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I am totally confused


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I started a clinical study of Taxotere and Carboplatin in July.I have had two treatments,one every 3 weeks.Another is scheduled this Friday.

I just recieved an explanation of benefits from Anthem Bc/Bs saying the charges for my first chemo treatment was denied.I haggled with them over the reason it was denied.(Technicalities over billing because I live on the state line and get services from two different states.My PCP is in New Hampshire,I am receiving treatment in Maine).

I guess I was naive thinking that the treatment under a clinical study wouldn't be billed to insurance,(or to me).I thought the costs of a clinical study was covered by the hospital?

The business office where I am being treated didin't even know I was in a clinical study.The study was being underwritten by Dartmouth/Hitchcock hospital in New Hampshire,or so I thought.Now I am scared.My insurance ran out on July 31.I haven't been able to work since the last week in June.

I have applied for SSDI,but we know how slow that is,and it won't cover the treatment.

I am in deep trouble here if I am responsible for the $5,600 for EACH Chemo treatment.There is no way I'll be able to pay for even a portion of it.I already owe $600 for Dr. bills that the HMO didn't cover,when I was insured,that I can't pay.My wife works between 32-40 hrs a week(depending on orders).She earns a minimum wage.We are barely surviving to say the least.She couldn't afford to put me on her insurance,because the premium would've taken too big a chunk of her paycheck.(We do need to eat).

I went for a CT scan last Friday and won't know the results until this coming Friday at my next chemo appt.I am nervous enough about that,and now this.Can they throw me out of the treatment ,and just leave me to die,if I can't afford it? Or will they just take our house and everything we have?

Aren't clinical trials usually covered by the hospital that is involved?

Help! I feel like I have enough to worry about without having to worry about paying for treatment,too.It isn't helping to keep a positive outlook.

Any info.would be appreciated.

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Guest Michael

I'm also confused. We just donated $15 Billion to fight AIDS in Africa which is money down the drain and Billions each month in Iraq another waste plus Billions to keep troops in South Korea and Germany and the list goes on and on. You have every reason to be confused and angry. I know that this is not the response you're looking for but I have to VENT. It's time we took care of our own FIRST. You should not have to be going through what you're going through and have to be concerned about losing your home. I'm truly getting a bit disgusted with this country and its priorities. I'm not attempting to place politics on this Board but feel that Americans with serious illnesses should be our priority and not Africans, Iraqi's, Koreans, etc. Imagine what all these wasted billions could do for our own people especially Americans fighting cancer. I had to get this off my chest.

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My mom's HMO does not currently have LC trials going on right now, so I'm possibly having my mom enter into a clinical trial at another medical group. I was repeatedly told by my mom's HMO that they wouldn't pay for clinical trials outside of their group. I did some research on Cancer.gov and discovered that a bill was passed in California stating that they are in fact required to pay clinical trials. I made a copy of the bill (Senate Bill 37) and my uncle talked to the Senator that drafted the approved Bill and he reiterated that my mom's HMO has to pay for the clinical trial since they are unable to offer any clinical trials within their group. Well I wrote a letter to the doctor and sent a copy of the letter to the California Department of Managed Health Care. Now the doctor says she is going to write a letter of referral for the trial and going to have it submitted.

Maybe Cancer.gov will have some information on legalities in Maine.

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