No Avastin coverage in Florida

[melindasue37]

Hi All,

I was hoping to get some information from all of you in Florida....or anyone else if you know anything about Medicare and Chemo.

As some of you know, my Mom is down in Florida for a few months.

She met with her doctor last week and was told that the Avastin she has been receiving is not covered while she is down in Florida.

My parents will need to pay for the cost (1800.00 each treatment) out of their pocket while in Florida. This just doesn't make sense to me. If it is covered here in Illinois, why wouldn't it be covered in Florida???

She did mention that the doctor might be able to reimburse them but they weren't real sure about the details yet.

Luckily they have the money to be able to do this. But, what about those that live down there that could maybe benefit from this new regimen. It just doesn't seem fair. Any information would be greatly appreciated.

Melinda

[Ann]

Melinda...I can try and get some information for you tommorrow about this. I have a friend who's the lead clinical nurse at MD Anderson in Orlando. I'll give her a call in the morning and then post. What part of Florida are your parents in?

[melindasue37]

Hi Ann,

My parents are in Moore Haven....she is getting treatments in Ft. Myers.

I really appreciate you offering to do this Ann.

Let me know what you find out.

Warm Hugs,

Melinda[/code]

[hollyanne]

We looked into Avastin in Utah -- and it is not covered by Medicare here either. The state administrator makes the decision as to which drugs are covered by Medicare. I know that in this state they are lobbying the admin to have it included as a traditional LC treatment, unfortunately it will be too late for my mom.

I thought that it was covered in Florida....I will search my old messages as I know someone on the board is getting it covered in Florida.....

Good luck.

[hollyanne]

Melinda -

Try asking KarHart (Karen) -- They got Medicare in Florida to pay for it for her husband Ken...here is what she told me a while ago...

"My husband is a patient at Moffitt Cancer Center in Tampa. We had to sign an agreement to pay for the Avastin ourselves before he could get it (at a reduced price). They then submitted it to Medicare so they could get the denial from them that is necessary before you can apply to the SPOC program. However, Medicare paid it. At first they thought it was an error on Medicare's part. However, when they brought it to Medicares attention they said they had just decided to pay for it for LC since studies had shown benefit."

I know you can look into SPOC as well if your mom has it with same chemo from the studies..

[melindasue37]

Holly,

Thank YOU!!!

I sent you a pm too.

I have a feeling this request for payment is something "fishy" with her doctor.

She didn't like him from the moment she met him.

Anyway.....thank you both for your help.

Warm Hugs,

Melinda