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Thread: Breast Reconstruction Funding

  1. #1

    Breast Reconstruction Funding

    In 20 days I will have my 3 year mastectomy anniversary.

    In one way, it's a good anniversary because I'm still alive.

    In another way, it TOTALLY sucks because I didn't have insurance, and therefore wasn't able to have reconstruction surgery.

    I'm still making payments on the 2 surgeries I had in 2005 so money is an issue; but LET'S FACE IT.... who the heck would have $25K sitting in the bank to pay for the surgery I need even if my financial status wasn't so dire???

    My cancer was my wake-up-call to finally divorce my "spouse" (sorry, but the word "husband" doesn't apply because he's totally screwed me over for money & I've been in the middle of a nasty divorce for just under 3 years) - another good thing, the getting rid of him part....

    My point there is that besides the cash-flow problems that come with cancer, the divorce is another major factor. I'm glad to be rid of him, but I sure miss my money - not that it was much... lol...

    Everywhere I call tells me that since I'm under 65 and don't have kids that I can't get any help.....

    In this land of plenty called America, I found only one organization that helps with reconstruction, and it's called My Hope Chest. They have a website & I applied for help, and am on the waiting list.

    It's a GREAT foundation & God bless the founder for starting it. She had the same problem years ago, but thank goodness she was able to have her surgery after she went back to work & regained health insurance benefits.

    Unfortunately, the organization needs lots of help itself to enable it to fund surgeries, and for whatever reason.... people just aren't aware of the tremendous need. I spoke with the founder & she told me there are THOUSANDS of women in the same boat.

    Does anyone have any ideas they can share with me???

    My faith is EXCELLENT because God is good AND THEN SOME... but it sure would be nice to hear something positive... like that someone on here knows Oprah & will get the word to her to help My Hope Chest and/or instruct her accountant to set aside a fund for reconstruction.... Or at least feature them on a show during her Breast Cancer Awareness week of shows in October.....

    Anyway...... that's my story, and I've put it out there in hopes of SOMEONE SOMEWHERE having some ideas to help me & the thousands of other gals out there in need of a boob or 2........

    Thanks for being on this board! We all need to help each other out because cancer is one evil bugger that needs to be defeated!!!

  2. #2
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    funding for Breast reconstruction surgery

    You have two options.

    If you already have medical insurance, it doesn't matter how long after the original mastectomy, the insurance company is required by law to pay for the reconstruction surgery.
    More specific and detailed information about this law and variations by different states is available at this link.
    http://messageboards.makemeheal.com/...867c3c34482d51

    If you do not have medical insurance, then Option 2 is for you to apply for the Free Medical Assistance Program for Breast & Cervical Cancer.
    The same requirement applies here, once you have this Medical Assistance coverage, by law, they must pay for the reconstructive surgery regardless of how long it's been since you've had your mastectomy. This is NOT considered to be a purely cosmetic procedure. Instead, it's considered to be a medically necessary procedure after a mastectomy.

    Here is a general link that explains the Medical Assistance Program for Breast & Cervical Cancer.
    http://www.coverageforall.org/pdf/FH...vertyLevel.pdf

    If you respond to my email and let me know which state you reside in, I can get you detailed and specific information of the eligibility requirements and application process for that state. After working for 29 & 1/2 years for Public Welfare, I know how to search through government websites for information and applications.


    Barbara K.

  3. #3
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    I posted the wrong link in my previous message.
    That link was the link to the Federal Poverty Income limits charts.

    The correct link where it describes the Breast & Cervical Cancer Prevention & Treatment Act of 2000 is here.

    http://www.cdc.gov/cancer/nbccedp/le...law106-354.htm

    My apologies for putting the wrong link in the previous message.

    Barbara K.

  4. #4
    Hi Barbara,

    THANKS SO MUCH for your reply & the information!!!

    OMG, U JUST MADE MY DAY!!!

    I like to think that I'm somewhat informed; but people don't tell u the truth sometimes when u look for help... for whatever reason....

    I live in Florida.

