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#1
Wed Jun 3, 2015, 03:27 PM
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Medicare paying for a Stem Cell Transplant
Has anyone had Medicare pay for a stem cell transplant or had problems getting them to pay for one? I have an appointment later this month to talk to the transplant team and wonder if Medicare will pay for it.
Thanks Data
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Prostate Cancer: Treated in early 2013 with HDR Brachytherapy. MDS-RCMD: Oct 2014. Biopsies: 46,XY,t(7;18)[2]: 46,XY,del(7)( q22)[3]: 45,XY,-7[6]: 45,XY,-7[10]: 45,XY,-7[13]. HSCT in April 2016. 
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#2
Wed Jun 3, 2015, 08:34 PM
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I went in Jan 1, 2015, for my SCT. I ended up costing me about $800 which was mostly my $40 copays to the doc who made the daily rounds. Seems like all fees I paid were the ones thru my Advantage plan (doc visits) and never saw a bill for Medicare.
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John, 68, Portland, Or. Dx with CMML on 12/1/2013, 3 days before admission for SCT, blasts went to 23%, AML. Did 7+3 chemo regimen. The chemo worked and blasts are 1% and did BMT on 1/1/15.- 12/2/15, ongoing GVHD in eyes. Lung fungus and Bronchiolitis Obliterans (BO).
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#3
Wed Jun 3, 2015, 09:27 PM
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Medicare pays for SCT if you were on an approved clinical trial. My provider was denied twice and approved on the third appeal. I was on an approved clinical study. Medicare and supplement paid the entire amount.
See http://www.cms.gov/medicare-coverage...=ACAAAAAAIAAA& or google does Medicare pay for stem cell transplants Ray
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#4
Thu Jun 4, 2015, 05:24 PM
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Thanks Ray and John,
At this point they are just talking about it. Hopefully I wont make it to the point I need a SCT.
__________________
Prostate Cancer: Treated in early 2013 with HDR Brachytherapy. MDS-RCMD: Oct 2014. Biopsies: 46,XY,t(7;18)[2]: 46,XY,del(7)( q22)[3]: 45,XY,-7[6]: 45,XY,-7[10]: 45,XY,-7[13]. HSCT in April 2016.
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