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Curious ...Can just anybody see a specialist? Curious ...Can just anybody see a specialist?

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Unread 01-25-2007, 06:06 PM
Curious ...Can just anybody see a specialist?

Luckily right now I don't need one, but, I was wondering how does a person go about booking an appointment with a higher end institution like Sloane or Anderson or UCLA/USC or Cancer Centers of America? Lets take for example the average person without any health insurance, and little if any money in savings. How does this person become eligible, in a timely manner, to be seen and evaluated by cutting edge doctors/boards at these centers? How does this person afford to travel to these hospital destinations? Are there financial aid or grant programs for this, or does further diagnosis and treatment come strictly out of the patients pocket? What if the patient has no access to funding, or even if they do, how can they keep from getting completely wiped out financially and then have to live on the street?

Dunno... I think maybe I am not the only one who thinks about this stuff? Any suggestions, please do chime in. Personally, thus far I have been lucky with the onc/gyn care I have received at the county level, after I finally got into the system, but what will I (and others like me) do if this source dries up or if I would ever need further treatment. Thanks in advance!!!
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Unread 01-25-2007, 10:01 PM
Curious ...Can just anybody see a specialist?

Dear Folky,

My insurance paid 50% for my visit to Sloan Kettering, and that got me in the door. Actually, they never did send me a bill for the balance! They told me then not to worry about the money, so maybe that's what they meant.

We called them on the phone and they made setting up the appointment very easy. Luckily we have family in Manhattan, so we didn't have to pay for a hotel. I know they can make hotel arrangements for you, too, in places that give discounts for SK patients.

Sadly, I do not know what the deal would be for the uninsured -- that must be very rough on you. Our great country is no place to get sick.

I hope you'll now have a clean bill of health forever and you won't need any of this advice!
Unread 01-26-2007, 03:24 PM
Curious ...Can just anybody see a specialist?

Folky: You could go to there website and contact them about a second opinion, or review of your case. If you are treated there, they do charge for the services since many insurances do not cover their services, while others only pay a portion. My insurance only covered about 80% of the hospital bill and my doctor's bills, my doctor ignores the balance of the amount over that which she gets, the hospital worked with me to pay the balance off over a two year period. They are very responsive and I am sure some of the social workers can speak to you about financial arrangements. I hope that you continue in good health. Good Luck.
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Unread 01-26-2007, 09:14 PM
Curious ...Can just anybody see a specialist?

The US is the BEST place in the world to get sick. We have the highest cancer cure rates of any country in the world, despite having so many immigrants who often come here ill. Everyone gets treatment, the only question is who pays, the insurance companies or the government.

If you want to compare various kinds of cancer, the rates of incidents, and the cure rates around the world, you can find all of that here: Some of the stats are rather shocking, rather amazing how much better the US cures cancer than anyplace else. I am SOOOOO thankful to live here and to have been cured of cancer. My odds would not have been as good, anywhere else in the world.

If you want an appointment at those cancer facilities, call and ask them how to arrange it. There are so many charities that help out patients and Medicaid will cover the costs of treatment if you are too poor to afford insurance and/or treatment.

Best of luck to you,

Best to you,
Unread 01-26-2007, 10:06 PM
Curious ...Can just anybody see a specialist?

Thanks all. Again, luckily right now I personally am not in need of further treatment or second opinions, but I was curious about this. I hope these great answers might be able to help somebody else who may be asking these same questions.

Problem with medicaid, medi-cal is that the average uninsured single person between the ages of 21ish and 64, who doesn't qualify for disability, can fall between the cracks! "Able bodied" mid-agers either have insurance because they pay thru the nose for it, or have it because of a spouse, or from a work benefit, or are on a insurance program because they have dependent children. But many don't, and just can't afford the medical bills, let alone the insurance.

I qualified for medical help at the county level based on my income. I did not qualify for any other financial assistance because I was not "disabled" for 12 months. It only took one month after surgery for my little savings account to get wiped out completely. The crazy thing is that to continue with my followups I can not earn any money to get me out of this mess. I also need hundreds of dollars of necessary dental work, and if I earn enough in a month and deposit that in a bank account to pay for the dental work it is considered by the county to be a luxury, and my sliding scale medical payment goes up because dental is not deductible. (Same with groceries, prescriptions, old business debt. When you pay these bills it is also added as income if it ends up in your checking account, not deductible, so it is like paying your debts double... is there something very wrong with this picture?) Anything over $500/month is luxury, even if your bills amount to double that. It's twisted.

Sorry about the ramble above. I don't think I even explained it correctly. But, my point/question still being is how can an average uninsured person (or someone with insurance and a sizable co-pay) can get in to see a specialist at one of the great research centers? Thanks for all the answers and suggestions!
Unread 01-28-2007, 08:54 AM
Curious ...Can just anybody see a specialist?

Dear Folky,
The ounce of prevention you seek now will prevent a pound of worry should you need it latter. I suppose this is your way of arranging your "insurance" policy. I think that it is a good idea to do this research now. No need painting yourself into a corner having to make decisions when you may be scared, tired or out of time.

I hate that I do not have a specific answer for you..but here is what I would suggest. I went to MD Anderson for treatment. While I was not in your position, when I was on their website arranging my visit, I did see links and FAQ's regarding payment issues and programs. There are also case managers whose full time job is to take patients and prospective patients through the process of setting up appointments and talking logistics; IE. transportation, lodging & fees. I suggest you research a couple. I would encourage you to find out what the best cancer center in your state is and go through the same process there.

