Invasive Squamous Cell Carcinoma, how soon should I get surgery?

Posted by dalenc @dalenc, Feb 27 2:49pm

Just got diagnosed with: INVASIVE SQUAMOUS CELL CARCINOMA, MODERATELY TO POORLY DIFFERENTIATED.
DEEP AND PERIPHERAL TISSUE EDGES ARE INVOLVED

Location: top of head
Size: 1.0 X 0.7 X 0.2 cm

I have no insurance and very little money, but Medicare starts in 2 months. Dermatologist indicated I should get surgery ASAP, and said they could do surgery in April, but I know that if I wait until May then Medicare would pay for it. Would I be OK to wait an extra month?

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@dalenc Welcome to Mayo Clinic Connect. This is an awkward situation to be in, isn't it?

My suggestion is to ask your dermatologist for his recommendation, giving him the details you told us here. Even if you wait until May for Medicare to cover the procedure, you may need to wait for the office to put the paperwork through and get approval. That's a fairly large spot.

Please let me know what your doctor says, okay?
Ginger

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@gingerw

@dalenc Welcome to Mayo Clinic Connect. This is an awkward situation to be in, isn't it?

My suggestion is to ask your dermatologist for his recommendation, giving him the details you told us here. Even if you wait until May for Medicare to cover the procedure, you may need to wait for the office to put the paperwork through and get approval. That's a fairly large spot.

Please let me know what your doctor says, okay?
Ginger

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Thanks. The dermatologist is recommending surgery ASAP, but I was just wondering if 1 month difference between April or May would mean the difference between life or death. I had the biopsy done, and since I got the report back all I can talk to are assistants with no real long term experience in the severity of waiting an extra month to do the surgery.

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Have you checked to see if you qualify to get insurance coverage right now, which is outside enrollment period, but there are exceptions?

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@celia16

Have you checked to see if you qualify to get insurance coverage right now, which is outside enrollment period, but there are exceptions?

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I'm only 2 months from getting Medicare and outside of the qualifications for ACA.

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@dalenc

I'm only 2 months from getting Medicare and outside of the qualifications for ACA.

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ask a large insurance brokerage company if they have a recommendation. might be with limited benefits, but it may take care of your immediate need. best wishes. - bill scanlon

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Getting enrolled is n Medicare is trickier than through an employer.

May I ask what state you are in? North Carolina has an organization called S.H.I.I. P (state health insurance information program) and every county has an advisor to help with shepherding new enrollees
Into Medicare and/Or Medicaid.

It may be that you can have your eligibility documented and all the choices for basic part A/B ready to go into effect on your birthday. Otherwise that will be another delay.

What might be more likely is to get a urgent ACA (affordable Care Act aka Obamacare) Policy bridge for the two months. An ordinary insurance agent can put you on that with a policy virtually immediately. And those premiums are sliding scale. And they don’t gig you with pre existing condition penalty.

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@dalenc , The fact that it is moderately to poorly differentiated means it is a more aggressive form and should be dealt with sooner rather than later. Has anyone directed you to CareCredit which is designed for medical procedures like this? I have metastatic SCC and I recommend doing everything possible to have it removed as soon as possible. There could be a delay in enrolling in Medicare so I would certainly get the procedure scheduled.

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Couldn’t agree more. The hospital finance office should be able to help you find a fast track in some funding path. They deal with this all the time.

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@dalenc

Thanks. The dermatologist is recommending surgery ASAP, but I was just wondering if 1 month difference between April or May would mean the difference between life or death. I had the biopsy done, and since I got the report back all I can talk to are assistants with no real long term experience in the severity of waiting an extra month to do the surgery.

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I just was diagnosed with this too, and I did some research on it. It does appear that SCC in a wound is very aggressive. You have to be the one to decide, but that information has me very nervous—especially because I had to postpone surgery from yesterday until I can get my blood pressure down! I am tentatively scheduled for next week, if my BP cooperates.
You should research Medicaid and/or other emergency services for uninsured individuals. Something might come through quicker. Your doctor may be able to point you in the right direction, since he should know what’s available in your area.

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