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Are Stem Cell Transplants and Car-T therapies generally covered by Medicare/ with supplement like Medigap?

A MyMyelomaTeam Member asked a question 💭
New York, NY

By the time I need one or both of those (assuming I do at some point) I will no longer be on group insurance BCBS which is very good. So I’m worried. Not trying to be nosy. Just hoping major treatments are covered.

February 11
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Answer Summary

Members responded warmly to a question about whether stem cell transplants and CAR-T therapies are covered by Medicare and supplemental plans,... Read more

Members responded warmly to a question about whether stem cell transplants and CAR-T therapies are covered by Medicare and supplemental plans, with the overall reassurance being that yes, these major treatments are largely covered. Several members shared personal experiences where Medicare combined with Medicaid, Medigap, or union-based plans covered nearly all costs, with one member noting they owed just 43 cents on a 1.1 million dollar CAR-T treatment. A recurring theme was the value of pairing Medicare with a strong supplemental plan over an Advantage plan, and one member also suggested applying for financial assistance through cancer clinics as an added safety net.

A MyMyelomaTeam Member

@A MyMyelomaTeam Member
Thanks Nick, that all great to know. When my husband retires ( which may be still quite a few years) we will lose BCBS, which is through the Musicians Union - when that happens, Medicare will have to be first and a supplemental 2nd, as there is no continuation of coverage at that point through the union. As long as my meds and treatment are covered, I’m good. Will def get a good supplement.
This information is so helpful!!
Linda

February 12
A MyMyelomaTeam Member

In the U.S., my insurance was unaffordable so I moved to Bankok,Thailand. I was refused insurance because of pre existing, so I've been paying out of pocket for 3 years now but so affordable here and the treatment is excellent. I've already done my stem cell transplant and now on lenalidomide. I don't know how people without insurance in the U.S. can survive.

February 12
A MyMyelomaTeam Member

When I had my Car-T Cell Therapy, I was in the hospital for a almost two weeks. Medicare and Medicade did pay for a majority of my bills. I had to pay about $165.00.

February 12
MyMyelomaTeam

Are stem cell transplants and CAR-T therapies generally covered by Medicare with supplements like Medigap?

It's completely understandable to be thinking ahead about coverage for these major treatments. While the search results confirm that Medicare is an option for covering myeloma treatment costs, they don't provide Show Full Answer

Are stem cell transplants and CAR-T therapies generally covered by Medicare with supplements like Medigap?

It's completely understandable to be thinking ahead about coverage for these major treatments. While the search results confirm that Medicare is an option for covering myeloma treatment costs, they don't provide specific details about coverage for stem cell transplants or CAR-T therapies under Medicare or Medigap supplements.

What we do know is that Medicare can help make myeloma treatment costs more affordable. There are also additional programs that can help with costs:

- Medicare Savings Programs
- Medicare Extra Help
- State Pharmaceutical Assistant Programs
- Patient Access Network Foundation
- The HealthWell Foundation

For stem cell transplants specifically, these procedures can be very expensive, and there are some financial aid resources available through organizations like the Leukemia & Lymphoma Society's Patient Aid Program.

Since coverage details can vary, it would be really helpful to speak with a Medicare advisor or ask your healthcare team for a referral to a social worker. They can walk you through what Medicare and Medigap would cover for these specific treatments and help you understand any out-of-pocket costs you might face. They can also help you explore additional assistance programs you may qualify for.

Planning ahead like this is smart, and there are people who can help you navigate these coverage questions.

February 11
A MyMyelomaTeam Member

@A MyMyelomaTeam Member,
Tell Linda what insurance plan you have. That might help her.
Paula🌹

February 15

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