I am curious as to what insurance others have and whether it covers everything 100%.
I have Medicare which covers 80% and Kaiiser Permanente HMO that covers the other 20% in most cases as I understand it. I am currently in Pittsburgh at the UPMC for consultation and I think I have just discovered a disadvantage to an HMO. I was given a referral to come here and it has been determined that I am a good candidate for treatment that involves Cyberknife type radiation in conjunction with
Erbitux. It turns out this is a clinical trial. If it was a Medicare covered clinical treatment, which it is not, Kaiser has no problem with my having treatment here for Medicare covers their part and I am responsible for the balance some how. Since Medicare will not cover anything Kaiser says I have to have the treatment in Atlnta and claims to know a Doctor there that can do the treatment. If that Doctor can do the same or better that is fine with me but I am not sure that he can. My request to Kaiser is to let me stay here for treatment OUTSIDE OF THE CLINICAL TRIAL and Kaisers network because the doctors here specialize in head and neck cancer.
My other question here, other than the one about the insurance others have, is: If the Doctor in Atlanta does not have the same equipment and expertise as the Doctors at UPMC does it seem there is any reason I MUST have some similar treatment done in Atlanta?