I have a big decision to make before 12/8. I do not see the uro-oncologist until 12/10. Currently my Medicare HMO severely limits my doctor choices. I can opt out of my Medicare HMO if I do it before 12/8. I am thinking about this based on the size of my tumor (covers 30% of my bladder)and the likelihood that the small sample biopsied (G3T1)will be consistent all the way across the tumor area. It seems a long shot that somewhere it has not invaded the muscle. So, if I in the near future am diagnosed with T2 or higher, I will be in the hands of that small group for insurance purposes. If i went out of network I assume the cost of such a surgery would wipe me out financially. Switching to original Medicare would open up a much larger option I believe and even some of the best BC hospitals in the event removal is required.
However, if I am am lucky and the entire tumor is G3T1 and BCG is recommended, I would be paying 20% of the BCG treatment costs as paid by Medicare. Does any one know how much Medicare pays for BCG treatments so I have some idea of my potential out of pocket costs?
If I do not make this choice before 12/8, I am stuck in my HMO plan until 2015. I'd hate to find out before then I need removal and be so limited to local doctors for the procedure. Any help will be appreciated.