My husband is 75 and going through the first stages of treatment. He's on cycle 3.
Who makes the decision whether or not he can have a stem cell transplant? The doctor? The hospital? The insurance?
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Joannem - Name: Jo Anne
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: February 2016
- Age at diagnosis: 75
Re: Who decides on stem cell transplant eligibility?
The doctor will be the first to decide if your husband is eligible. It will be decided based on whether your husband is strong enough to go through this process, Does he have other medical issues? Then I believe most insurances will pay for this. Not sure about Medicare. I saw a post several weeks ago from someone not in the United States, and they said there was an age limit in their country, so I called my insurance and the above is what they told me.
Re: Who decides on stem cell transplant eligibility?
MaryB,
I hope your husband is doing well on his treatment plan and I wish you both the best on this journey.
If his doctor recommends a stem cell transplant, and his insurance company approves it and the center where it will be done, Medicare may pay. They do cover stem cell transplants under certain conditions. They approve a single transplant, but not tandem transplants. However, in some circumstances they will pay for a second transplant if it has been two years since the first one.
Age was formerly a factor. Age 77 was the cutoff period for Medicare approval because insurance companies did not have enough outcome data for patients over that age. However, some transplant centers now consider physiological age to be more important than chronological age in determining eligibility.
Please keep us posted on your husband's progress.
I hope your husband is doing well on his treatment plan and I wish you both the best on this journey.
If his doctor recommends a stem cell transplant, and his insurance company approves it and the center where it will be done, Medicare may pay. They do cover stem cell transplants under certain conditions. They approve a single transplant, but not tandem transplants. However, in some circumstances they will pay for a second transplant if it has been two years since the first one.
Age was formerly a factor. Age 77 was the cutoff period for Medicare approval because insurance companies did not have enough outcome data for patients over that age. However, some transplant centers now consider physiological age to be more important than chronological age in determining eligibility.
Please keep us posted on your husband's progress.
Re: Who decides on stem cell transplant eligibility?
Thanks for the replies. We have Medicare and Tricare for Life. He is a retired Air Force Lt. Colonel. We have never been denied for any medical claims, but there is always a first time. I just hope the doctor has lots of say in it.
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Joannem - Name: Jo Anne
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: February 2016
- Age at diagnosis: 75
Re: Who decides on stem cell transplant eligibility?
My husband, retired navy, 68 years old, was told it is up to the transplant doc, which depends on statistics, but really the health, stage, and condition he is in when it comes time for the transplant. Transplant doc requires 6 rounds of Revlimid, Velcade, and dex.
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Wife - Name: Mary
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: Oct4 2015
- Age at diagnosis: 68
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