My Journey Begins, Cancer and Medicare, Maybe this will help some others one day
- Thread starter alarmguy
- Start date
Glad your dad is doing well. I am curious, did they stop the surgery because they ran into scar tissue?
I ask because I was told, there was a 20% chance, should I choose removal that once I was opened up they may have to stop and close because of scar tissue.
Yes, radiation is going to make me tired along with the drug I am taking is going to do a number on me for 6 months. I think the drug is going to be worse than the radiation, radiation 5 weeks, drug 6 months. Im all for it though, to beat this thing and glad I am getting the best that the current PROVEN technologies can offer me. It's a crappy cancer to have. No right or wrong way to treat it depending on each individual person and their doctors.
My personal thoughts are radiation in the 1990s was scary stuff only based on my own reading of not being well focused as today.
2000s it start to come under refinement, currently 2020's some see it better than prostate surgery due to its precision MRI/CT technology the impact on surrounding tissue is much less. BUT not gone. Of course, I was influenced by my doctors, actually a team, who each believed in what they do, surgeons and radiologists in MY PARTICULAR situation, none are exactly the same between different people. I have to admit that I am REALLY excited to get started.
Continued good wishes for him!
Im at a loss for words regarding your cancer, except I wish you well and glad to hear everything is coming up good on the scan and future scans.
I have to admit I am REALLY excited to get started, the meds came in on Jan 15th and started taking them. On Jan 23rd I have almost a full day, 1st meeting with a Medical Oncologist just for the sake of reviewing the medication I already started, 2nd meeting is my radiation oncologist (and maybe setting a schedule), 3rd will be mapping the area that radiation will be applied, 4th will be CT/MRI scan.
Wife coming with me, my day will start there at 8AM and hope to be done at 1Pm.
Last edited:
I wasn't there the day of the surgery, so I'm going off of what my mom told me. I know there was mention of more bleeding than the Dr expected, and also they had trouble keeping his blood pressure stable while under anesthesia. The third factor she said was something about the fat tissue being difficult to cut through, but now that I've read your comment, I'm wondering if she misunderstood, and it was actually scar tissue.
Thanks for your kind words and well wishes!
Thank you for your good wishes.
Im excited for Jan 23rd and hoping the weather doesnt cause them to cancel my appointments for the day. MRI Tech just called me to confirm, so far he has not heard any talk for cancelling appts.
It doesnt seem (at the moment) much snowfall but any amount may not be good. I dont know if they have salt trucks here. I only moved to this area in 2023. They didnt have them at our last home in SC.
The concern might be freezing rain and the trip is a one hour trip. We will see, so far it's a go and the good news is I am taking the drug which I have to take for weeks before radiation anyway. SO I am already being treated by the drug.
Are you near the coast in between the South Carolina border and Wilmington?
I would be relieved if you are!
Praying for you man, f*c# cancer. You seem well versed, and an active participant, in your plan of care. Those are important aspects of this process and being proactive, which you most certainly are, often aids in positive outcomes. My daughter had cancer at 17 months (she’s now almost 5). I can relate to the roller coaster ride from hell. Fight the good fight and pray.
How is your daughter doing?
Around a decade or two back my nephew, who is now married, and has children was a relatively young age I believe still in high school when he somehow developed Hodgkin’s lymphoma. I can certainly understand how affected one might be even more so when a young person is stricken with cancer.
I hope your daughter is doing well, that must be really rough. My nephew beat it and it’s been a long time now and still no return of the cancer.
I donated to St Jude’s Children's Hospital this year, I have in the past but I am going to make a habit of it every year at Christmas time.
For those that don’t know Saint Jude’s is a children’s cancer research hospital and they do not charge for treating children, maybe everyone, but at the very least for those that cannot pay.
