studiodad

Interesting question. I have stage 4 metastatic melanoma and currently treating with nivo. I have had six treatments with minimal side effects: very tired and skin rash on back and chest. During routine visit with my dermatologist last week he detected a mole under my hairline in my scalp that he believes should be biopsies. Suppose the mole is a new melanoma, what would the treatment be— nivo? why have my hair cut andthe mole shaved? My thought is it would be far better to monitor the mole over a period of time and not rush to removal as it was the only option. I plan to discuss this option with my oncologist next week. I will report back.

It may be time to lawyer up. Immunotherapy is covered under Coverage “b” in my Medicare plus supplement. At first, I was told Opdivo was not covered. It turns out it is, subject to any coverage “b” co-pay. My co-pay for all coverage “b” treatment is $4200 annually. I just finished my 4th Opdivo infusion and I pay nothing since the prior medical treatments for all coverage “b” treatments (scans, doctor visits, dermatology, primary care visits, etc. exceeded $4200. Starting January 1, I again will be responsible for co-pays only. Since my treatment is about 40,000 to 45,000 a month, all treatment after the first infusion are cost free. Your policy should pay all infusions after your co-pay. If your policy does not exclude Opdivo treatments it is likely covered. You may want to seek legal advice to review your policy coverages. It seems to me that they are viewing Opdivo as a prescription drug under Coverage “d”. It is part of Coverage “b”, not “d”.

Sorry for what you and your husband are going through, especially at such a young age. My advice is to consider your doctor’s recommendations and follow his/her treatment plan. You will get a lot of advice on this Board from well- meaning cancer patients, but they all have different diagnoses, goals, medical histories and experiences. Rely on your medical professionals. You can’t predict your treatment success by the reports of a few patients.
The common theme that I believe applies to all of us is Be PATIENT and BE STRONG. Don’t be afraid to get a second opinion on treatment plans. Your medical health insurer will likely pay for it. Best of luck.

You need to address your insurance status immediately. Since you have no coverage with your new job you have to contact your California insurer and make a clear record in writing that you were diagnosed with your current condition during their policy period. You may have a reporting Requirement under the terms of the policy to notify them of all applicable dates. If your health insurance in California was employer provided you may be able to lawfully extend coverage for a period of time, I.e. 18 months. Don’t delay taking care of this even though you are trying to cope with the new diagnosis, the new move and other pressures. If you receive a cancellation notice of health insurance coverage consult with an attorney familiar with health insurance policies.

2nd infusion today. First one 28 days ago with Opdivo went well 30 minutes. No side effects except for exhaustion. Today after 7 minutes of planned repeat infusion, I experienced sudden onset of low back pain. No history of pain in that area and it was excruciating. After they stopped Opdivo flow they injected Benadryl and steroids and 10 minutes later pain resolved. They waited about 20 minutes and infused at slower rate (about 50% slower) and the sped up the remaking 25% Opdivo at a rate between the 30 minute and 60 minute periods. No further problems. Plan for next treatment in 28 days is Benadryl first and then 60 minute pace for Opdivo. Hope this works. It is now 6.5 hours after todat’s Infusion and all is well.

Really happy for you Mike and wish you the best. No one should go through your ordeal and have the added financial stress because our health care system remains a for profit industry. Your choices should be which treatment is best for your medical condition, not which is affordable. Dr. Hamid seems to understand this. You were lucky to find him.

I just started Opdivo with first infusion last week. I have Medicare and AARP Medicare Complete. The program is through United Health. I have been assured that immunotherapy is covered under Coverage B, not under any Coverage D prescription supplement. Therefore, when you receive any Coverge B service, your annual co-pay deductible for Coverage B is all you pay each year. All charges in excess of that are paid by your insurer. This has nothing to do with prescription coverage. Your plan May not have an annual deductible. Mine is $4200. You pay co-pays for scanning and all Coverage B procedures until you reach the deductible. Every Coverage B expense above that for the rest of the calendar year is paid by your insurer. You start over again each January 1 and pay until the annual deductible is reached. I know this is the procedure for me with United Health but call Medicare directly to confirm this is the case if no supplement is part of your plan

Hi SKS. Sorry to hear about your recent setback. But I’m sure there are other tools in your oncologist’s toolbox to continue the fight. If not, maybe a second opinion would be warranted. One thing you do not want to do is take treatment advice from patients on this message board. There is a big difference between personal experience and medical advice. Here you will find compassion from other similarly situated patients and stories about their experiences that may help you in discussions with your oncology team. Although well intended, some comments cross that line between compassion/experience and medical advice. I’m new to Opdivo and just had my first treatment 5 days ago. No side effects yet and first post-treatment scans will be in 3 months. If there is bump in the treatment road, I will work with my oncologist to find a different path. In reading many helpful posts on this website I have quickly realized that there are many obstacles to overcome. The best way to proceed is to partner with your informed doctor and beat this awful disease. Best of luck.

I was diagnosed stage 3B metastatic melanoma a year and a half ago and a tumor was removed from my back. Subcutaneous melanoma in my fatty tissue so no other treatments called for. Two weeks ago a biopsy confirmed metastases to my scapula. Now at stage 4 and my first nivolumab infusion was yesterday late pm. This morning I walked 3 miles and have absolutely no side effects. I know it is early but I was told most common side effects can be addressed with over the counter meds. I am hoping my tolerance to Nivo continues. So,, the short answer is you might be able to continue work. Let’s hope so.