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Need help forming letter to employer/insurance

rhlkale
Posts: 1
Joined: Jan 2013

My husband was diagnosed Oct'12 and has had 4 rounds of chemo so far. Our insurance(Cigna) only approves bone marrow transplant prodecure at Mayo clinic in Phoenix-we live in Tucson,AZ which is 3.5 hours away. Tucson has a great local cancer treatment center but not covered. Our doctor suggested writing an appeal to my employer to ask for a variance due to hardship. We have 4 children ages 9-15 and can not make daily trips to Phoenix for treatment-advised it is daily for a month then every other day for month or two after that. Insurance will cover hotel, rental car, milage and food for 2 up to $10,000(lifetime) but I would have to lose work, pay for childcare on top of my husband unable to work.

Has anyone else had to write a letter to get insurance to allow local treatment? If so, was it successful? I need help soon as his bloodwork shows he needs the treatment sooner rather than later.

Thank you in advance for any help,

Rachael

Jan1122's picture
Jan1122
Posts: 2
Joined: Feb 2013

Have you thought about going directly to the insurance company & asking them for some letter advise, they possibly have a worker there that works directly with cancer patients. I know there are many avenues out there in which to seek help, I unfortunately just do not know them all. I completely understand your hardship & anyone dealing w/ this dreadful disease has to understand. I'm going to watch & see if anyone steps up to help you that may have more insight than I do. I would like to see you get all the help you need, I can hear the desperation in your letter.

I would also check with your Oncologist office, they may have a person on staff that has dealt with this before & can lend you some knowledge, if it certainly worth a call.

God Bless you & your entire family.  I will keep watching your posts. IF I hear of anything that will benefit you, I will post it immediately.

 

Best Wishes for a speedy recovery or @ least complete remission. Smile

GKH
Posts: 292
Joined: Jul 2012

I had CIGNA too and they are tough. Mine was a disability claim but its the same company.  I am currently suing them. Please get the advice of an attorney before accepting any offer from them. My experience is they will "set you up" for future denial of claims so get everything in writing. If they tell you something on the recorded phone line they somehow seem to lose the recording and may deny saying it. Not to say they are bad people or even a bad company. They are just a large bureaucratic organization run by lawyers and accountants. They do have a patient advocate who is supposed to be impartial. You may try that. Also Arizona has a state insurance commission whose job is to help you with matters like this. They seem to be more responsive to patient needs than the CIGNA folks.Don't want to discourage you just want you to know they have far more lawyers and accountants than they have doctors.

 

Be sure to get a copy of your policy. Not just the summary but the entire policy.It may be handy thing to have in the future. These policies change continuously. You need to specify that you want the one in effect when your husband became ill.

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