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Health insurance is the last thing John Oberg wants to be dealing with during what may be the final months of his mother’s life, but he can’t seem to get a straight answer about why coverage for chemotherapy at her usual hospital suddenly stopped.
His mother, Karen Oberg, 59, had been receiving treatment for her terminal stage IV lung cancer at the University of Michigan Health System, but the night before her latest appointment on Jan. 20, John Oberg says he got some bad news: the insurance company called the hospital to say it would no longer pay for his mother’s care.
In-network/out-of-network - and Medicaid. Insurance companies sometimes will pay out-of-network providers - to a point - usually for emergency or if appropriate care can't be had at one of their in-network facilities.
Apparently, Total Health decided it had reached that "point" and treatment could now be done elsewhere - and probably for less. Pieces are missing in that story. It's not like she has NO coverage - she just doesn't have coverage at that facility any longer.
She was on Medicaid, which is state run. It was unfortunate her initial problem was misdiagnosed. Mine was too (and I wasn't on medicaid). My doctor told me I had sciatica and sent me on my merry way. (while my aggressive tumors continued to grow and morph into stage 4 for months.) Doctors, and hospitals screw up. When this lady was finally correctly diagnosed, proper treatment was started. It was nice that she got to go the hospital of her choice even though it wasn't supposed to be that way. But the reality of our tiered medical system is that opportunity for similar treatment, doctors and hospitals is not available for everyone.
Though I understand her desire to finish her treatment with the same hospital and doctors, it is not the end of the world if she has to move to another facility. When you are on Medicaid your options are limited. Everyone will undoubtedly have a different opinion of whether similar medical care should be available for all, or whether it should be divided in accordance with your station in life.
With our present situation, I would chose to look at the situation as seeing the glass half full. She was lucky to be able to go to a different hospital and find different doctors being on medicaid. And on another positive note, she has a very loving and caring son.
So..for 8 months she has been receiving converge outside of the terms of her plan and is considered terminal, but is still receiving chemo and now her insurance company wants her to go to someone in network for those treatments....I guess I am missing the issue here. If she wants to stay in-network, get a different insurance plan or go to another clinic for her chemo treatments???
Complaining about payment/availability of chemo for a terminal cancer patient reminds me of a different thread ( awhile back) where a woman said she would sue Hospice if they didn't do everything to revive their father who was on Hospice care.
Either them or I are confusing medical terminology.
why is money even spent/wasted paying for chemo for people with terminal cancer ?
Yup. My 79 y/o mother-in-law refused all treatments. She had pancreatic cancer with numerous tumors in stomach and pancreas. She'd been transporting many of her peers for cancer treatments over the years and always viewed their ordeals as pointless. She actually lived three months longer than the doctors expected and did pretty well up until the last month or so.
why is money even spent/wasted paying for chemo for people with terminal cancer ?
Just curious, I think that is one of the reasons health care. health insurance is so expensive.
Would you say the same thing if it was one of your loved ones? There have been many cases where people were considered terminal but still lived for many more years. Wouldn't you want your loved one to keep fighting if there was even the slightest bit of hope? The healthcare system needs to do whatever it takes to save someone even if it costs millions. Just think about all the tax money that is wasted every year on military expenses. If we put that towards healthcare, we'd be much better off.
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