Thank you very much for the kind words. Yes, a cancer diagnosis affects everyone in the “patients” life. It’s an awful disease that I am very glad to hear your nephew overcame. I hope, and pray, you overcome this as well. It’s great to know that your nephew is thriving as an adult, and parent, now. His kids may not be of age to realize how lucky they are to have “dad” in their life, but will one day cherish that. Cancer most definitely affects one’s outlook on life; both those diagnosed and their family/friends as well. Donating to St. Jude’s is fantastic and commendable. There are kids much less fortunate, in terms of health insurance and the financial means to obtain superior levels of care, that need this assistance. Thank you for your contribution. I didn’t elaborate regarding my daughter as I didn’t want to detract from your post; however, I did want to express my concern, offer my prayers, and note my ability to relate to your situation. Again, thank you for asking about her; she is doing well. She was diagnosed with stage E Retinoblastoma (the most advanced stage) at 17 months. My wife and I are both RN’s and thought we caught this early (thought she had a lazy eye initially and sought treatment for it). She had to have an enucleation (her right eye was removed) due to the severity of the cancer. Fortunately, she did not require chemo or radiation. She has undergone many exams under anesthesia and continues to be monitored to this day; now in the office since she is older. My wife and I are truly appreciative of the care that she receives at the Cleveland Clinic. But again, this isn’t about our journey this is about yours. And I genuinely hope that you persevere and beat this. Remain optimistic, pray often, and know that those around you are with you along the way.
Last edited:
@6.7 CTD
Thank you again for your good wishes. I still felt. I need to reply one last time and wish the best for you. Yes, a cancer diagnosis certainly changes your outlook on life.
Another reason that I had to respond is the Cleveland clinic. I know it well, but only from its publications, which I subscribed to typically that has to do with men’s health and cardiac health every month. I get one of those publications delivered to my home and ironically, one on the prostate
In addition, I got lucky enough here on the coast where I have a cardiologist who interned there. I don’t have any debilitating heart disease, but I do have some inherited yet. I stay proactive on that as well and my EF score is still at a perfect 60.
OK, sorry I’m rambling on, best wishes to you and God bless your daughter. It looks like maybe you caught this and she’s lucky to have the both of you for parents.
Thank you again for your good wishes. I still felt. I need to reply one last time and wish the best for you. Yes, a cancer diagnosis certainly changes your outlook on life.
Another reason that I had to respond is the Cleveland clinic. I know it well, but only from its publications, which I subscribed to typically that has to do with men’s health and cardiac health every month. I get one of those publications delivered to my home and ironically, one on the prostate
In addition, I got lucky enough here on the coast where I have a cardiologist who interned there. I don’t have any debilitating heart disease, but I do have some inherited yet. I stay proactive on that as well and my EF score is still at a perfect 60.
OK, sorry I’m rambling on, best wishes to you and God bless your daughter. It looks like maybe you caught this and she’s lucky to have the both of you for parents.
@bbhero
Well scratch that.
We got 4 inches (possibly 5 in some areas (snow) by Wed morning, cold temperatures too. Didnt get above 32 on Wed and well I got a call Wed during the day 3 of the 4 appts were canceled for today Thursday. Medical oncologist, Radiation oncologist and the radiation simulation (they put you on the table to configure the radiation machine for the future treatments)
Only appt left today is an MRI at noon. Medical oncologist is rescheduled for Friday afternoon. Waiting on the radiation sim and radiation oncologist to reschedule.
Sun was strong Wed but still cold, 7AM today Thursday it is 17 degrees here at the coast of NC. There really are no or very little trucks to treat the roads and nothing to clear parking lots except the sunlight. This weather is kind of extreme, relentless cold for the coast here.
Oh well...
Good news is, it's been a week now of taking the drug Orgovyx so nothing is being held up as the drug needs to be taken for a period of time before the radiation. I just hate when appointments have to be changed around for fear someone might mis a step because of it. *LOL* Not only that but this is almost an hour drive from me and originally it was wrapped up nice and tidy for a full morning and early afternoon event all on one day. Now it will be scattered all over... oh well.
(update, last call just came in, everything canceled for today)
Last edited:
- Joined
- Apr 22, 2016
- Messages
- 1,286
Unfortunately, Plan N is not an option with Guarantee Issue rights, it never has been. Someone or some people made mistakes along the way getting you enrolled in your supplement plan.
Because of MACRA if your Medicare coverage began before 2020 the plan F is only guarantee option and if your Medicare began in 2020 or after, plan G is the only guarantee option.
To obtain plan N it would need to be underwritten and with a recent cancer diagnosis it would be declined.
At the end of 2024, there were a lot of Advantage members that had this specific loss of coverage occur in many states and with a hand full of Insurance companies too.
