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Got approved for two shots after going on Medicare

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Well I got my two shots like I have gotten for the last four years.  Northwestern said they had been approved.   I am still a little bit suspicious, but at least if they try to collect the eight grand from us for the second shot we were told by northwestern that they are approved for the next seven shots.  I think that is our supplemental insurance where cigna which had been our primary approved the shots out through July, and they are our supplemental carrier with Medicare, but we have been told repeatedly Medicare has not in the past paid for the second shots of sandostatin.   So my next shots are at the end of January and we will see if they put a hold on the second shot because Medicare said no.

We saw the MRI as I am now asking for a disc after every imaging, and I very distinctly have a tumor on the spine near the tailbone where I have been experiencing pain, and where my last cat scan which was an ocreotide scan showed metastasis in the collarbone, ribs, and two in the vertebra.   I will wait to see what the doc wants to do, but the pain levels are increasing as I have not played poker at home for two months and just briefly in Metropolis and the dog track in Pensacola......sitting at tables playing has just become too uncomfortable.....still waiting to hear on the American PRRT trial which I should know more in January, but hell I appear to have lived to 2017 which three years ago I would have given you 10-1 odds that would not happen....all is good and the journey continues.

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Glad the shots were approved.

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Thanks for the update. May there be no screw-ups on the shot approvals. Fingers crossed for the continuation of second shots as needed, and for the PRRT trials. Congrats on reaching 2017, and all the best going forward from there. Just sorry you're having to experience pain along the way.

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Just sorry you're having to experience pain along the way.


Nothing that is that horrible right now. Actually, I would say discomfort when I twist, or sit for a long time. I am able to find comfort in the lazy boy, so many cancer patients have no reprieve. I have comfort positions right now, but do understand what is coming.

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Congrats Mr. Oats on continuing the fight for survival and keeping a positive attitude . . . . I ask myself if I could live up to your example and I seriously consider to wonder . . . . . hard to say but you have set the bar high!

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Again Endocrine Cancer is slow.  Last February when I had my first lung tumor debulking, when they radiated those tumors, they spilled radiation on my tongue and I lost my sense of taste, and my tongue felt like it had been burned for about three months.  Slowly, I got my taste back, and the second debulking of the lung tumors in October, only resulted in sores on the tongue, no loss of taste.  Our annual Christmas party among former golf buddies, one friend has a grapefruit size benign tumor on his brain which they cannot operate on because of its size and have been radiating the tumor in hope it will shrink and they can operate and remove the same.  He had lost about twenty pounds, and I can remember about twenty of us went on the Adkins diet in the late 1990s and he has lost more weight now because of a benign tumor and the loss of taste where he simply hardly eats now.   He was miserable from his treatments and had great discomfort in his neck.   For the last three years he has worried about my health......and so I am struggling, but see daily too many examples of folks just getting screwed with their health that one cannot help being positive because I have been blessed with relative quality of life which still makes every day enjoyable and a new challenge.  I have reported these challenges since the days of the PNJ hoping others can learn, but I simply never thought I would see medicare, and in fact the two shot challenge of Medicare coverage often made my wife and I laugh about as a pipe dream problem......well how can you not remain positive when you have been blessed with three years of quality life which certainly the historic stats of this disease said was highly improbable?

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2seaoat wrote:Again Endocrine Cancer is slow.  Last February when I had my first lung tumor debulking, when they radiated those tumors, they spilled radiation on my tongue and I lost my sense of taste, and my tongue felt like it had been burned for about three months.  Slowly, I got my taste back, and the second debulking of the lung tumors in October, only resulted in sores on the tongue, no loss of taste.  Our annual Christmas party among former golf buddies, one friend has a grapefruit size benign tumor on his brain which they cannot operate on because of its size and have been radiating the tumor in hope it will shrink and they can operate and remove the same.  He had lost about twenty pounds, and I can remember about twenty of us went on the Adkins diet in the late 1990s and he has lost more weight now because of a benign tumor and the loss of taste where he simply hardly eats now.   He was miserable from his treatments and had great discomfort in his neck.   For the last three years he has worried about my health......and so I am struggling, but see daily too many examples of folks just getting screwed with their health that one cannot help being positive because I have been blessed with relative quality of life which still makes every day enjoyable and a new challenge.  I have reported these challenges since the days of the PNJ hoping others can learn, but I simply never thought I would see medicare, and in fact the two shot challenge of Medicare coverage often made my wife and I laugh about as a pipe dream problem......well how can you not remain positive when you have been blessed with three years of quality life which certainly the historic stats of this disease said was highly improbable?

We are all proud for you and of you . . .

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knothead wrote:We are all proud for you and of you . . .

cheerscheerscheerscheerscheerscheerscheerscheerscheerscheerscheerscheerscheerscheerscheers

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I agree!

cheers cheers cheers cheers cheers cheers cheers cheers cheers

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Glad to hear the shots are approved. Hopefully the trials too! Take care and live life to its fullest this year.

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SheWrites wrote:Glad to hear the shots are approved.  Hopefully the trials too!  Take care and live life to its fullest this year.  

Somehow I think "living life to its fullest" is something Sea could teach us, not the other way around.  
Smile   Smile   Smile

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Glad to hear it Oatie. Bob went so fast it was unbelievable.

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Well I got my two shots like I have gotten for the last four years. Northwestern said they had been approved. I am still a little bit suspicious, but at least if they try to collect the eight grand from us for the second shot we were told by northwestern that they are approved for the next seven shots. I think that is our supplemental insurance where cigna which had been our primary approved the shots out through July, and they are our supplemental carrier with Medicare,

Congrats if it's true. Cigna may have approved them under your group insurance. If you came off group went on a cigna supplement it is a whole new ball game. Medicare became your primary and without their approval your supplement will not pick up their part. Always remember if Medicare approves the supplement will pick up their part. If Medicare does not approve the supplement will not pay.

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I was just reading the insurance forums and forgot all about something the congress has been pushing for past few months and have a good chance of pushing it through early 2017. They are trying to get rid of anything deemed an infusion therapy (which might be sandostatin shots) from being covered under Part B of Medicare and throwing it back to be covered under Part D prescription drugs, which would greatly increase your out of pocket costs but would also get to your catastrophic coverage under Part D in a couple of months then reducing it to more manageable level's.

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Congress may say they will leave Medicare alone except for future generation's but are doing everything they can to dismantle coverage one at a time for the current group on Medicare.

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ppaca wrote:Congress may say they will leave Medicare alone except for future generation's but are doing everything they can to dismantle coverage one at a time for the current group on Medicare.

How depressing and worrisome.

Thanks for the info, ppaca.

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RealLindaL wrote:
ppaca wrote:Congress may say they will leave Medicare alone except for future generation's but are doing everything they can to dismantle coverage one at a time for the current group on Medicare.

How depressing and worrisome.  

Thanks for the info, ppaca.


It's no wonder Americans prefer cockroaches over Congress.

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