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NancyD
New Member


Date Joined Sep 2008
Total Posts : 1
   Posted 9/30/2008 10:04 AM (GMT -6)   
Did anyone not have insurance? My huband has only been charted for a UTI treatment by our GP. Does anyone think if we get insurance b4 we see the urologist that we have a chance he could be covered?

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4840
   Posted 9/30/2008 2:53 PM (GMT -6)   
Does you GP "suspect" PC?
Do you already have an appointment with a urologist?
 
It'll probably be a coin toss...Could have a waiting period on the insurance cause they've been here before....Might have to get a physical...
Age 53   - 5'11'   205lbs
Overall Heath Condition - Good
PSA - July 07 & Jan 08 -> 1.3
Gleason - 6
(biopsy done March 4, 2008-> 2 of 12)
 
06/25/08 - Da Vinci robotic laparoscopy


don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 9/30/2008 5:50 PM (GMT -6)   

Hi Nancy,

I did not have insurance at the time of my diagnosis. I was in the process of obtaining a policy and, quite stupidly, had a PSA test as a result of a follow up visit for a kidney stone. I was diagnosed with PCa before the insurance took effect and thus it was not covered under the pre exisiting condition clause. I must be covered for twelve months for my insurance to start picking up the costs of my PCa treatment. Given the seriousness of my situation I went ahead with the radiation and hormone treatment. I have been very fortunate as my doctors and the treatment center have all worked with me on the cost. By the time the insurance kicks in I will already have paid for everything except for three hormone shots. I am told that I will be assigned to the high risk pool and the cost of the insurance will rise dramatically.

The hospitals, testing facilities (blood and pathology) have not been as willing to reduce the costs and the anesthesiologist was at full cost. The hospitals, after much arugument and some BS from thier business agent, finally agreed to a 10% discount for cash at time of service.

If you do not have insurance and you are in the process of getting it I would stop any and all investigation of PCa until you have the insurance. This includes a PSA test. If your husband has already been diagnosed with an abnormal PSA or PCa you may be in a bit of a bind.

Best of luck to you.

Don


Diagnosed 04/10/08
Age 58
PSA 21.5 (first and only test resulted from follow up visit to emergency room for kidney stone. first time for kidney stone too)
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear
Chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
PSA test on July 14, 08 after 8 weeks hormone .82
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
Second Lupron shot 09/11/08
Next PSA test by oncologist 03/09
 
 


Banker
Regular Member


Date Joined Sep 2008
Total Posts : 30
   Posted 10/2/2008 1:12 AM (GMT -6)   
Depending on your financial situation and your state, you could be eligible for govt assisted program, such as medicaid or other state sponsored programs. In a few states there are "free care pools," that can pay for medical care, including specialty care. If you are not eligble for these assistance programs, you might try doing some anonymous investigations directly with insurance company to find out their policies and limitations. Another potential resource is the benefits manager at your local hospital. This person will know the insurance rules in your state, and may be able to direct you to the right place. Lastly, the benefits coordinator in your GP's office might be able to help with information as well. Please post your findings. I bet it wil be helpful for others too. Best.
born 1952
diagnosed with HIV 2001
PSA--ranged from 2-7
2 previous biopsies-all negative
diagnosed with prostate cancer:Sept 30, 2008
Gleason Score 3+4=7
 

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