I just got a call from a woman in the Managed Care department at MD Anderson. She went through this whole long explanation about why they don't accept my Dad's insurance.
Apparently, Medicare pays MD Anderson MORE than most insurance plans do. So, if the insurance company won't agree to pay at least as much as Medicare, they don't accept that plan.
My Dad went with his current plan because it was less costly than Medicare and had more benefits. When he made this choice, cancer was not even a remote consideration.
She said my Dad could change to a plan they do accept (which are very few and may not even be accepted next year!) or go back to Medicare. If they decide to no longer accept your plan in the middle of your treatment, they are "kind" enough to not terminate your treatment, but when you are done, you are out and can't come back for follow-up.
When I asked why Dad could not pay out-of-pocket for the second opinion, she told me Medicare doesn't allow Medicare patients to do this as some doctors would then decide Medicare does not pay them enough and require the patient to make up the difference. So, Medicare mandates no out-of-pocket payment allowed.
Bottom line, if Dad does not want to change insurance providers or go back to Medicare, he can't go to MD Anderson. And, if he DID choose to go back to Medicare, it would take at least a month for the changeover and a month is a long time when you are dealing with an aggressive cancer.
He likes his doctor at UT Southwestern so I guess that is where he will stay. Bottom line, MD Anderson is a business and must be operated as such. The woman I talked to said that they were held accountable by the Texas taxpayers. Well, my Dad and my whole family are Texas taxpayers, but that really doesn't mean anything.
Needless to say, I am disappointed that one of the best cancer centers in the world is not available to my Dad and a little angry at how the system works (or doesn't work as the case may be.)
