Your Proton Treatment

 

We understand the importance of access to appropriate care, when you need it. That’s why we offer simple ways for you to request a consultation either by calling or filling out a request form online.

Meeting with one of our expert radiation oncologists for a consultation will allow you to create an individualized treatment plan that may include proton therapy either alone or in conjunction with one or more of our other therapy options, including conventional radiotherapy, chemotherapy or surgery. It’s possible after your consultation for the oncologist to conclude that proton therapy is not the right option. In the event of this recommendation, the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center offers traditional treatments along with an extensive list of integrative care services.

Proton therapy insurance coverage

The Maryland Proton Treatment Center has taken a leadership role in the industry by making proton therapy cost-neutral. This means, we bill your insurance company the same amount for traditional X-ray radiation therapy as we do for proton therapy. This policy ensures that you are presented with the best radiation treatment type for your cancer and helps eliminate additional barriers to treatment.

The process:

Throughout the process, our physicians as well as our dedicated team of patient representatives will work directly with your insurance provider to obtain authorization for coverage.

  • We will begin with a consultation with our team to review your treatment plan, your health background and insurance plan.
  • From there, we will reach out directly to your plan to establish coverage.
  • Before you begin treatment, we will review with you your insurance coverage, co-pays and out-of-pocket expenses so you know what to expect.

The center accepts a variety of insurance types and will be happy to discuss your specific coverage by calling us at 410-369-5200.

General guidelines include:

General Coverage: Proton therapy is generally covered by Medicare (non-HMO). In many cases, patients covered by Medicare supplemental insurance often incur few net-out-of-pocket expenses for treatment after deductibles, copays/coinsurance and annual maximum payments are met.

Treatment Based Coverage: Some private insurance companies cover proton therapy for specific disease sites (cancer types) or on a case-by-case basis. We will work on your behalf to obtain coverage including communicating the facts and clinical recommendation for proton therapy, providing comparative treatment plans and setting up physician-to-physician consultations between our team and your insurance provider.

We also work with insurance providers from around the country.

Self-Pay: If you do not have insurance or if you are coming from outside the U.S., the Center also has self-pay options and payment plans.

Coverage Denials: Should you insurance carrier deny your coverage for proton therapy, we will first appeal on your behalf. If the appeal is denied, we can also recommend some actions to take, recommend a different treatment option or work with you on a self-pay basis.

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