Cured?????

pattyanny
pattyanny Member Posts: 544
in Head and Neck Cancer #1
Hi Everyone! I am on my way to my scans at Mt Sinai. I was found NED in November 2010, so this will be my first scan since that wonderful news. I received a call yesterday that although I am scheduled for a PET/CT, my insurance company denied the PET stating it was not medically necessary. I was shocked, and as I spoke with them, explained the haunting "unknown primary" that looms over a lot of us, and the fact that early detection is vital. Of course all the could do was state the rules - not medically necessary. I told them I did not know that they came up with a cure for cancer! Wow! Where have I been? Lol!
I say this to those who may also go through this, after being elated by the NED diagnosis, and after the hell of chemo & radiation therapy. Maybe the doctors should not state this as a diagnosis on the insurance forms, so we can continue to monitor our health. I thank my CSN buddy (you know who you are :) ) who convinced me to keep this appointment. I will go for the CT scan this morning, and continue to believe, by the grace of God, I have been healed, and do not need the PET anyway.
May God bless you all. Although I have not posted, you continue to be in my daily prayers.
Love, faith, and Prayers, Patty
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Comments

  • Glenna M
    Glenna M Member Posts: 1,576
    #2
    Insurance companies...
    It's amazing that the insurance companies will not pay for a test or procedure that could detect a catastrophic disease early enough to save a life. No, instead you have to wait until you have symptoms. I'm sure that is the main reason my doctors have not ordered another PET so I have to have a CT every 3 months instead. Hmmmm, I wonder how many CT's equal the cost of one PET - LOL.

    God bless you Patty, just keep on believing. You have so many friends and family who are praying for you that He can't help but listen :)

    Love, hugs and prayers,
    Glenna
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #3
    Thoughts & Prayers - Abi Sister
    Hoping only for the best of continued good news...

    Sorry about the PET scan/insurance crap.... makes you wonder if their explanations would apply if it were them or their family.

    Best,
    John
  • ratface
    ratface Member Posts: 1,337 Member
    #4
    Skiffin16 said:

    Thoughts & Prayers - Abi Sister
    Hoping only for the best of continued good news...

    Sorry about the PET scan/insurance crap.... makes you wonder if their explanations would apply if it were them or their family.

    Best,
    John

    Hi Patty
    Nice to see you on the boards and hear the good news. I just got done with a 2 month battle to get my insurance company to pay for my last CT scans. I won, but we certainly don't need the aggravation on top of everything else. Personally I wouldn't fret too much about the PET as the a full body CT with contrast is probably a better test anyway.
  • Greg53
    Greg53 Member Posts: 849
    #5
    ratface said:

    Hi Patty
    Nice to see you on the boards and hear the good news. I just got done with a 2 month battle to get my insurance company to pay for my last CT scans. I won, but we certainly don't need the aggravation on top of everything else. Personally I wouldn't fret too much about the PET as the a full body CT with contrast is probably a better test anyway.

    Hey Patty
    Patty,

    Great to hear you're doing well! Sorry about the insurance hassle, just went thru one myself recently. What a PITA! Nice to see your post!

    Positive thoughts!

    Greg
  • rozaroo
    rozaroo Member Posts: 665
    #6
    Greg53 said:

    Hey Patty
    Patty,

    Great to hear you're doing well! Sorry about the insurance hassle, just went thru one myself recently. What a PITA! Nice to see your post!

    Positive thoughts!

    Greg

    Patty
    Wishing you my best on your scan today! I understand about the pet scan as head & neck is not covered here in Ontario. Plus private insurance will not pay either. I am sending
    positive thought's & prayer's your way!
    God Bless
    Roz
  • beru1977
    beru1977 Member Posts: 3
    #7
    Insurance
    Although my husband has great health insurance, we still encountered some road blocks in scheduling PET scans. We had an absolutely wonderful person, Annie, in the oncology office that dealt with all our insurance problems. Hang in there and keep fighting the fight.
  • sweetblood22
    sweetblood22 Member Posts: 3,228
    #8
    beru1977 said:

    Insurance
    Although my husband has great health insurance, we still encountered some road blocks in scheduling PET scans. We had an absolutely wonderful person, Annie, in the oncology office that dealt with all our insurance problems. Hang in there and keep fighting the fight.

    Patty, good luck on your CT
    Patty, good luck on your CT Scan.
  • meinken
    meinken Member Posts: 38
    #9
    No Pets for me either
    My insurance company refused Pet scans after my 2nd post treatment Pet. Since then the doctor has replaced them with a chest ct scan, brain mri and head/neck mri. Some with contrast. The insurance company hasn't balked at those yet. But the amount that the insurance company pays to the hospital for the 2 mri's and ct scan is about 1/4 what they paid for the Pet (though the hospital billed more for the MRIs and CT).

