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PET /CT versus Regular CT of H&N

osmotar's picture
Posts: 970
Joined: Jul 2011

Well I finally got the call a lot of you may have, after 3 PET/CT scans , the next was scheduled for Monday the 3rd, my insurance has deemed that thePET is not medically necessary for me, they will pay for a H&N CT only, and will only approve one of those every 4 months versus the PET/CT I was getting every 3. While my insurance has paid out close to $250K for my treatments and everything else last year to current , I shouldn't really complain, but even with the scanextity that we all experience before and after any scans I felt the PET/CT was like security blanket at least for me. My onco would be contacted to set up a " as needed" discussion concerning her requiring the PET/CT I also have 180 days to appeal; my first questions would be did you ever have cancer, does anybody in your family have/had cancer. I guess the words being proactive and preventative don't come into play with the folks who make the decisions for what's paid for or not. Ok Linda stop the venting,find your zen...I'll give my onco a call to see what her thoughts are.

Posts: 1901
Joined: May 2012

Hey Linda,
A regular CT or MRI will pick up changes in our bodies. And if our doctors are vigiliant and needing to have a PET/CT done because of possible problems....they know how to get the preapproval on them. Try to relax...and know your team won't let you down. Good luck, will be thinking of you ! Katie

osmotar's picture
Posts: 970
Joined: Jul 2011

Thanks Katie for the encouraging words, guess I'm so amped as I had just gotten off a 5 1/2 hour flight from the east coast.

Skiffin16's picture
Posts: 8240
Joined: Sep 2009

So far nearly four years out, I've been pretty lucky as for PET approval.

I've been able to have one each year after the initial year, but not as frequent as you.

My schedule is a CT in January - February and the PET July - August.

I know what you mean concerning it being a security blanket for early detection..., I'm with you.

But on a different view point..., my onco is the one that schedules them. My ENT isn't so hot on getting any additional radiation exposure.


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