confused and frustrated

karen1951

i have an appt tomorrow with my oncologist to discuss my disease progression....i will be starting on chemo again. it drives me crazy to wonder if the combination of drugs i will be given will be "the best" or just "the best my insurance will pay for" and/or is still available...in july when i had "suspicious recurrence" my onc said he wanted to put me on doxil which is now no longer available. and it looks like avastin may or may not be paid for by insurance!
and to top things off....don't know if any of you ladies live in pittsburgh like i do, but next june i will no longer have "in network" access to any of my doctors since our region"s two giant health care ins. provider"s (upmc and highmark bcbs) contract is expiring. so i will probably have to find all new doctors and new hospitals.
i'm not usually this negative but just had to "sound off" a little about this issue.

Sunnyjh

Sound off
Don't feel bad about sounding off, you have every right! Sound off we are willing to listen and sympathize with you. judy

mom2greatkids

Sunnyjh said:

Sound off
Don't feel bad about sounding off, you have every right! Sound off we are willing to listen and sympathize with you. judy

Sound off all you want!
Sound off all you want! None of us will take offense to your doing so! We may join in. When I began my first line chemo in June, my insurance would not pay for avaistan. However, my aggressive doctor had it approved by my second treatment. He plans to keep me on it for 2 years as maintenance. Good luck and keep us updated!! Carla

Cafewoman53

You are not alone
It drives me crazy that our drs cannot prescribe the course of treatment they want to due to shortages or insurance constraints. I am waiting to find out what treatment my Dr is planning, even at the start of my treatment she had to change the plan due to a shortage of cisplatin. I often wonder if she would have treated me the way she wanted to that I might have been doing better now.
Sorry you are dealing with this I would be upset if I had to change drs. They really don't understand what they are putting you thru. I would talk to your dr to see I would think maybe he will join whatever network will replace your old one. Good Luck !
Colleen

Kaleena

Hi Karen:Went to
Hi Karen:

Went to Pittsburgh. I am now going to Cleveland. In July of 2009, I was told I had a suspicious recurrence mass. Was told in Pgh to start chemo immediately, but that it was probably an inoperable tumor. Went to Cleveland for second opinion. Had surgery (short) - no chemo - tumor was negative.

Also, even though Pittsburgh was in-network (and at the time so was Cleveland), because I went to Cleveland after a while no one would flush my port in Pgh. They directly refused because my doctor and my local PCP doctor weren't associated with that particular hospital.

By the way, if you have Blue Cross/Blue Shield, Cleveland would be considered in-network because the State of Ohio has a reciprocal agreement with Blue Cross/Blue Shield.

I drive 3 hours for my appointments. I hope you can get your stuff settled without going that route! It is stressful enough without worrying about insurances and/or having to look for new doctors!

My best to you on your appointment tomorrow.


P.S. Due to the very high premiums of BCBS, we had switched to HealthAmerica (after being told we would get EXACTLY everything we had with BCBS, and that my doctor would be considered innetwork). Wrong! Cleveland at the time was not in-network so I was no longer able to get any tests done at Cleveland. Just in Pittsburgh. However, as of November of this year, Cleveland just now has entered into contract with HealthAmerica so now Cleveland would be considered in-network. I was so screwed when we switched insurances and I was extremely stressed because I was due for a PET Scan and the Health America refused it both in Cleveland and in Pittsburgh. I ended up getting a CT scan six months after I was to get a PET scan so I was scared if anything would show up because I didn't know what I would do if I would have needed treatment.

jbeans888

Kaleena said:

Hi Karen:Went to
Hi Karen:

Went to Pittsburgh. I am now going to Cleveland. In July of 2009, I was told I had a suspicious recurrence mass. Was told in Pgh to start chemo immediately, but that it was probably an inoperable tumor. Went to Cleveland for second opinion. Had surgery (short) - no chemo - tumor was negative.

Also, even though Pittsburgh was in-network (and at the time so was Cleveland), because I went to Cleveland after a while no one would flush my port in Pgh. They directly refused because my doctor and my local PCP doctor weren't associated with that particular hospital.

By the way, if you have Blue Cross/Blue Shield, Cleveland would be considered in-network because the State of Ohio has a reciprocal agreement with Blue Cross/Blue Shield.

I drive 3 hours for my appointments. I hope you can get your stuff settled without going that route! It is stressful enough without worrying about insurances and/or having to look for new doctors!

My best to you on your appointment tomorrow.


P.S. Due to the very high premiums of BCBS, we had switched to HealthAmerica (after being told we would get EXACTLY everything we had with BCBS, and that my doctor would be considered innetwork). Wrong! Cleveland at the time was not in-network so I was no longer able to get any tests done at Cleveland. Just in Pittsburgh. However, as of November of this year, Cleveland just now has entered into contract with HealthAmerica so now Cleveland would be considered in-network. I was so screwed when we switched insurances and I was extremely stressed because I was due for a PET Scan and the Health America refused it both in Cleveland and in Pittsburgh. I ended up getting a CT scan six months after I was to get a PET scan so I was scared if anything would show up because I didn't know what I would do if I would have needed treatment.

That's what we are here for.
That's what we are here for. I would be frustrated too. Cancer is such a money maker. It is ridiculous. It's bad enough we have to deal with cancer, but dealing with insurance and money is almost as bad.

ona

Hoppe and pray for a miracle

Hoppe and pray for a miracle medicine for us all, to end these worries.
God bless you. Have a wonderful Thanksgiving.