    2 MRIs and ct both w and w/o contrast, hospital billed 10,500 and was paid 1,400. For the Pet/ct hospital billed 7,800 and was paid 5,100.

    I will never understand hospital billing or how/what the insurance company pays. It is one of the mysteries of life.
  • Hondo
    Hondo Member Posts: 6,636 Member
    #10
    Skiffin16 said:

    Thoughts & Prayers - Abi Sister
    Hoping only for the best of continued good news...

    Sorry about the PET scan/insurance crap.... makes you wonder if their explanations would apply if it were them or their family.

    Best,
    John

    Hi Patty

    Don’t let it get you down, just stay as you are a strong and positive person, will keep you in prayer

    All the best my sister
    Hondo
  • Pam M
    Pam M Member Posts: 2,196
    #11
    meinken said:

    No Pets for me either
    My insurance company refused Pet scans after my 2nd post treatment Pet. Since then the doctor has replaced them with a chest ct scan, brain mri and head/neck mri. Some with contrast. The insurance company hasn't balked at those yet. But the amount that the insurance company pays to the hospital for the 2 mri's and ct scan is about 1/4 what they paid for the Pet (though the hospital billed more for the MRIs and CT).

    2 MRIs and ct both w and w/o contrast, hospital billed 10,500 and was paid 1,400. For the Pet/ct hospital billed 7,800 and was paid 5,100.

    I will never understand hospital billing or how/what the insurance company pays. It is one of the mysteries of life.

    Preaching to the Choir
    I know what you mean on wondering what drives insurance co. decisions, meinken. During induction chemo, I had all day chemo for two drugs, then had a third hooked up to me via fanny pack pump for 5 days of chemo at home. Still not over the fact that my insurance company would not pay for my chemo center (where I'd spent a whole day - center was 8 minutes from where I stayed during treatment) to hook up the pump, but WOULD pay for a private nurse to drive to me and hook me up. Huh?
  • Pam M
    Pam M Member Posts: 2,196
    #12
    meinken said:

    No Pets for me either
    My insurance company refused Pet scans after my 2nd post treatment Pet. Since then the doctor has replaced them with a chest ct scan, brain mri and head/neck mri. Some with contrast. The insurance company hasn't balked at those yet. But the amount that the insurance company pays to the hospital for the 2 mri's and ct scan is about 1/4 what they paid for the Pet (though the hospital billed more for the MRIs and CT).

    2 MRIs and ct both w and w/o contrast, hospital billed 10,500 and was paid 1,400. For the Pet/ct hospital billed 7,800 and was paid 5,100.

    I will never understand hospital billing or how/what the insurance company pays. It is one of the mysteries of life.

    Preaching to the Choir
    I must REALLY agree, meinken - double post
  • Pam M
    Pam M Member Posts: 2,196
    #13
    Keep Dancing with NED
    That bites. After treatment, my insurance company denied my doc's PET request, too - until the CT came back showing what we hoped it wouldn't. My doc opted to just do the CT, and go from there (so we did the PET later)- some go for the MRI. I know that some docs prefer CT and MRI over CT and PET. Hoping for another "good" scan for you.
  • luv4lacrosse
    luv4lacrosse Member Posts: 1,410 Member
    #14
    TWO THINGS TOSAY ABOUT INSURANCE COMPANIES
    LEGALIZED RACKETERING
  • pattyanny
    pattyanny Member Posts: 544
    #15
    Yesssss!
    Although I have no faith in the insurance companies, my faith in God remains strong. I want you all to know how much I appreciate your thoughts, prayers, and positive energy. GOOD NEWS!
    No change - I am still NED! Now I can celebrate another birthday this month, which I now view as a gift! I cannot believe all your posts about these insurance companies not paying for much needed scans, chemo, etc! It truly disgusts me - yes,it is the greed and lack of compassion. True again - What if it was THEIR loved one??? But by my faith,and my pitbull of a Sister got me to go, (not cancel) and BELIEVE! I am truly grateful to you all, and hope my experience will inspire you to believe in yourself, not the diagnosis. My PET is scheduled for August, as I told my Dr, UNKNOWN PRIMARY??? Please use it, not the NED diagnosis. She agreed, and hopefully they will approve the PET in August. Either way, I am going to dance, love, and live like there is no tomorrow! How can I go wrong? :)
    My love and prayer to my CSN family. Thank you!!!!
    Love and prayer, Patty - soon to be FATTY!!!!
  • rozaroo
    rozaroo Member Posts: 665
    #16
    pattyanny said:

    Yesssss!
    Although I have no faith in the insurance companies, my faith in God remains strong. I want you all to know how much I appreciate your thoughts, prayers, and positive energy. GOOD NEWS!
    No change - I am still NED! Now I can celebrate another birthday this month, which I now view as a gift! I cannot believe all your posts about these insurance companies not paying for much needed scans, chemo, etc! It truly disgusts me - yes,it is the greed and lack of compassion. True again - What if it was THEIR loved one??? But by my faith,and my pitbull of a Sister got me to go, (not cancel) and BELIEVE! I am truly grateful to you all, and hope my experience will inspire you to believe in yourself, not the diagnosis. My PET is scheduled for August, as I told my Dr, UNKNOWN PRIMARY??? Please use it, not the NED diagnosis. She agreed, and hopefully they will approve the PET in August. Either way, I am going to dance, love, and live like there is no tomorrow! How can I go wrong? :)
    My love and prayer to my CSN family. Thank you!!!!
    Love and prayer, Patty - soon to be FATTY!!!!

    Patty
    How wonderfull! I am so happy for you & also pleased that you received your great new's asap. What a great day this has turned out to be!
    God Bless
    Roz
  • Glenna M
    Glenna M Member Posts: 1,576
    #17
    pattyanny said:

    Yesssss!
    Although I have no faith in the insurance companies, my faith in God remains strong. I want you all to know how much I appreciate your thoughts, prayers, and positive energy. GOOD NEWS!
    No change - I am still NED! Now I can celebrate another birthday this month, which I now view as a gift! I cannot believe all your posts about these insurance companies not paying for much needed scans, chemo, etc! It truly disgusts me - yes,it is the greed and lack of compassion. True again - What if it was THEIR loved one??? But by my faith,and my pitbull of a Sister got me to go, (not cancel) and BELIEVE! I am truly grateful to you all, and hope my experience will inspire you to believe in yourself, not the diagnosis. My PET is scheduled for August, as I told my Dr, UNKNOWN PRIMARY??? Please use it, not the NED diagnosis. She agreed, and hopefully they will approve the PET in August. Either way, I am going to dance, love, and live like there is no tomorrow! How can I go wrong? :)
    My love and prayer to my CSN family. Thank you!!!!
    Love and prayer, Patty - soon to be FATTY!!!!

    Still smiling...
    I'm still smiling, with tears of joy in my eyes. You truly deserve this wonderful news!!!

    Now get out there and live, love and dance :) Tomorrow you will need to start eating so we can wish Fatty Patty a happy birthday.

    God answered our prayers and was there by your side.

    Love and prayers,
    Glenna
  • pattyanny
    pattyanny Member Posts: 544
    #18
    rozaroo said:

    Patty
    How wonderfull! I am so happy for you & also pleased that you received your great new's asap. What a great day this has turned out to be!
    God Bless
    Roz

    Roz
    Love Mt Sinai! Thanks for being so supportive! I am always there for you, do not forget that! God bless you too, I know I am blessed by friends by you! Love, Patty
  • pattyanny
    pattyanny Member Posts: 544
    #19
    Glenna M said:

    Still smiling...
    I'm still smiling, with tears of joy in my eyes. You truly deserve this wonderful news!!!

    Now get out there and live, love and dance :) Tomorrow you will need to start eating so we can wish Fatty Patty a happy birthday.

    God answered our prayers and was there by your side.

    Love and prayers,
    Glenna

    Yum! Food! - I will try!
    Okay! I am listening, and will concentrate on ME! I thank God for answering my plea, and for friends like you! Thanks Sis! Blessings! Patty
  • sweetblood22
    sweetblood22 Member Posts: 3,228
    #20
    pattyanny said:

    Yum! Food! - I will try!
    Okay! I am listening, and will concentrate on ME! I thank God for answering my plea, and for friends like you! Thanks Sis! Blessings! Patty

    Good news.
    Yay, Patty! Well that sure made my day. :)

    I'm going to need to wait an hour to happy dance. I ate too much rice and I feel like I'm going to explode right now.
  • pattyanny
    pattyanny Member Posts: 544
    #21
    sweetblood22 said:

    Good news.
    Yay, Patty! Well that sure made my day. :)

    I'm going to need to wait an hour to happy dance. I ate too much rice and I feel like I'm going to explode right now.

    DancinGg!
    Lol Sweet! You have the best recipes, I am going to have to start copying them. I will gain weight for sure! How about we "happy dance" today? You were to full, and I was exhausted! I fell asleep about 6pm and slept right thru! So today we dance! Thanks Sweet, you are the best!

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