Guest guest Posted September 24, 2002 Report Share Posted September 24, 2002 Dear Joanne, I don't think any accidental payment happened in Virginia. I have been trying to get reimbursement for 4 years and have given up Manson Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 24, 2002 Report Share Posted September 24, 2002 Hi! I seem to remember reading of perhaps two other adults who received HBOT, possibly post CVA, and Medicare " accidently " covered part of it. Does anyone know if that is the case? If so, do you know which State and/ or the condition? I am preparing for a hearing and perhaps if I can say other States did the same as Louisiana Medicare with me, it may open a door, perhaps. Thanks! Joanne Brindley ________________________________________________________________ GET INTERNET ACCESS FROM JUNO! Juno offers FREE or PREMIUM Internet access for less! Join Juno today! For your FREE software, visit: http://dl.www.juno.com/get/web/. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 24, 2002 Report Share Posted September 24, 2002 Dear Mr. Manson, Hi! Although I understand the frustration, please, please don't give up. Every time they are challenged, they receive a " ping " in their armor. A ping here and there is no big deal, but multiple assaults.... I know it is a long, arduous, frustrating fight, but we must continue. Think of how long it took Mr. Freels and others. Once one of us penetrates Medicare's armor, a precedent will be set which I pray can be used by everyone who follows. Remember, Truth is on our side! Joanne Brindley ________________________________________________________________ GET INTERNET ACCESS FROM JUNO! Juno offers FREE or PREMIUM Internet access for less! Join Juno today! For your FREE software, visit: http://dl.www.juno.com/get/web/. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2006 Report Share Posted December 5, 2006 for a single implant, yes. Traditional Medicare does not cover bilaterals. Steinerman Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2006 Report Share Posted December 5, 2006 Sherri, You are in good hands with Dr. Kveton & Myles. You have nothing to worry about on your being covered by Medicare. Good luck. Ralph CII 8/01 HiRes 2/03 > This is a practice (affiliated with Yale) that does CIs routinely, the > surgeon and chief audiologist have been doing them for over 20 years. Is > it a > safe bet to go with " Don't worry, we know what qualifies for coverage... " > or is > Medicare coverage so 'iffy' that we should push for confirmation of > pre-approval? > > TIA, > Sherri > CT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2006 Report Share Posted December 5, 2006 Hi Sherri, I am on M-care with a secondary. My CI clinic (House Clinic in Los Angeles) knows the guidelines on what m-care will pay and what they won't. It depends solely on the hearing test. The surgeon will know automatically if your husband is a candidate depending on the scores of the tests (words, sentences, tones etc) I wouldn't worry about it. Medicare coverage is not iffy. It is cut and dry. Wishing your hubby success on Dec 11. a B Implanted Freedom 8-21-06 On Dec 5, 2006, at 7:50 AM, brnrpal@... wrote: > The archives have lots of discussion about the need to document > insurance > approval in writing before proceeding with surgery. Does the same > hold true > for Medicare? > > Surgery is scheduled for my husband's first CI on Dec 11, but when > I asked > the surgeon's billing dept for a copy of the Medicare approval, > they basically > told me not to worry... if the doctor has determined Len's a > candidate for > CI, Medicare will cover it. > > This is a practice (affiliated with Yale) that does CIs routinely, the > surgeon and chief audiologist have been doing them for over 20 > years. Is it a > safe bet to go with " Don't worry, we know what qualifies for > coverage... " or is > Medicare coverage so 'iffy' that we should push for confirmation of > pre-approval? > > TIA, > Sherri > CT > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 13, 2008 Report Share Posted November 13, 2008 I was diagnosed with CML in Aug. 1998. After 26 months of INF, I started Gleevec and have been doing well ever since. Along the way, I had 16 BMB's, but for the past several years, I have been monitored by PCR/FISH blood tests every 6 months. About a year ago, Medicare stopped covering these tests for me. According to Quest Labs, Medicare reports that these tests " are not medically necessary " and " do not meet Medicare Guidelines to support the medical need for the test " . My supplemental ins. will not cover these tests because they have been denied by Medicare. My provider claims they have not changed the diagnostic codes and can't do anything more. Before contacting Medicare (which can be an arduous undertaking), I