    I just said to my BF on the phone earlier today that the Office Manager where I worked for about 6 months in 2006, who administered the health plan told me I couldn't get surgery thru the plan, and that I would make the rates go up & the owner wouldn't be too happy about that. I lost my job a few months later, and I've had occasion to wonder if my health concerns were why..... I was told that my job was being "phased out", but I know that was a lie because they hired more people after I left.

    And I told my friend I was thinking of contacting an attorney now that I'm well past the trauma that came with a mastectomy in 6/05, initiating a divorce in 11/05, and then getting fired in 6/06....

    Helluva year, ya know???

    Your message today was definitely sent down thru the cosmos because I've been thinking on this lately, and just today verbalized it.....

    Whatever info you've got, I'd love to know.

    Again, THANK YOU!!!!!!!!!!!!!!!

  5. #5
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    Tori;

    For Florida, the best place for you to start is at the following link.
    http://www.doh.state.fl.us/Family/bcc/default.html

    The white paper report about this program is available in pdf format using this link.
    www.floridasac.org/documents/report_bccc.doc

    Another good link is here at this url
    http://www.ahirc.org/cat_list.cfm?cat=198&st=FL


    The eligibility requirements in Florida for uninsured women is age 50 to 65 and the income limit is 200% of the Federal Poverty Income Guideline.
    http://ahca.myflorida.com/Medicaid/m...nes_083104.pdf

    Barbara K.

  6. #6
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    Hi Tori:

    It's Barbara again.

    I reread the documents again and realized I gave you incorrect information.

    The eligibility for the free screenings at the first link
    http://www.doh.state.fl.us/Family/bcc/default.html
    puts an age limit of women aged 50 to 65.

    The eligibility for the Medicaid program as listed in the pdf document states that this program is available for women under age 65 (any age, as long as it's less than 65) and 200 % of the Federal Poverty Income Guidelines.

    http://ahca.myflorida.com/Medicaid/m...nes_083104.pdf

    My apologies for the error in my previous message.

    Barbara K.

  7. #7
    Hi Barbara,

    Thanks again! I'm checking all the links to see what applies to me & looked at the links you'd posted previously.

    I am 43 & had my mastectomy at age 40 when I was uninsured.

    Would you know if I should have been covered thru my work health plan that I mentioned in my earlier post?

    Like I said, I thought about it this past week or so & then just mentioned it to my friend about the whole intimidation factor at my job so I didn't pursue it further 'cause I'd hoped to stay employed.

    Thank you so much.

  8. #8
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    You should have been covered under your work insurance while you were still employed there.
    However, once you lost the job, then you also lost that coverage. There's no legal way you can force your previous insurance to pay for breast reconstruction surgery now.

    Barbara K.

  9. #9
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    Hi Barbara K. I live in Kentucky and I just signed up on this site today and read your information you put out about help with paying for reconstructive surgery after mastectomy and isurance payment for that as well,Im 48 years old and I was just diagnosed with breast cancer and will be having my Mastectomy this September the 17th, 2011, I read what you said about breast reconstruction surgery financil help, could you please send me the information, I have insurance but not sure if they will pay for it. Im totally disabled and on Passport Advantage HMO, If you could let me know if they pay for the Reconstruction surgery or is there some other help. Im on a very limited income and have heart disease and Diabeties now breast Cancer as well, I want reconstructive surgery but cant afford it. Please help me get the information i need I live in Radcliff KY. Please can you get the detailed eligability information for kentucky if you dont mind. Im just worried about my finances, email address (Please contact via private message on these forums) if you would like you can send the information to my email address Thank You Sherry E.
    Last edited by pbj11; 09-04-2011 at 11:35 PM. Reason: left out information about self

  10. #10
    Administrator Top User pbj11's Avatar
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    Sherry,

    Call your insurance carrier. They'll be more than happy to explain your options. I believe it is required that reconstruction surgery is covered.

    This is an old thread, so I don't know that many will see it.

    I'm sorry about what you'll be facing, but keep the faith.