My guess is that you will not get a clear cut answer for your situation because getting "money" isn't easy. The path is convoluted and murky; I guess they make the "tweeners" (not really poor, just us working middle class with NO wiggle room for a catastrophe) have to work really hard to find the answers. Good luck with your research, I think finding your answers now is a smart move!

Here's Hoping You'll Never Need The Answers,
Unread 01-28-2007, 11:26 AM
Curious ...Can just anybody see a specialist?

Dear Folky,

You mentioned wondering about the top cancer hospitals in California. According to the NCCN, there are three.

From their website:
"The National Comprehensive Cancer Network (NCCN), a not-for-profit alliance of 20 of the world’s leading cancer centers, is dedicated to improving the quality and effectiveness of care provided to patients with cancer."

The three members of this group that are in California are UCSF CCC (comprehensive cancer center), Stanford CCC, and the City of Hope Cancer Center in LA. You might want to check in advance with all three to see what kind of financial arrangements they can make.
Unread 01-28-2007, 01:00 PM
Curious ...Can just anybody see a specialist?

Thanks Again for all the good info... I will store it away. And yes, hopefully I will not need it. Sorry, but I still have my worries even though I was given an "all clear" so far. I still have various aches and pains all over my body even though I am trying to keep bad thoughts out of my head!

I have to have a mysterious mouth/gum sore looked at further ...Yes, I have put it off for months because of the money issue, and the dentists in my town don't deal with oral surgery. I guess the same situation applies at these medical centers if I end up having to need further procedures... at least this is motivation to try to do something whether I can afford it or not. My county facility doesn't refer out for any dentistry other than extractions.

I was just lucky to have caught my uterine cancer when I did. I am hypothyroid and I was originally was getting medical help (mainly for my thyroid tests and women's check ups) from a nurse practitioner who travels in a mobile RV unit. They park the "van" in different spots here in California's high desert. I mentioned some of my female discomforts to her and she said it was because I was headed into menopause, getting older, and because I am overweight. I did get a referral to a county endocrinologist for my thyroid because of how I was feeling. I was then denied an appointment with the county (basically because my complaints were too vague). But, they told me if I get an appointment with a county GP they can try to refer me again. That's when I (me the vague complainer) went and I was handed appointment cards for the county psychiatrist. This county GP also told me I was fat, getting older, and that my stress incontinence (from pressure on my bladder) was a behavioral problem!

Basically, this resident student GP rolled her eyes back in her head and asked if I wanted a PAP ...and after that came back abnormal (which was probably one that fell in 20% false reading) and finally an ultrasound that showed some "small" fibroids, I was referred to the gynecological clinic. I don't remember how long it took to get to this point, but it was 6 months from the bad PAP before I could get my first gyn appt last February, a year ago. After my biopsy in March and D & C in April, it then all moved very fast after that! (BUT, 3 years later I have still never been able to get that original referral to the county endocrinologist!)

So yeah, I would like to have my ducks all in a row next time, if ever need be! I hope the wonderful information supplied here can also be of help to other sisters as well! Thanks bunches!
Unread 01-28-2007, 01:44 PM
Curious ...Can just anybody see a specialist?

I am NOT an expert on dental issues; but if you are a smoker, you should press a doctor if you can't get a dentist to look at that mouth sore. Cancer prevention guidelines ask that we look into "any unusual sore that will not heal." It sounds like you have had this thing in your mouth for a while. I had a friend whose son developed mouth CA and it started as a sore under his tongue that would not heal. (They believe his was caused by chewing tobacco) There are probably many things that this could be and maybe you even have a hint as what it might be.

Don't mean to stick my nose in, especially with your insurance woes. I suppose all you need is one more person telling you what you already need to see a doc.
Unread 01-28-2007, 09:15 PM
Curious ...Can just anybody see a specialist?

Thanks Beachball! I really do need a kick in the butt! Different dentists have told me to see an oral surgeon. My latest dentist said it looks like a callus on my gum. It does not show up on the x-rays. It's where a tooth once was... had it pulled out like about 15 years ago. It's not bleeding, just keeps getting banged. The last few days it has started to get bigger I have noticed. (In the last two weeks I have also had a wisdom tooth pulled and an epoxy build up to fill in about 1/3 of a missing tooth. Going back this week to have something else fixed too. I just need to get my mouth taken care of... enough already!)

My county low income coverage won't help me with any dental problems, other than extraction. Any money I might earn and put into the bank towards taking care of this will be added "luxury" income as far as the county is concerned. I have a freelance job right now that will take a few weeks, and I am hoping to pay for my mouth work and other immediate bills with this. But, anything that I deposit in the bank won't be deductible towards the dental work, so I will be out that amount for the dental work rendered plus I will have to pay that much more for my gyn followup appointments, based on my sliding scale. That money will already be spent. I am evaluated month to month because I am self employed and I will be responsible for a co-pay at my doctor's appointment that I just do not have! It has happened before... I have walked away from the clinic's reception desk because I didn't have $100 in my pocket to be seen. (My 83 year old dad can help me, but you must know that for a lot of reasons I hate to ask. Plus, that would still be added income if he lends it to me, and I am still in this same situation.)

Sorry about the ramble. This is just part, my part, of this story. Thanks again!

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