How Medicare Advantage Helped a Veteran Receive Life-Changing Surgery

Prostate cancer, the 2^nd most common cancer in American men, is more likely to develop in men over age 65 and in non-Hispanic African American men. About 1 in 8 men will be diagnosed with prostate cancer during his lifetime. The average cost of prostate cancer surgery is about $42,720, an amount that does not include the costs of care for conditions that may develop following surgery.

After retired military veteran, George, 59, received treatment for prostate cancer in 2018, he needed an unexpected follow-up surgery to improve his quality of life. However, the cost of the follow-up procedure was out of financial reach for George. George is not alone --in fact, 49 percent of insured adults say they would not be able to immediately afford a $1,000 unexpected medical bill.

That’s when Humana’s team stepped in. Humana Care Management Social Worker Wendy Panourgias reviewed George’s Humana Honor PPO Medicare Advantage (MA) plan and identified two available benefits that would help to ease his financial challenges. George’s MA plan included a Flexible Care Assistance (FCA) benefit for certain qualifying members that he could use to cover the financial burden for the follow-up procedure. His MA plan also offered $30 each quarter to pay for over-the-counter health supplies, a benefit which gave him the financial flexibility to order supplies as he needed them.

“I sincerely look forward to work every day. The moment that George shared his personal hardship with me, it became my responsibility to ensure that his need was met,” said Wendy. “I feel tremendous pride to work for a company that emphasizes a culture of communication and collaboration between departments to ensure individual member’s needs are met.” 

With his MA plan’s Flexible Care Assistance benefit, George was able to undergo the follow-up procedure as scheduled. George said that Humana really came through for him when he most needed the help. This is one example why nearly half of people for Medicare choose Medicare Advantage. And collaboration and coordination helped to ensure that a valued veteran received the human care he needed.

Your results may vary. It may not be typical to improve health conditions by taking the actions George did.

Humana is a Medicare Advantage [HMO, PPO, and PFFS] organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal.

The benefits mentioned are a part of special supplemental program for the chronically ill. Not all members qualify.

The Humana Honor plans are available to anyone eligible for Medicare, and veterans should consider all their health plan options.