Cancer treatment emergency - Advice on how to return home to get treated please

[music065]

I have been diagnosed with cancer and am trying to figure out the best way to return to the USA to get treated. Apparently the chemo and radiation treatments will take several months. I'm having trouble with the logistics of how I can do this because I don't really have family or friends back in the States to stay with while I'm arranging all this. Any advice on the best strategy? All I can think of is to fly to a US city and go to an emergency room and hope they admit me? Or if they don't admit, perhaps stay in a hotel there while working out the logistics, but I do not have a lot of money to cover that for very long. This has been a shocking time for me and I admit I'm not thinking that clearly. BTW I am open to going to any city. I was thinking LA or SF because I'm from CA but I could go anywhere that would be more efficient. I have Medicare part A but will try to get part B asap when I get there. 

 

I am am kind of at a loss as to exactly what to do and how to best proceed. What would you do?  Please post any and all advice or strategies you might know of. I think the combined wisdom here is enormous. Thank you so much.

 

 

 

[Lefty]

I am just finishing up treatment for tongue cancer at M D ANDERSON in Katy TX ,a suburb of Houston.7 weeks,5 days a week chemo and radiation treatments.MDA IS ranked as nbr 1 in the U.S. for cancer treatment . Strongly suggest you get part B and a supplemental  policy  group F, in which case there will be little or no cost to you, get before you go to hospital.Weekly hotel rates in Houston can be gotten for $250. website gomedigap.com for Medicare supplemental policy.

Previously was treated successfully for prostrate cancer at the same facility.

Lefty

[music065]

Lefty,

 

THANK YOU! This is great information, I will definitely look into it. Very helpful 

[oldcarguy]

Do you need to go to a hospital where your USA residence is on your Medicare ?

 

If I   needed to go thru this I would think of an area that had a top hospital but also comfortable living where you can go outside and walk around ,  not to hot or cold...

 

San Diego would probably be my first choice ,

 

You will recover better if you can get outside and enjoy life and not be stuck inside and needing AirCo

 

Good luck , let us know what you find out

 

[taxout]

As you probably know, unless you'll be hospitalized for surgery, Part A will not give you much coverage. It's Part B that gives the coverage you need.

 

There's an open enrollment period for Part B that ends three months after the month in which you turn 65. If that period is over and you didn't enroll then, you can normally only enroll later during January through March of any year, with coverage to begin July 1 of that year.

 

This is a harsh rule in your case, and you'll have to explore with Social Security whether any exception applies to you. There are some exceptions permitting late enrollment in Part B outside the January-March period, but most apply to those who were covered by other insurance. So if you've got any kind of medical coverage in Thailand, take the paperwork with you. There's no general exception for expatriates, however.

 

There is, though, an exception that allows returning expatriates to enroll in Medicare Advantage plans.  (Medicare Advantage is an HMO-type plan that sort of combines Parts A and B.) You need to be resident in the U.S. to qualify for Medicare Advantage, and I don't know whether your failure to enroll in Part B affects your eligibility for Medicare Advantage. In any event, the window to act is short: if you qualify as a returning expatriate, you need to enroll in a Medicare Advantage Plan within two months of returning to the U.S.

 

Similarly, a returning expat can qualify for enrollment in Part D, drug coverage, outside the normal enrollment period, but again, you need to act quickly.

 

(As suggested above, a Medigap F policy would be great in your case, but you need Part B coverage before you can take out a Medigap policy.)

 

In terms of timing, a warning that it took Social Security months to process my enrollment in Part B. You send your papers in, and they disappear into a bureaucratic mire; nobody knows where anything is.

 

If the Medicare options don't work out for some reason, of course there are other possibilities, like Obamacare and Medicaid. How quickly you could get enrolled in these I don't know. For something like Medicaid, I presume you'd need to document your assets and income.

 

Any large medical center in the U.S. has staff familiar with the ins-and-outs of insurance programs, since it's in their interest to get you insured as quickly as possible. I think they're usually the first people you see, before the doctor even.