decided to find out what others have experienced. Thus, my question is, have any of you who are on Medicare had a similar experience with coverage denial from them? Thanks for your replies and suggestions. Earl in Tucson Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 14, 2008 Report Share Posted November 14, 2008 Suzzie: Thanks for your reply. BMB costs $1000+ and the PCR/FISH is $115.17. It's a no brainer. I con't figure why Medicare refuses to pay. Earl > > HI EARL: I was diagnosed in Dec. of 1998, and went through the > Interferon/Ara-C only for a few months before it became toxic to my > liver. I am not on Medicare yet, but you should fight it with them. I > do not know if the PCR is more expensive than a BMB, but tell them that > this is the way they determine your status to be sure you are in > remission. They probably feel that if your routine blood work is > holding steady that you do not need the tests. My oncologist told me > to just get the PCR's every 6 months, so they do not have to keep going > into my bone for biopsy. I would tell them they will be paying out a > lot more if your status goes into blast phase, and thats why testing is > needed to keep track. I hope you get the right answers. We have been > very blessed since 1998 > Suzzie > > I was diagnosed with CML in Aug. 1998. After 26 months of INF, I > > started Gleevec and have been doing well ever since. Along the way, > > I had 16 BMB's, but for the past several years, I have been monitored > > by PCR/FISH blood tests every 6 months. About a year ago, Medicare > > stopped covering these tests for me. According to Quest Labs, > > Medicare reports that these tests " are not medically necessary " > > and " do not meet Medicare Guidelines to support the medical need for > > the test " . My supplemental ins. will not cover these tests because > > they have been denied by Medicare. My provider claims they have not > > changed the diagnostic codes and can't do anything more. Before > > contacting Medicare (which can be an arduous undertaking), I decided > > to find out what others have experienced. > > Thus, my question is, have any of you who are on Medicare had a > > similar experience with coverage denial from them? > > Thanks for your replies and suggestions. > > Earl in Tucson > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 14, 2008 Report Share Posted November 14, 2008 That's very interesting, a BMB for $1000.00 I just received the invoice for my Oct. BMb/BMA, ONE BILL WAS:$6,331.00, AND ANOTHER, SAME DATE, $1,219.00, MAKING IT , TOTAL $7,550.00. I AM IN A TRIAL SO DO NOT PAY ANY OF THIS, BUT THERE IS QUITE A DIDFFERENCE IN PRICE, NO? Bobby a (Bobby) Doyle Brecksville, Ohio, USA DX 05/1995 02/2000 - Gleevec Trial/OHSU 06/2002 - Gleevec/Trisenox Trial/OHSU 06/2003 - Gleevec/Zarnestra Trial/OHSU 04/2004 - Sprycel Trial/MDACC, CCR in 10 months #840 -  Zavie's Zero Club 09/2006 - out of CCR 04/29/08 - XL228 Trial/ U.of Michigan 06/02/08 - CCR ( in 4 weeks)  From: earlharford <earlharford@...> Subject: [ ] Re: Medicare coverage Date: Friday, November 14, 2008, 6:08 PM Suzzie: Thanks for your reply. BMB costs $1000+ and the PCR/FISH is $115.17. It's a no brainer. I con't figure why Medicare refuses to pay. Earl > > HI EARL: I was diagnosed in Dec. of 1998, and went through the > Interferon/Ara- C only for a few months before it became toxic to my > liver. I am not on Medicare yet, but you should fight it with them. I > do not know if the PCR is more expensive than a BMB, but tell them that > this is the way they determine your status to be sure you are in > remission. They probably feel that if your routine blood work is > holding steady that you do not need the tests. My oncologist told me > to just get the PCR's every 6 months, so they do not have to keep going > into my bone for biopsy. I would tell them they will be paying out a > lot more if your status goes into blast phase, and thats why testing is > needed to keep track. I hope you get the right answers. We have been > very blessed since 1998 > Suzzie > > I was diagnosed with CML in Aug. 1998. After 26 months of INF, I > > started Gleevec and have been doing well ever since. Along the way, > > I had 16 BMB's, but for the past several years, I have been monitored > > by PCR/FISH blood tests every 6 months. About a year ago, Medicare > > stopped covering these tests for me. According to Quest Labs, > > Medicare reports that these tests " are not medically necessary " > > and " do not meet Medicare Guidelines to support the medical need for > > the test " . My supplemental ins. will not cover these tests because > > they have been denied by Medicare. My provider claims they have not > > changed the diagnostic codes and can't do anything more. Before > > contacting Medicare (which can be an arduous undertaking) , I decided > > to find out what others have experienced. > > Thus, my question is, have any of you who are on Medicare had a > > similar experience with coverage denial from them? > > Thanks for your replies and suggestions. > > Earl in Tucson > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 15, 2008 Report Share Posted November 15, 2008 Earl I had Lab corp for the last 2 years , switching onc now I will have Quest ..Will not get statment for about 3 months. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 15, 2008 Report Share Posted November 15, 2008 Mine was also $6,000.00 plus..Had mine about 3 months ago.. SharonS In , ROBERTA DOYLE <rcd1929@...> wrote: > > That's very interesting, a BMB for $1000.00 I just received the invoice for my Oct. BMb/BMA, ONE BILL WAS:$6,331.00, AND ANOTHER, SAME DATE, $1,219.00, MAKING IT , TOTAL $7,550.00. I AM IN A TRIAL SO DO NOT PAY ANY OF THIS, BUT THERE IS QUITE A DIDFFERENCE IN PRICE, NO? Bobby > > > a (Bobby) Doyle > Brecksville, Ohio, USA > DX 05/1995 > 02/2000 - Gleevec Trial/OHSU > 06/2002 - Gleevec/Trisenox Trial/OHSU > 06/2003 - Gleevec/Zarnestra Trial/OHSU > 04/2004 - Sprycel Trial/MDACC, CCR in 10 months > #840 -  Zavie's Zero Club > 09/2006 - out of CCR > 04/29/08 - XL228 Trial/ U.of Michigan > 06/02/08 - CCR ( in 4 weeks) >  > > > > From: earlharford <earlharford@...> > Subject: [ ] Re: Medicare coverage > > Date: Friday, November 14, 2008, 6:08 PM > > > > > > > Suzzie: Thanks for your reply. BMB costs $1000+ and the PCR/FISH is > $115.17. It's a no brainer. I con't figure why Medicare refuses to > pay. Earl > > > > HI EARL: I was diagnosed in Dec. of 1998, and went through the > > Interferon/Ara- C only for a few months before it became toxic to my > > liver. I am not on Medicare yet, but you should fight it with them. I > > do not know if the PCR is more expensive than a BMB, but tell them > that > > this is the way they determine your status to be sure you are in > > remission. They probably feel that if your routine blood work is > > holding steady that you do not need the tests. My oncologist told me > > to just get the PCR's every 6 months, so they do not have to keep > going > > into my bone for biopsy. I would tell them they will be paying out a > > lot more if your status goes into blast phase, and thats why testing > is > > needed to keep track. I hope you get the right answers. We have been > > very blessed since 1998 > > Suzzie > > > I was diagnosed with CML in Aug. 1998. After 26 months of INF, I > > > started Gleevec and have been doing well ever since. Along the way, > > > I had 16 BMB's, but for the past several years, I have been > monitored > > > by PCR/FISH blood tests every 6 months. About a year ago, Medicare > > > stopped covering these tests for me. According to Quest Labs, > > > Medicare reports that these tests " are not medically necessary " > > > and " do not meet Medicare Guidelines to support the medical need for > > > the test " . My supplemental ins. will not cover these tests because > > > they have been denied by Medicare. My provider claims they have not > > > changed the diagnostic codes and can't do anything more. Before > > > contacting Medicare (which can be an arduous undertaking) , I decided > > > to find out what others have experienced. > > > Thus, my question is, have any of you who are on Medicare had a > > > similar experience with coverage denial from them? > > > Thanks for your replies and suggestions. > > > Earl in Tucson > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 15, 2008 Report Share Posted November 15, 2008 I would like to know how people on Medicare are paying for their Gleevec. I am not there yet, but it is my biggest worry. _________________________________________________________________ Color coding for safety: Windows Live Hotmail alerts you to suspicious email. http://windowslive.com/Explore/Hotmail?ocid=TXT_TAGLM_WL_hotmail_acq_safety_1120\ 08 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 15, 2008 Report Share Posted November 15, 2008 I get it through Novartis Patient Assistance. If they ever stop giving it away - I don't know what I'd do. Tammy _____ From: [mailto: ] On Behalf Of Cohen Sent: Saturday, November 15, 2008 6:44 AM Subject: RE: [ ] Re: Medicare coverage I would like to know how people on Medicare are paying for their Gleevec. I am not there yet, but it is my biggest worry. __________________________________________________________ Color coding for safety: Windows Live Hotmail alerts you to suspicious email. http://windowslive. <http://windowslive.com/Explore/Hotmail?ocid=TXT_TAGLM_WL_hotmail_acq_safety _112008> com/Explore/Hotmail?ocid=TXT_TAGLM_WL_hotmail_acq_safety_112008 Quote Link to comment Share on other sites More sharing options...
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