After uproar, man with breast cancer OK’d for coverageLast month, Raymond Johnson, a year-old single South Carolina man, discovered he was one of the estimated 2, men who are diagnosed with the disease each year. Rates of women who are opting for canccer mastectomies, such as Angeline Jolie, have increased by an estimated 50 prop testosterone cycle in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a percent guarantee, it's major surgery -- and women have man with breast cancer denied coverage options, from a once-a-day pill to careful monitoring. The eligibility rules for coverage under the Act are complex, but Johnson met all criteria, except one: Man with breast cancer denied coverage says he doesn't know how he's going to pay for his care.
Man with breast cancer denied coverage - Health - Men's health | NBC News
For Raymond Johnson it was bad enough being diagnosed with cancer when he was just 26 and with no health insurance, but his shock was only aggravated when he was denied Medicaid, because rules say men are not covered for breast cancer. Johnson, a construction worker from Charleston, S. But doctors say even though the numbers of cases may be small compared to the number of women who get the disease, what male breast cancer patients suffer is no less real.
When Johnson developed the lump, he said he ignored it, thinking it was just a cyst and wanting to avoid the cost of a doctor's visit. Besides not having health insurance, he said, his job for a small construction company does not allow him to make ends meet as it is.
But then over the July 4 weekend, he said, the lump caused an unbearable pain and he rushed to the emergency room. Johnson said he was shocked, because he'd never had health issues before, but more than that he was concerned about how he would pay for treatment.
He was sent to the Charleston Cancer Center to seek treatment and arrange for surgery to remove the baseball-sized tumor, according to his medical records at the center. He and his family met with Susan Appelbaum, a breast cancer navigator and patient advocate for the Charleston Cancer Center, and he told her he had applied to the Department of Health and Human Services for Medicaid.
On July 11, he called Appelbaum to tell her he'd been denied coverage because he's a man. Medicaid told Johnson that the supplemental breast cancer coverage is for women only and that it's written as such in the https: Jeff Stensland, public information officer for South Carolina's Department of Health and Human Services, agrees that the situation is "really wrong" but says that they can't get around this "overly rigid interpretation" of the Act, which specifically states that these benefits apply to women with breast or cervical cancer.
South Carolina DHHS has urged the federal government to change their opinion to allow the program to cover men, but has been told on "numerous occasions" that it is only for women, says Stensland.
Though health care reform may change Johnson's position because single, childless men and women will then be eligible for Medicaid if they make under a certain income, for now, Johnson is left on his own.
Marisa Weiss, the founder of Breastcancer. When there's an unusual case with HHS, she said, it's a matter of being persistent, making several calls, and speaking to a lot of people until you reach the right one that will take the case, she said. Appelbaum, who has about patients that she counsels from diagnosis through treatment, surgery and into cancer survivorship, said Johnson is the only male breast cancer patient at the Charleston Cancer Center.
In her career, she said, she's only had one other male breast cancer patient. This boy is never going to recover financially. Appelbaum said that while the Center will be able to help with some of his finances for breast cancer treatment, the bills for his chemotherapy and eventual surgery will be astronomical. He is scheduled to get chemotherapy once every two weeks for the next two months, after which he will receive chemo once a week for 12 weeks.
Surgery to remove the lump will be arranged soon after that. So far Johnson has applied for Medicaid twice, and he said that both times representatives have told him his applications were rejected because they're not able to provide a man coverage for breast cancer treatment. Johnson said the case workers have told him they would research how they can possibly cover him and that he should follow up with them.
In the meantime he keeps getting bills almost every time he gets the mail, he said. Appelbaum said she's contacted community leaders and lawmakers in Congress hoping for a change. The only positive response she said she's received has been from the office of Rep. Trump's attorney withdraws 2 defamation lawsuits. DOJ inspector general has sent McCabe case to prosecutors for possible charges. No criminal charges in Prince's accidental overdose death.
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