 

As to where to go, a couple of thoughts.

 

First, someplace with good public transport might be important to you.

 

Second, if you need to fall back on public resources like Medicaid, some states are more generous than others. Whether there are issues like minimum residency requirements, I don't know.

 

Finally, I would research medical centers and make contact with them now. I would not simply fly to the U.S. and then start calling around.

 

 

[music065]

Thank you for the in depth reply, very helpful. I obviously have a lot to consider here. This is more complicated than I thought. 

[dotpoom]

May God be with you on your journey ahead.

    Not a bad person to have in your corner in time of need.

                       Choke Dee.

[travelerjim]

I believe your too late to apply for Medicare Part B as the enrollment date has passed.

Without Part B you will not be able to get a Medicare Advantage plan ...

one must have BOTH Part A & B to enroll in a Medicare Advantage plan..

 

The next open enrollment for Part B will be in January of 2018.

The effective date of that would be July 1.

 

My suggestion is to stay in Thailand and go to the government hospital in Chonburi.

It has an excellent Cancer Treatment Center.

The costs for medical care in the government hospital will be reasonable.  Living expenses too.

 

Good luck in your treatment and recovery.

 

Tj

 

 

 

 

 

[sgracer]

3 hours ago, oldcarguy said:

Do you need to go to a hospital where your USA residence is on your Medicare ?

 

If I   needed to go thru this I would think of an area that had a top hospital but also comfortable living where you can go outside and walk around ,  not to hot or cold...

 

San Diego would probably be my first choice ,

 

You will recover better if you can get outside and enjoy life and not be stuck inside and needing AirCo

 

Good luck , let us know what you find out

 

 

Look at renting something in Tijuana or Rosarito to save some $ if you choose a SD hospital

[Muzarella]

I send you a message about.

[uhhh ohhh]

There are a lot more knowledgeable people, on this board, than me who can give information regarding the Medicare Plans, and their availabilities regarding your specific information/needs. I talked to a heath insurance specialist in the states as I approached Medicare age and told her my specific information and the things I wanted included with my plan.....i.e. keep my doctors, past health issues, a good subscription plan (which you may need), etc. I might start by contacting a professional regarding your circumstances and what you can and need to purchase. As TAXOUT mentions I would do the research via Internet/phone first and not just fly there.

You don't mention the type of cancer you have, which no one else really needs to know, but I would do my own "Due Diligence" as to the type of treatment you need and the best hospitals/locations where you can get treatment that is within your preference and budget. Sometimes hospitals can give you a list of close hotels, extended stay, short-term affordable apartments where you can stay within your means and are in a convenient location. LEFTY mentions MD Anderson which is an excellent facility for treating numerous cancers.

On a personal basis, for anything serious like cancer, a bad heart condition, etc, I would want to go back to the states for treatment. Don't take long to do your research and make a decision. I CERTAINLY wish you the very best of luck!!!!!!!


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[TGIR]

You haven't said what kind of Cancer and what stage you are in.  It would be helpful to know.  

 

I went back to Ca after six years here for a temporary consulting job without having applied for Part B because I didn't anticipate going back to the states at the time I turned 65.  I arrived in the U.S. on Jan 10, went within a couple of days to the Social Security office and still didn't get Part B until July.

[music065]

Thank you all for the great info. Now I have a number of strategies to pursue. In answer to the questions, it's stage 2 prostrate cancer. 

[eddie61]

I would consider getting treatment in BKK at Bangkok Hospital on Soi Soonvijai. Their cancer center gets people from all around and has a link with Andersen medical center, which is considered pretty advanced.

 

My wife had treatment there and i think they did what they could.

