kamataca Posted July 10, 2006 Share Posted July 10, 2006 Last Monday we found out that Mom's primary tumor is growing, and there are new tumors in her lungs. Tarceva has been a miracle for us for the past 17 months, but it is time to move on. Mom was initially ready to do the chemo (Gemzar), but we have hit a snag. My mom is a widow living alone, with Social Security as her only source of income. She has no drug insurance, which worked in her favor, as the company that produced Tarceva was providing it for her for free. Now she has realized that the lack of drug insurace with eat her alive with the chemo. Her Dr office is already working with the company who produces Gemzar, and I am very hopeful that they will work with her in some way, but each day that she puts off starting chemo she becomes more fatalistic. She cries easily, which is so unlike her. On the one hand, I am glad that she is expressing her emotion (she has always been very stoic to the world), but it just tears me up to see her like this. We keep telling her not to worry about it...that we can take care of her, but she isn't of a mind to go far into debt. I don't know how long it would take her to file for federal drug insurance, or even if she can still so that. Again, I think this will all work out, but the waiting is so hard. She was mentally prepared to start chemo, but her resolve is weakening, and she feels helpless. We are taking her out to lunch with some friends today, so she isn't sitting around all day waiting to hear from the Dr's office. Paperwork takes time--and they have been so good in helping us in this way so far. She was supposed to start the chemo today. I hope we hear something soon. Hopefully I will be posting soon that it is all OK, but I'm not very good at this patience thing. It is frustrating for all of us! If you could send your prayers out for this bump in the road, we'd sure appreciate it! Kelly Quote Link to comment Share on other sites More sharing options...
trish2418 Posted July 10, 2006 Share Posted July 10, 2006 Prayers going your way. Good luck with the bureaucrats. Trish Quote Link to comment Share on other sites More sharing options...
cindy0519 Posted July 10, 2006 Share Posted July 10, 2006 Kelly, If your mom is on SS -- isn't she also on Medicaid? If not maybe that is something to check into. Not sure if Medicaid covers Gemzar but I know it did cover (quite well actually) my Dad's chemo. Also wonder if there is a Gemzar trial that she might be able to get into? I know this was in trial when I looked at trials the beginning of the year for my Dad. Prayers for you and for Mom, waiting is NEVER easy! Cindy PS - LOVE the crowning picture of your Mom - just beautiful!! Quote Link to comment Share on other sites More sharing options...
Don M Posted July 10, 2006 Share Posted July 10, 2006 Kelly, your mom has my prayers. don M Quote Link to comment Share on other sites More sharing options...
Linda661 Posted July 10, 2006 Share Posted July 10, 2006 Kelly: Where's Medicare in all of this? With your mom's age and on SS, she should have Medicare benefits (and the premiums are probably automatically deducted from her SS) -- your mom would have had a choice whether she wanted only Medicare Part A (hospitalization, some therapy, limited skilled nursing facility care, and hospice) or also chose to have Medicare Part B (outpatient care and professional charges) as well. If Gemzar is an IV chemo administered in an office, it should be covered under Part B (at least taxol was...., tarceva is not since it is an oral med taken at home and needs prescription drug coverage). Part B pays 80% (if I remember right) of the charges and the patient is responsible for the rest, but that's 20% responsibility of the Medicare approved charges (which are lower than what offices try to bill). Ex: For a doctor office charge of $650 for each taxol/carbo treatment, my mom was responsible for $128. Doctor followups were between $10-$16 each; and things like Aranesp shots for anemia (billed at over $900 each), mom paid around $185.00. The figures hopefully will give you some idea of what to expect for expense burden to help your mom with this. My mom had private supplemental insurance to cover that Part B 20% responsibility -- there may be an option for reasonable supplemental insurance like that through some place like AARP (at least AARP or some other senior services organization ought to be able to point you in the right direction if it's a possibility). Shouldn't be too late to get Medicare Part D coverage (Rx drugs), but the last deadline for signup without paying a premium penalty was in May 2006, last I remember. Part D is handled by private insurance companies around the country -- I don't know all the details because my mom didn't need Part D coverage, but there is provision for income issues as I remember. Linda Quote Link to comment Share on other sites More sharing options...
Welthy Posted July 10, 2006 Share Posted July 10, 2006 So sorry to hear the beast is active again. Tony was on Medicare and Gemzar was paid. Hopefully this will be the case for your Mom. Keep us updated. Darn it!! Welthy Quote Link to comment Share on other sites More sharing options...
Don Wood Posted July 10, 2006 Share Posted July 10, 2006 Prayers for your mom. Quote Link to comment Share on other sites More sharing options...
hollyanne Posted July 10, 2006 Share Posted July 10, 2006 Linda took the words out of my mouth -- where is Medicare? My mom's primary insurance was Medicare, she also had secondary -- but the Medicare was absolutely amazing -- in her state it covered everything except for Avastin. Keep us posted. I am so sorry you have hit this bump..she has done so well for so long! Quote Link to comment Share on other sites More sharing options...
ztweb Posted July 10, 2006 Share Posted July 10, 2006 Oh Kelly, Honestly you seem quite patient to me. I am so sorry that this is happening. Stay strong girl! I am impressed! May God grant peace to you and your mom, renewed strength, and swift answers for unanswered questions. God bless! Jen Quote Link to comment Share on other sites More sharing options...
Treebywater Posted July 10, 2006 Share Posted July 10, 2006 Thinking of you both... Praying for the best. I'm sorry things are so tough right now, Kelly. Quote Link to comment Share on other sites More sharing options...
francesbean Posted July 11, 2006 Share Posted July 11, 2006 I'm sorry to hear about the setback, Kelly. Prayers that things will work out very soon. We are in a financial burden also. Love Frances Quote Link to comment Share on other sites More sharing options...
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