    God bless,
    PBJ
    Husband diagnosed with NSCLC Stage IV in 3/2005. Fought & lived over 2 1/2 years with multiple lines of treatment.

    Post describing our journey: http://cancerforums.net/viewtopic.ph...er=asc&start=0

    Left my embrace to live with our Heavenly Father in October of 2007 and now breathes with ease forever. I will miss this gentle, giving soul with the easy smile for the rest of my days, but have faith we will be together again. He's just getting a little break from me!

  11. #11
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    pbj11 Thank you very much for the information I was worried about it because I have my Mastectomy this Saturday the 17th. God Bless Sherry

  12. #12
    Administrator Top User pbj11's Avatar
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    Oh Sherry! I missed your post and you're likely done with your surgery by now. I ask God for good outcomes and quick healing for you.

    Let us know how things went when you are able.

    God bless,
    PBJ
    Husband diagnosed with NSCLC Stage IV in 3/2005. Fought & lived over 2 1/2 years with multiple lines of treatment.

    Post describing our journey: http://cancerforums.net/viewtopic.ph...er=asc&start=0

    Left my embrace to live with our Heavenly Father in October of 2007 and now breathes with ease forever. I will miss this gentle, giving soul with the easy smile for the rest of my days, but have faith we will be together again. He's just getting a little break from me!

  13. #13
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    Hi

    I have a question, I had surgery a couple years ago at age 37 for early stage breast cancer. Almost exactly a year later the breast that had surgery is now nearly nonexsistant. While I wasn't a large or even close in size it was and still is very heart breaking to now look and see almost nothing. My question is with my not having insurance nor a mastectomy are there resorces to help me get back some of my womenhood and confidence. Thank you for any assistance and may we all get through there times.

  14. #14
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    I know this thread is really old, but if at all posslble, can you provide me witht the information on CO for Free Medical Assistance Program for Breast & Cervical Cancer
    I was underinsured at the time of my diagnosis. I had a double mastectomy last July (2011) and I had a tissue expander put in me during the mastectomy. Although I did have insurance, my deductible is $10,000 and my co insurance is $10,000. This is anually. I have not even paid for the surgery i got last year, and my plastic surgeon says he will not give me the next surgery until i pay him $5000 for the last surgery and a loarge down payment towards my final implant surgery. I am 37 single mom, struggleing to make ends meet. I AM concered about how long this tissue expander can stay in me....

  15. #15
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    BFF has no medical insurance, what should she do?

    Quote Originally Posted by Barbara K View Post
    You have two options.

    If you already have medical insurance, it doesn't matter how long after the original mastectomy, the insurance company is required by law to pay for the reconstruction surgery.
    More specific and detailed information about this law and variations by different states is available at this link.
    http://messageboards.makemeheal.com/...867c3c34482d51

    If you do not have medical insurance, then Option 2 is for you to apply for the Free Medical Assistance Program for Breast & Cervical Cancer.
    The same requirement applies here, once you have this Medical Assistance coverage, by law, they must pay for the reconstructive surgery regardless of how long it's been since you've had your mastectomy. This is NOT considered to be a purely cosmetic procedure. Instead, it's considered to be a medically necessary procedure after a mastectomy.

    Here is a general link that explains the Medical Assistance Program for Breast & Cervical Cancer.
    http://www.coverageforall.org/pdf/FH...vertyLevel.pdf

    If you respond to my email and let me know which state you reside in, I can get you detailed and specific information of the eligibility requirements and application process for that state. After working for 29 & 1/2 years for Public Welfare, I know how to search through government websites for information and applications.


    Barbara K.
    Hi Barbara,
    I'm searching for some help for my BFF. She had a breast removed because of cancer several years ago. She wasn't able to afford reconstruction surgery at the time because she was/is a self employed hairstylist w/out health insurance. She has been looking for some help every since. She is unable to work as a stylist as she did before so she has applied for disability (unsuccessfully) as well.

    Can you help with as much info as you have on the subject of financial help for reconstruction surgery. We live in the state of Kansas.

    Thank you,
    MRSSHU

 
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