 

Obviously, only if insurance covers it!! You can stay at the nearby A1 hotel for 1200 per night,

 

 

 

 

[likeke]

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It would take you at least 2-3 months to get your Part B. Why not get treatment in Thailand? My ex had cancer was treated successfully at a Bangkok government hospital. I visited her frequently and was impressed with her care there. Foreigners can also use these hospitals at a fraction of the cost of private hospitals. If your situation happened to me I would get treatment at Bangkok Christian however. I can afford it, but not sure about your financial situation. 

[music065]

Several people have suggested that I look into Thai government hospitals so I will do that. I do have insurance but I've recently heard about cases where people had trouble getting them to pay out on claims. Will research it more

[nervona81732]

Go to the nearest state that has legal medical cannabis and purchase or make cannabis oil 20% THC or above, take one small blob on finger in the morning and one small blob on finger in the evening. To make look up Rick Simpson RUN FROM THE CURE on YOUTUBE and many of his articles will be up the. I don't care what stage you have 1,2 3, or four. This will Knock it out. Chemo and Radiation treatment is a death sentence and extremely costly. Cannabis is extremely cheap cheap cheap in comparison. If you want to support the big pharma cartels go for it. If you want the real truth , check this out now. This is absolutely what I would do if I were in your situation.

[Sheryl]

1 hour ago, music065 said:

Several people have suggested that I look into Thai government hospitals so I will do that. I do have insurance but I've recently heard about cases where people had trouble getting them to pay out on claims. Will research it more

 

When this happens there is usually a clear reason, related to the terms of the policy.

 

If you can advise what insurance policy you have (company, plan name, maximum coverage amount) I may be able to advise further.

 

Stage 2 prostate cancer has a number of different treatment options. These in turn have different cost and time implications -- you should not make the treatment choice based on cost, but you do need to know the cost of the treatment and the time involves option you select, so deciding on this is a priority. You do nto mention where you were diagnosed, but in any case I recommend you take all your records to Dr. Viroj at Bumrungrad for a consultation to review the various treatment options and their pros and cons. By all records I mean, in the case of scans, the actual films (on CD or otherwise) and not just the written radiologist report. Unless your insurance coverage is high you would nto want to undergo treatment at Bumrungrad, but a consultation will not cost much and well worth it to pay for doing privately so that you have ample time with the doctor.

 

https://www.bumrungrad.com/doctors/Viroj-Chodchoy

 

By the way, chemo is not  usual treatment for Stage 2 so something seems a little off there.  See the following for good overviews of treatment options:

 

https://www.cancer.org/cancer/prostate-cancer/treating/by-stage.html

 

http://www.texasoncology.com/types-of-cancer/prostate-cancer/stage-ii-prostate-cancer

 

And, the fact that you were told it is stage 2 should not  be taken for granted but rather confirmed with a second opinion.

 

If you do opt for treatment in Thailand my recommendation would be Chulalongkhorn Hospital in Bangkok over the Chonburi cancer hospital.

 

You will not be admitted to the hospital in the US unless your condition requires hospitalization (in which case you'd have trouble withstanding the flight). Otherwise you would be treated as an outpatient except for  surgery if you opt to have it, and even for that the admission would be very, very brief.  So in the US you would need to be paying for housing as well as food, transport etc. Depending on your income level and assets, you might qualify for some sort of assistance, and that would vary greatly by state so this as well as living costs and proximity to a hospital with good cancer services (there are a number f them) would be  factors to consider in deciding where to go, if you go back.

 

Regardess, you should move on getting Medicare Part B  - even if you decide to be treated in Thailand it will help expand your options for the future. There is a financial penalty levied for every year past age 65 you did not have Part B so waiting will increase the premium costs (for life) plus, as you have discovered, when you need it, it is not something that can be quickly arranged.

