Mesothelioma patients and their families face many concerns as they seek treatment for this asbestos-related disease. In addition to the extensive number of tests and procedures that may be needed to diagnose this rare cancer, many patients are concerned about the cost. Patients worry that they may not be able to pay for the best treatment options offered by their doctors and medical team.
Many mesothelioma patients seek treatment at the International Mesothelioma Program (IMP) at the Brigham and Women’s Hospital (BWH) in Boston, Massachusetts. This unique program includes doctors from many disciplines, including pathologists, surgeons, oncologists, and clinicians, all focused on finding the best treatment options and ultimately a cure for mesothelioma. Dr. David Sugarbaker, the Chief of Thoracic Surgery at Brigham and Women’s Hospital, is the founder and director of the International Mesothelioma Program.
The entire team at the International Mesothelioma Program has dealt with issues related to the cost of medical care for many years and can help guide patients through the process. Dr. Sugarbaker considers this guidance part of their overall mission to ensure that patients receive all of the support and advice they need at every level.
Treatment is the First Priority
The International Mesothelioma Program works with the patient’s health insurance provider to ensure that a lack of personal financial resources does not interfere with the patient’s mesothelioma treatment – whether it is surgery, chemotherapy, radiation therapy, or a combination of therapies. There may be differences in allowable benefits among health insurance providers, including private insurers such as Blue Cross/Blue Shield PPO plans and HMOs like Kaiser Permanente, federal Medicare and state Medicaid programs, Veterans Affairs’ beneficiaries and dependents, and active duty military personnel covered by Tricare. However, each insurer has an obligation to honor the terms and conditions of the patient’s insurance policy or plan benefits.
A Patient’s Role and Obligations
When a mesothelioma patient contacts the International Mesothelioma Program for a consultation or evaluation, the administrators at Brigham and Women’s Hospital work with the health insurance carriers or plan administrators to verify eligibility and obtain payment approvals. To accomplish this, current insurance information from the patient as well as a referral from the primary care physician or treating doctor is needed. In some cases, additional documentation such as a statement of a lack of necessary and recommended care at the patient’s local hospital or medical clinic is required before treatment at the International Mesothelioma Program may begin. While the staff at the International Mesothelioma Program often deals with the insurance carrier directly, they may ask for the patient’s help to expedite matters by obtaining certain required documents or contacting the primary care physician.
Recent Patients’ Experiences
Some of the mesothelioma patients seeking treatment at the International Mesothelioma Program are represented by the Galiher law firm, a nationally recognized Hawai‘i law firm that has handled thousands of asbestos-related personal injury claims. Over the years, some of the firm's clients have had surgery performed by Dr. Sugarbaker to remove the mesothelioma cancer. Attorneys at the Galiher law firm are mindful of the importance of ensuring their health insurers work hand in hand with the IMP staff:
“We are all aware of the high costs associated with medical care and treatment, especially when surgery and hospital care are required. The treatment which Dr. Sugarbaker and his team at the International Mesothelioma Program provides includes surgery to remove the visible mesothelioma tumor, followed by a treatment of chemotherapy drugs. This surgery is typically followed by a few days of recovery in the Intensive Care Unit and another week or 10 days of hospitalization. Because of the associated costs, it is important that a patient’s health insurance company and the IMP staff coordinate closely with each other.”
One such patient had private insurance while another received health care benefits through Veterans Affairs because of his military service. Both of these patients received prior approval from the insurance company and Veterans Affairs respectively before their operations. With all that a mesothelioma patient is dealing with, seeking pre-approval from the medical insurance carrier may seem stressful and overwhelming. The team at the IMP has vast experience in working with the various medical insurance carriers and will lend a supportive hand so a patient’s treatment can be scheduled expeditiously, and financial concerns about insurance coverage will not be a stumbling block to proceeding.
