Hi All,
I was diagnosed with multiple myeloma 4 years ago. I had my first PET scan 2 years ago ordered by an oncologist. Recently, I had some shoulder and back problems, and my primary doctor ordered a PET/CT which is scheduled for next week. Meanwhile, I heard some conflicting information about Medicare refusing some PET scans.
I did some Internet searches but couldn't find clarity on it. Does anybody have some reliable information that might shed light on the issue?
Thanks.
Kate
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4 posts
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Re: Medicare coverage of PET/CT scan
I can only speak from a personal experience. I have had three PET/CT scans the last three years in order to monitor the activity of my multiple myeloma. All three were paid for by my Medicare insurance (approximately $7500 each).
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coachhoke - Name: coachhoke
- When were you/they diagnosed?: Apri 2012
- Age at diagnosis: 71
Re: Medicare coverage of PET/CT scan
Kate,
I just started Medicare last July. I also have a supplemental policy. I just had an MRI of my wrist which I also was concerned about the out of pocket expense. Of course my doctor wrote the order, and it was up to me to make the appointment.
I don't live far from where the MRI was being performed so I just drove there and set up my appointment. The first thing they ask is what type of insurance do you have. And they were able to tell me what, if any, costs would be expected.
I would suggest talking with the office staff where you will be having the PET/CT done about any out of pocket cost.
Castaway
I just started Medicare last July. I also have a supplemental policy. I just had an MRI of my wrist which I also was concerned about the out of pocket expense. Of course my doctor wrote the order, and it was up to me to make the appointment.
I don't live far from where the MRI was being performed so I just drove there and set up my appointment. The first thing they ask is what type of insurance do you have. And they were able to tell me what, if any, costs would be expected.
I would suggest talking with the office staff where you will be having the PET/CT done about any out of pocket cost.
Castaway
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Castaway - Name: George
- Who do you know with myeloma?: just myself
- When were you/they diagnosed?: 1/24/14
- Age at diagnosis: 62
Re: Medicare coverage of PET/CT scan
It may depend on whether you have original Medicare with a supplemental plan vs. a Medicare Advantage (HMO) plan.. With original Medicare and supplemental, the provider of the service must tell you if Medicare might not pay for the service, and you must sign and agree to pay if Medicare doesn't cover the service. It should have the amount listed on the paper you sign. I refuse to pay any bill if I have not signed that specific form telling me how much it will cost.
My guess is you won't have to pay for an MRI since you have a specific pain complaint. It is the annual MRI/PET scans that are done to monitor multiple myeloma without pain complaints that are in question. as concerns Medicare payment.
My guess is you won't have to pay for an MRI since you have a specific pain complaint. It is the annual MRI/PET scans that are done to monitor multiple myeloma without pain complaints that are in question. as concerns Medicare payment.
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torimooney - Name: tori
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: apr 2012
- Age at diagnosis: 64
4 posts
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