 

 

[al007]

I have both colorectal and prostate and had first class treatment here in Thailand at affordable cost, and so far very successfully, I am sending my phone number  by PM to you,  please call me if you wish

 

I can also help you with Prostate surgery in India

 

God Bless do not panic the good news is you have identified it 

[uhhh ohhh]

Music, I'd advise you to go to this site ASAP to assist you with your options and research: www.yananow.org. It's a wealth of information regarding prostate cancer....treatment options, info about each stage.....personal stories per stage/age/Gleason scores....results of treatments, etc, etc, from ALL OVER THE WORLD! Also, and again this is a personal choice one should make with his doctor, there are drugs that one can take to significantly slow the growth of the tumors/cancer, while you're making a decision. It might give you a little more time. I'd never tell anyone what they should do and the treatment they should receive. That's a very personal choice. Again, my best wishes. You're certainly welcome to PM me any time you'd like! This is a cancer that can be treated with a great deal of success if you catch it early and it hasn't spread beyond the prostate.


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[Ninni]

Music065!

I just want to say GOOD LUCK with your treatment where ever you get it!

I had the big C 2013, went back to Denmark from Thailand and I'm still standing up..........

Now I take life day by day and really try to stay positiv!  Again GOOD LUCK and STAY STRONG! ?

[howard ashoul]

Did you think about treatment options in Thailand?

 

As I understand money could be an issue in long run. If you travel to the USA and start paying those crazy prices for hotels and hospitals (not first hand experience, just what I heard) you could easily run out of money very quickly. Then what?

 

A lot of people are traveling to Thailaind to get their breast done, teeths, surgeries etc. Because it is much more cheaper. And you are already here. So why not take advantage of situation? It could be a good option in long time run.

 

QUALITY - my GFs mother got cancer. She had no insurance. She visited thai public hospital, she was hospitalized, was receiving chemo for 4 months and went though surgery. All this care was available even in cheapest public thai hospital to broke farmers with 0 Baht. Private hospitals are even ten times better. So look for some good thai hospital, eg Bangkok hospital.

 

As you can see, advanced treatment is available even in lowest thai hospitals. Can you imagine what could you get, if you visited just a little bit fancier hospital? If even cheapest one have chemo and surgeries? It would be at the same level as the USA. And prices would still be very very reasonable.

 

PRICES - she was staying in hospital for about 4 months. All we payed was about 80 Baht/day. (again, she had no insurance, it was lowest hospital possible). I went to private hospital with anxiety and was charged 2500 Baht for consultation, test and treatment. I payed in private hospital 500 Baht for xray of chest. I payed in private hospital 3500 Baht for CT scan of brain. How much would I pay in the USA? I would probably end up in bankruptcy after 2 visits. You need that better thai hospital as me, not like her mother, but it's still much more cheaper than USA.

 

 

 

Burmungrang hospital. Its the best hospital in Thailand but its also the most expensive. If you visit it, you will be surrounded by muslim sheiks arriving in their limos. And everything is very expensive. I went there, spoke with doctor and was prescibed nose spray for my allergy. And I ended up with 16000 Baht bill! It would cost me 500 Baht in any other private hospital. If you're not a millionaire it could bite your ass in long run. Not this hospital. Try Bzngkok hospital or something like that.

 

 

 

Just to sum it up. (1) Don't burn all your money in the beginig. It can be a long figh. You can end up not beign able to make money during treatment. Worst situation you can end up is spent all your money on tests. And then not being able to afford months of needed treatment. (2) Thai hospitals offers all modern treatments. And are cheap even for farangs.

 

I wish you all the best. Kick it's ass!!!

Edited May 27, 2017 by howard ashoul

[Blue bruce]

Two years ago i was diagnosed with prostate cancer. I immediately got on an airplane to the U.S. because i have full medical coverage. Medicare part a & b and supplemental plan f along with the pharmacy plan. I had 45  radiation treatments 5 times a week for 9 weeks. The total bill was over $100,000.00 U.S. My cost was zero.  Now i have my PSA checked every 6 months here in Thailand and it's completely negative. My medicare is taken directly out of my S.S. check. Best move i ever made was to sign up for medicarei 

[music065]

Blue Bruce, interesting. Our situations are similar in some respects. May I ask where you stayed in the US while you were undergoing treatment? People are telling me that some cancer treatment centers have subsidized places with beds near the treatment centers where people can stay while receiving treatment. I'm checking into this this, as this would cut down on a big expense. Currently deciding whether to go to US for treatment or do it here in Thailand. Leaning toward doing it here because it would take me awhile to get all the Medicare pieces in place. 

