and established contact and treatment with UCSF recommended to us. No problem then. Now we live in The Bay Area and my husband still gets treatment there.

In my humble opinion I think they take in too many new patients since response times for his treatments and feedbacks slowed down considerably.

JWPMP profile image
JWPMP in reply to specialmatter

That's something else I was wondering, perhaps capacity issue...

pj1121 profile image
pj1121

Use a friends address?

JWPMP profile image
JWPMP in reply to pj1121

Someone suggested that, but it wouldn't match with our insurance

j-o-h-n profile image
j-o-h-n

So if we had a 911 disaster in Nevada close to the California border, would that mean that California hospitals would not treat the victims? We are so fuckedup........

Good Luck, Good Health and Good Humor.

j-o-h-n

JWPMP profile image
JWPMP in reply to j-o-h-n

That 👆 💯

Ldtyson profile image
Ldtyson

I'm a patient of UCSF Oncology for prostate cancer. My doc is Eric Small. I do all my appointments on Zoom and my labs are done through LabCorp in Reno. I also have a cancer doc here in Reno as a liaison to UCSF when body scans need to be ordered. UCSF set this up for me. It all works well. I also have a GI doc and colonoscopy doc at UCSF. When I have in person procedures I go to SF. I refuse to have any invasive procedures done in Reno because of the poor quality of medicine. Too many of my clients have died from post op infections here. Not a safe medical community in my opinion.

JWPMP profile image
JWPMP in reply to Ldtyson

Wow! That's disturbing, and also very good to know. Thank you. I'm going to wait until when/if we decide to make an offer on the property. At that⁶ point, I will speak with his actual MO and the liason dept if necessary. Is it the Renown Center in Reno you go to, or would you rather not say. I totally understand if that's the case. Appreciate you sharing your experience. This situation is confusing. Thank you!

Ldtyson profile image
Ldtyson in reply to JWPMP

The Cancer Care Specialist group with Dr. Santhosh Ambika. UCSF coordinates my care through him when anything needs to be ordered that they can't do. He just ordered a body scan for me that I'm completing in Reno next month. If there is something not offered or better I'll go to UCSF. Anything invasive I'll go to UCSF. I had very complex back surgery done at UCSF.

In the past I went to Stanford but they have lowered their quality of care significantly. That's why I go to UCSF. I'm currently on vacation from all cancer meds for more than a year. They still monitor me.

I hope this all helps you.

JWPMP profile image
JWPMP in reply to Ldtyson

Yes it helps. Thank you for sharing this.

Teacherdude72 profile image
Teacherdude72

Just another reason to not live in California

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