Medicare denies BMT for MDS?

[Loretta]

I'm posting this question for a lady from SC, whom I met at MD Anderson. She is being treated for MDS, and has been advised to have BMT (Bone Marrow or Periphereal Stem Cell Transplant) but Medicare denies the claim. They told her she had to wait until she progressed to AML. Has anyone else faced this problem?
Loretta

[Bill Britton]

Yes, Medicare also denied me a stem cell transplant for MDS. That is standard for them. Crazy isn't it, since many seniors will be diagnosed with MDS in the next 5 - 10 years. (I am 65) You are a "Spring Chicken" at 58. I was 56 when I had my first transplant at the Seattle Cancer Care Alliance in Seattle, unrelated donor, my diagnosis stage at transplant RAEBt - not too good. But until recently, just under 9 years disease free survival, doing OK. Now faced with possible 2nd MDS transplant.

My advice to you, which MD Anderson may already have accomplished is to undergo either a full transplant or a "mini" transplant -- assuming you can find a donor. This is your only hope of long term survival (I am not a doctor, but an expeirenced patient.)

Now that you are converted to AML Medicare should pay for the transplant.

If not already accomplished, do it now. MD Anderson is one of the 3 or 4 best transplant facilities in the country. You can not go wrong there.

My very best wishes to you and your family.

[ginabarrett]

Liam was on Title 19 and they denied the claim saying it wasn't standard treatment. There was no standard treatment though. We went through the appeals process and it was all eventually covered. Fight it!!!

Gina
www.caringbridge.org/visit/liamreinier