 

Health care in the US and in many parts of the world has such an absurd number of moving parts. One must almost become a part time insurance agent to begin to deal with the many permutations and occurrences that may come up. 

[Langsuan Man]

I just hope there are many of the I'm never going back to my home country members reading this thread 

 

No matter how good the treatment is here in Thailand  you are never going to be able to understand exactly what is happening due to the language barrier.  Maybe your main doctor will be able to speak English but how about all the support staff;  nurses, technicians, etc. that you have to deal with

 

Experts will tell you that you that your psychological outlook has a tremendous impact of the success of any treatment.  Can you really have that assurance if you can't communicate with the health care providers

 

I think not,  so my monthly $134 for Medicare Part B is a small price to pay for the peace of mind it brings that I am not stuck here for treatment in the case of a major illness

 

Doesn't help the OP,  but should serve as a wake up call to others that it can happen to you 

[al007]

3 minutes ago, Langsuan Man said:

I just hope there are many of the I'm never going back to my home country members reading this thread 

 

No matter how good the treatment is here in Thailand  you are never going to be able to understand exactly what is happening due to the language barrier.  Maybe your main doctor will be able to speak English but how about all the support staff;  nurses, technicians, etc. that you have to deal with

 

Experts will tell you that you that your psychological outlook has a tremendous impact of the success of any treatment.  Can you really have that assurance if you can't communicate with the health care providers

 

I think not,  so my monthly $134 for Medicare Part B is a small price to pay for the peace of mind it brings that I am not stuck here for treatment in the case of a major illness

 

Doesn't help the OP,  but should serve as a wake up call to others that it can happen to you 

Some observations

 

I can have free treatment in the UK, before those negative ones say no, so long as I am returning permanently I get it

 

Like wise for USA citizens keep paying your premiums it gives you options

 

I CHOOSE to have treatment here (I have no private insurance), I also have no home or place to stay in the UK

 

I choose the Chulalongkorn the best cancer hospital in Thailand and government and affordable prices and has state of the art UK and USA equipment, that private hospitals may not be able to afford

 

Originally I was faced with maybe three major operations and some serious time as an inpatient so far I have avoided this, a miracle I feel helped by top consultants and very excellent computerised equipment

 

I did have very good prostate surgery Holep in India at sensible affordable cost, on Devinchi robotic surgery India is very much more advanced than Thailand, (incidentally I very much like Intuitive Surgical Stock ISRG on the nasdaq manufacturers of this equipment)

I can help with urologists there

 

I had no language problems and feel I have a strong team looking after me, my radiologist consultant was trained at John Hopkins in the USA, I have a team of four consultants and many nurses who by now know me well and all speak english, for emergency my wife translates, but generally I do not allow conversations in Thai it is important I understand what is going on

 

I had radiation and chemo as an outpatient over 7 weeks , since finishing at the end of November last year, at the moment, I am clear but have extensive tests every three months, and have just finished the first three month test, it could come back but so far so good

 

At the end of august I go back for more tests, another MRI, another colonoscopy, another biopsy a bundle of blood tests, and reviews with four consultants

 

If you have treatment overseas then you have to be prepared to travel for follow up and check ups

 

I think this is a very high level of care for which I am very grateful, I also feel I would not have easily got such good care in the UK

 

The key here is choose your consultants carefully and then see they have the most up to date equipment

 

I am very grateful and say thank you God, and of course many others, without which it would not have happened

[teddog]

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Cancer Treatment Packages in India

