TLDR: Title
My Mom has severe treatment-resistant Crohns Disease that has disabled her in recent years. One of the only remaining promising treatments is a study that uses Stem Cell transplants. After she left work on disability, my brother an I began splitting something like $1100/mo on COBRA to keep her insurance so we could continue fighting to get this procedure approved. We spent literally a year through the appeals process and failed.
We then switched insurers and started all over again. With the help of the doctors running the study, we managed to get insurance to FINALLY approve it in December. The only issue is that in order to be admitted to the study, she needs to show active inflammation from Crohns, which means we basically have to wait for her to get hospitalized with a flare up that is bad enough to detect. Her first hospitalization on Christmas didn’t pan out, and she’s in again now and we’re waiting results.
The complication is that my mother is set to finalize her enrollment in Medicare in March. From what I understand from the doctors, it’s nearly impossible to get Medicare to approve this study. Also from what I’ve read, we cannot unenroll her in Medicare without her also losing her social security, which is now her only source of income.
What….do I do? I know almost nothing about the machinations of insurance, medicare, etc. My mother has for the most part managed all of her own healthcare, but she’s mentally unreliable when hospitalized.
submitted by /u/momslosinginsurance
[link] [comments]TLDR: Title My Mom has severe treatment-resistant Crohns Disease that has disabled her in recent years. One of the only remaining promising treatments is a study that uses Stem Cell transplants. After she left work on disability, my brother an I began splitting something like $1100/mo on COBRA to keep her insurance so we could continue fighting to get this procedure approved. We spent literally a year through the appeals process and failed. We then switched insurers and started all over again. With the help of the doctors running the study, we managed to get insurance to FINALLY approve it in December. The only issue is that in order to be admitted to the study, she needs to show active inflammation from Crohns, which means we basically have to wait for her to get hospitalized with a flare up that is bad enough to detect. Her first hospitalization on Christmas didn’t pan out, and she’s in again now and we’re waiting results. The complication is that my mother is set to finalize her enrollment in Medicare in March. From what I understand from the doctors, it’s nearly impossible to get Medicare to approve this study. Also from what I’ve read, we cannot unenroll her in Medicare without her also losing her social security, which is now her only source of income. What….do I do? I know almost nothing about the machinations of insurance, medicare, etc. My mother has for the most part managed all of her own healthcare, but she’s mentally unreliable when hospitalized. submitted by /u/momslosinginsurance [link] [comments]Read Morer/HealthInsurance