Amy's Story: Breast Cancer Treatment Beyond Medicaid
November 13, 2009
Amy’s story: Breast cancer treatment beyond Medicaid
By Sharon McMillan on October 3, 2009 · 8 Comments · Email This · ShareThis
Breast cancer survivors walk through downtown Denver during the 2008 Race for the Cure. This year's event is Sunday at the Pepsi Center.
When Amy Bixby and her husband, Jon, made the decision to suspend their medical insurance coverage due to their financial strain, they were making a cut that is not uncommon to families recently.
They figured that if the family had been well enough while under medical coverage, how would their health know the difference of being without it?
The Bixbys always planned to resume coverage when their finances improved, but only two months before they were going to re-start their policy, cancer seemed to have a different plan.
In October 2008, Bixby sought further evaluation of a few lumps in her breasts and under her arms. A medical practitioner had already told her that breast cancer was highly unlikely, that Amy was extremely low-risk: She had already delivered and nursed six children, had never taken hormone therapies, had never been overweight and was not a smoker. She also had no family history of breast cancer.
The only risk factor was being female, but at 34 years old, she still wasn’t even in the high-risk age group. But since the lumps remained significantly noticeable, Bixby got a second opinion.
Another physician noticed the lumps and immediately ordered a biopsy, which led to a diagnosis of breast cancer. Bixby also mentioned that she was a day or two late for her period. Suddenly, from never having anything but regular and benign concerns, Bixby found out she had cancer and also was pregnant.
Without health insurance, Bixby was quickly referred to the Caritas Clinic at Exempla St. Joseph Hospital, where she was treated through a grant provided by Susan G. Komen for the Cure of Denver. She has had a mastectomy, nine rounds of chemotherapy and 25 radiation treatments. Through it all, even after applying for and being granted Medicaid, she doesn’t recall receiving any bill related to her treatment except a couple of co-pays.
“It’s pretty amazing to see how much people do for people like me. You hear a lot about people being uninsured in this country, and being one of those uninsured, and I probably will be uninsured for the rest of my life, I mean the state they are in right now . . .” Bixby said. “There are so many doors of help for people. I didn’t know about them when I needed them, but they opened for me, and people sent me that way, and I hope I can be as much of a contributor as I have been a beneficiary in the future.”
It is unusual that Bixby was eligible for Medicaid assistance for her breast cancer.
Colorado is one of 16 states that opted for the most restrictive option when making Medicaid assistance accessible to women who need to be screened or treated for breast cancer. In Colorado, Medicaid eligibility is offered only to women screened or diagnosed with federal Centers for Disease Control and Prevention funds. Colorado is also among 14 of those states that require a woman to have received at least one CDC-funded screening or diagnostic service for her to be considered “screened under the program.”
Bixby wasn’t initially screened and diagnosed under those criteria, and she also was younger than the 40-64 age-group requirement. But she had already been placed in other helping hands. Susan G. Komen for the Cure of Denver is an affiliate and branch of the Susan G. Komen Foundation national organization, which is the world leader in funding treatment and research of breast cancer.
Just in the past year, the Denver affiliate awarded $2.83 million to 36 different people. Since 1993, the Denver Komen for the Cure has granted more than $20 million to nonprofits throughout Colorado.
The organization doesn’t directly fund individuals but instead funds community breast health education and breast cancer screening and treatment programs. Funds go to nonprofits that provide these direct services.
The funds are specifically reserved for the uninsured or underinsured who wouldn’t necessarily qualify through the Medicaid option because of age or because they weren’t able to go through the “right” doors to access the assistance.
The “right” door in Colorado is through Women’s Wellness Connection, which manages Colorado’s breast and cervical cancer early-detection program. Women’s Wellness Connection has more than 120 health care providers throughout Colorado but faces challenges in providing access to people who live in rural areas or are not informed about the available assistance and its restrictive requirements.
Michelle Ostrander, executive director of the Komen for the Cure branch in Denver, encourages all women who need assistance with breast cancer screening and treatment to first go to Women’s Wellness Connection.
Race for the Cure volunteers have plenty of joy to share.
“Any woman who is between 40 and 64 years old needs to call them (WWC) first,” Ostrander said. “Because they need to go through the right door if they are qualified so if they are diagnosed, they can access treatment. Don’t self-pay. If you qualify for that program, go into one of those clinics. If they can’t help you . . . that’s when Komen comes into play.”
Bixby will continue hormone therapy for the next five years and has a 40 percent chance of reoccurrence. Her strength and faith support her, and you can hear the perseverance in her voice when she speaks of life with her seven children, including the recent addition, Gilead. She compliments the providers for outstanding treatment and is grateful to Komen for the Cure and Exempla St. Joseph.
“Komen for the Cure, the ladies that I have met up there, they are encouraging, kindhearted and sweet. It’s been neat to see the ladies in person and meet some of the faces behind the Denver affiliate through all of this. . . . They put a lot of work and hours into what they do,” Bixby said. “It makes me want to return the favor.”
Komen for the Cure’s primary funding source is the Komen Denver Race for the Cure, which is coming up Sunday at the Pepsi Center in Denver. There is still time to register for the run by going to the Pepsi Center on Saturday between 1 and 5 p.m.
Another funding source is the popular Pink-Tie Affair, which is scheduled for Nov. 7.
Click here to find out more about the Race for the Cure on Sunday.
To learn more about Susan G. Komen for the Cure in Denver, visit www.komendenver.org, and go to www.komen.org to learn more about the national organization.