Cancer is often termed as one of the most dreaded diseases. The treatment of cancer many times becomes burdensome for those who do not have enough money, especially in the western countries. Medical India Tourism offers all-inclusive cancer care and treatment packages including best of medical facilities such as state-of-the art technology, sought-after hospitals, room fee, tests and examination, medicine, nutritional care, radiation therapy and surgery costs for the duration of the treatment. The patients get benefit from the services of a team of cancer specialists and professional assisting staff at extremely affordable rates. In India, one can opt for Cyberknife surgery at Cancer treatment Hospitals or any other specialty hospital which is quite cheaper and beneficial in comparison to traditional radiation therapy. There is also facility of PET scan and Da Vinci or Robotic surgery for prostate cancer, brain tumor or breast cancer.

Cancer Treatments	No of Ward days	Procedure Cost (USD)	Procedure Cost (INR)
Breast Cancer Treatment - Complete Medical Evaluation	2	1800	108000
Breast Cancer Treatment - Conservative or Modified Radical Mastectomy	Depends upon the treatment	4500	270000
Colon Cancer Treatment - Complete Medical Evaluation	2	1800	108000
Colon Cancer Treatment  - Cryosurgery	Depends upon the treatment	7,500	450000
Colon Cancer Treatment - Polypectomy	Depends upon the treatment	3,000	180000
Colon Cancer Treatment - Bowel Diversion Surgery	Depends upon the treatment	6,000	360000
Advanced Oral Cancer Treatment - Surgery, Radiation and / or Chemotherapy	Depends upon the treatment	4500-8500	270000-510000
Whipple Procedure for Pancreatic Cancer	Depends upon the treatment	7800	468000
Total Pancreatectomy for Pancreatic Cancer	Depends upon the treatment	5000	300000
Radical Hysterectomy for Pancreatic Cancer	Depends upon the treatment	5000	300000
Advanced Esophageal Cancer Surgery	Depends upon the treatment	8000	480000
Ovarian Cancer: Radiation Therapy	Depends upon the treatment	3,000	180000
Ovarian Cancer:Chemotherapy	Depends upon the treatment	4,000	240000
Ovarian Cancer:Radical Hysterectomy	Depends upon the treatment	5,000	300000
Robotic Prostate Cancer Surgery	Depends upon the treatment	9000	540000
Laproscopic Radical Prostatectomy Surgery	Depends upon the treatment	7000	420000
HIFU Treatment for Prostate Cancer Surgery	Depends upon the treatment	9800	588000
Brain Cancer Surgery- Craniotomy	Depends upon the treatment	9,000	540000
Brain Cancer Surgery - Micro Surgery	Depends upon the treatment	12,000	720000
Brain Cancer Surgery - Gamma Knife Surgery	Depends upon the treatment	6,600	396000
Laparoscopic Minimally Invasive Thyroid Surgery	2	6000	360000

 

The charges mentioned in the above packages are just an estimate and are subject to change, depending on the medical problem and condition of the patient. These are not final packages as post-surgical complications also have a say in the actual bill.

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Edited May 28, 2017 by teddog

[al007]

Cancer Treatment Packages in India

Suggest one keeps an open mind on India as an alternative, originally I was very not sure, but having experienced it like a few others on this forum, in some instances it can be excellent, and I was very happy

[teddog]

Just now, al007 said:

Cancer Treatment Packages in India

Suggest one keeps an open mind on India as an alternative, originally I was very not sure, but having experienced it like a few others on this forum, in some instances it can be excellent, and I was very happy

 

India outshines anything that Thailand has to offer medically and affordability...but you will not be experiencing tropical sun there soon, but tropical rain a'plenty.

[Chongalulu]

On 27/05/2017 at 8:53 AM, dotpoom said:

May God be with you on your journey ahead.

    Not a bad person to have in your corner in time of need.

                       Choke Dee.

I think what he needs and is looking for is helpful practical advice ,not delusional comfort from an imaginary friend....who gave him the cancer in the first instance?