Transporting cancer patient long distance (USA)?

September 14, 2021 7:30 AM

How do I help my friend figure out how to get her mom (stage 4 cancer patient) from the deep south to the northeast a) safely b) affordably and c) ideally covered by insurance and or Medicare?

I'm asking on behalf of a non-mefi friend ("Molly") whom I'm trying to help deal with the logistical nightmare that is her life right now.

Molly's mom has stage 4 cancer, is basically immobile, and is currently in the deep South (where she has been living). Molly has been with her the last two months, away from her own home in the Northeast, in an exhausting whirlwind of home care and hospital visits. They will learn more about Molly's mom's treatment options tomorrow (whether palliative care or aggressive treatment).

In either case, they are now trying to figure out how to get her mom from the south to the northeast, with the following caveats:

- her mom cannot fly
- her mom cannot sit up for long periods of time
- they cannot afford the 10k+ bill they've been quoted for medical transport out of pocket
- Molly needs to return to work in the northeast soon, so staying in the south for much longer is not an option

Our main questions are:

- has anyone had any experience with something similar?
- if so, have you been able to figure out how insurance OR medicare will cover the cost of the $10k medical transport?
- if not, what other means did you use for transport?

Also:

- I live in Boston and can easily make calls to the many many great medical centers in the area, but I don't know who to ask for / where to turn / how to concisely ask my questions to get the answers I need.
- Are there certain types of departments / employees / medical centers / support orgs I can ask for who will help me out in answering some of these questions?

Recognizing this is a very niche situation, any and all help is appreciated.

posted by seemoorglass to Health & Fitness (10 answers total)

If there are funds available for moving her just for palliative care, PanCan can probably point you to them.

If the intention is for her to move close to a cancer hospital in the Northeast, I would try contacting the chosen hospital directly to see if they can make suggestions.

I would try to get a clearer idea of her likely remaining lifespan. PC often takes people very fast once a stage 4 diagnosis is made. I don't know the specifics of the situation, but I wouldn't want to subject her to such a journey if she only had a few weeks left if I had any choice in the matter.
posted by praemunire at 7:50 AM on September 14, 2021 [2 favorites]

I agree with praemunire (aside: is a link the correct way to "tag" someone here?) that it is better to get an idea of remaining lifespan. Relocating will not only be a somewhat arduous journey but it's also not fun to find a whole new fleet of medical care professionals that you like and/or trust.

I think your friend may be overlooking another option which is that they could negotiate with their current employer to see whether remote work is possible under the circumstances. Working remotely while being with their mom, while the mom received palliative care, seems a better option to me.
posted by TimHare at 8:03 AM on September 14, 2021 [3 favorites]

This is the sort of thing that hospice care is usually able to help with, at least in the sense of giving you a realistic view of the options available to you, if Molly's mom was enrolled in hospice care. I'd also think that perhaps a social worker affiliated with the hospital in the southeast or north east would be a good starting point for Molly.
posted by plonkee at 8:45 AM on September 14, 2021 [1 favorite]

(BTW, I'm sorry; I don't know how I read "pancreatic cancer" into the original post. But whatever the cancer is, there is likely a patient organization similar to PanCan that should be very easy to google, and the rest still applies.)
posted by praemunire at 9:00 AM on September 14, 2021 [3 favorites]

I’m sorry to be the bearer of bad news, but neither commercial insurance nor Medicare will pay for medical transportation. In many states, Medicaid will provide local transportation to medical appointments, but not interstate transportation.
There are several charity transportation resources for cancer patients, but most of them provide seats on planes, and Molly’s mom can’t fly.

When you describe a stage IV cancer patient as “basically immobile,” and add in a planned discussion about goals of care, it doesn’t sound like Molly’s mom is going to be able to tolerate a lengthy journey of any kind. I’m sure Molly is beyond stressed. There is definitely a social worker or a patient navigator affiliated with the oncology practice who can provide support to Molly and her mom. If Molly’s mom is ultimately found to be hospice eligible, maybe Molly could work remotely as someone suggested upthread and stay where her mom can receive hospice services.

If, rather than being better served by hospice, Molly’s mom is found to be a good candidate for ongoing cancer treatment, and Molly manages to find a way to transport her mom that does not jeopardize her fragile health, the current oncology provider should be able to help facilitate transferring care to a cancer center closer to Molly. This is not likely to be a super quick process, even in non-pandemic times. Molly’s mom might have to stay in her current location for her next scheduled treatment(s), and a transfer might theoretically be coordinated during the intervals between rounds of treatment.

My heart goes out to Molly and her mom. I lost my mother to cancer, and I’m a nurse case manager (though not your nurse case manager). You’re a good friend , OP.
posted by little mouth at 10:21 AM on September 14, 2021 [4 favorites]

I've been transported by Grace on Wings.
posted by jocelmeow at 10:38 AM on September 14, 2021 [1 favorite]

Response by poster: Thank you all so much for the responses so far. I have passed them on to Molly and she is finding the info useful.

One clarification - she is currently working remotely, but does work in a field where she has to be physically present for her work in the Northeast every so often.
posted by seemoorglass at 11:00 AM on September 14, 2021

I know I'm late to the discussion, but Angel Flight is another option similar to the one that jocelmeow mentioned. I know you said she can't fly, but wanted to put this out there as an option in case the problem was more logistical.
posted by richmondparker at 11:48 AM on September 14, 2021 [1 favorite]

I know I'm late to the discussion, but Angel Flight is another option similar to the one that jocelmeow mentioned.

I was thinking about that, but there are going to be different logistical challenges that may be worse than trying to go commercial. The biggest problem is going to be actually getting in and out of a small airplane, which can be difficult even for healthy, able-bodied people. The trip is also going to take significantly longer than commercial, but you may have the opportunity to stop and rest along the way.

I have not personally flown for Angel Flight, but I'm not sure that their mission statement covers this kind of situation, unfortunately.
posted by backseatpilot at 1:29 PM on September 14, 2021 [1 favorite]

Would Molly's mom be able to travel lying down in an RV, or is she too fragile for that?
posted by Mender at 2:34 PM on September 14, 2021 [4 favorites]