Because of this, many insurance companies got backed up with an abnormal amount of guarantee issue applications. When this happens during the annual enrollment period some insurance companies will just auto approve applications without an underwriter overseeing anything. This is most likely why your plan N was approved.
I hope the insurance company does not find out during the two year incontestability period. They do have the right to rescind the policy, refund your premiums and deny any claim that has been paid.
Not trying to rain on your parade, just letting you know in case you start receiving mail from your insurance company in regards to this.
Good luck.
Because of MACRA if your Medicare coverage began before 2020 the plan F is only guarantee option and if your Medicare began in 2020 or after, plan G is the only guarantee option.
To obtain plan N it would need to be underwritten and with a recent cancer diagnosis it would be declined.
At the end of 2024, there were a lot of Advantage members that had this specific loss of coverage occur in many states and with a hand full of Insurance companies too.
Because of this, many insurance companies got backed up with an abnormal amount of guarantee issue applications. When this happens during the annual enrollment period some insurance companies will just auto approve applications without an underwriter overseeing anything. This is most likely why your plan N was approved.
I hope the insurance company does not find out during the two year incontestability period. They do have the right to rescind the policy, refund your premiums and deny any claim that has been paid.
Not trying to rain on your parade, just letting you know in case you start receiving mail from your insurance company in regards to this.
Good luck.
I was under the impression if your Medicare Advantage plan was terminated for your area, a person has the right to choose any plan regardless of preexisting conditions
Thank you, I need to look into this obviously I found what you are talking about.
This would be the question, and I will try to get in touch with an agent today. Since not too much has taken place this month but it’s about to next week and I might have to put it off.
My guaranteed issue right last until the end of February 2025
Will an agent be able to switch me into a plan G and will that plan G be effective starting January 1, 2025
I’m also questioning in regard to your statement regarding that two year. That protects policyholder and insurers.
I’m not quite sure that would pertain to this as it does not involve fraud.
With that said this information is helpful and I am going to look into it for sure. I do have a letter of acceptance stating continuation of coverage is the reason I have been accepted.
I seriously doubt an insurance company would be allowed to give somebody healthcare coverage, find out you were sick and then tell you that you can’t have the coverage once they find out that you are sick when they never asked any questions or looked into your claims history.
I appreciate the post because I have no problem going into plan G and at this point based on what you wrote, I would prefer too however I really need to speak to a very knowledgeable agent and fast.
More or less my thinking is they accepted me without underwriting. Also, when filling out the form I typed in Aetna Medicare advantage plan is not being offered for renewal 2025. Other than that, there were no health questions at all.
Thanks again for your post. I am definitely taking this serious because that’s who I am and we’ll seek to get it clarified because as it stands, I have to the end of February to go into a guaranteed acceptance plan.
Ps.
Come to think of it, guaranteed acceptance means just that. The company cant deny you unless it’s those two plans mentioned.
One of those is G, which is a great plan and about the same cost. So anyone with guaranteed acceptance clause has to be accepted into G, but that does not bar the company from excepting you into other plans.
If you’re accepted into another plan, to me it would make sense you have to be covered in that plan, it would be their fault for accepting somebody that they did not want to. Even more so, not looking into your history or asking any questions.
Meaning I applied for plan N and I was accepted because they accepted me.
I do appreciate this and it should be a warning for others to be careful because if I had to do it all over, I would’ve simply chose G, but I seriously doubt they could take away my plan N because they gave it to me to begin with.
You certainly made a great post and will be helpful to others in the future. Thank you.
I’ll look into it, but my key contention will be. I was already accepted and there was no fraud on my part involved. All I did was apply for a plan N
Letter of acceptance came in with the wording, something like “continuation of coverage”
@Pablo
Last edited:
Medicare Advantage plans are heavily advertised on early afternoon shows like Hot Bench, Steve Wilkos, Maury Povich, Karamo... should tell one all they need to know. People fall for the less important benefits they throw in...gym memberships, grocery allowances, Uber/Lyft reimbursement to appointments, OTC medicines, minimal dental and vision coverages, basically fluff.
When it comes to the serious claims...good luck.
I'm glad I squeaked under the wire for Plan F.
Plan G is your next best option.
