I need a shoulder to cry on...

So sorry that you had to go through these. Hopefully, your oncologist can resend a request to your insurance company. Did you also touch base with social- worker in the hospital who could look up some resources for you. I once enquired about loans for cancer treatment, CTCA has some resources where they could provide some loans based on your life insurance coverage or something. I am so sorry I couldn't recall the specifics. 

Will be praying for you, Good luck !

Insurance companies interfering with your doctor's clinical decisions for you and high deductibles and high maximum out of pockets. I had a $4500 deductible last year and $7500 max OOP and met them both plus $10,000 in expenses that were not reimbursable. That's what our politicians should be talking about. 

This kind of thing makes me furious! I am so sorry you have to deal with this. Soup is right, though. I have known several people who managed to diminish their costs that way. Sucks to have to go through machinations like this when all you should be focused on is healing.

Go to your State Department of Insurance and register a complaint. Insurance companies also hate that. You can either call or also probably do it online. 

Hi, I wish you the best with getting the appeal.  I dont know completely how you feel, but i almost lost my insurance right before my radiation treatments started. I was on state insurance and it looked like I was going to loose my insurance.  It was so stressful.  I hated it.  Worrying about money is the last thing a cancer patient wants.  Im glad you are feeling better after comming to this forum.  Thats What helped me too.

Lots of love Janae

If I were you, I would first take a look at your 2017 Coverage Brochure and see what it states as far as coverage for radiation for cancer.  That will tell you what has to be shown for the radiation to be a covered service.  This information should be provided to your rad-onc who will need to establish how your radiation treatment meets the coverage criteria. 

Several years after I finished treatment for endometrial cancer, my insurance company notified me that they would not provide coverage for my CA-125 blood test because it was only used to monitor ovarian cancer.   I contacted my radiation oncologist, who had ordered the test for which the insurer had denied payment.  My rad-onc wrote an appeal letter to the insurer and provided supporting documentation.  The appeal letter stated as follows:

"I received a letter from one of my patients indicating that you will not provide coverage for her to receive a CA-125 blood test, a tumor marker that is being followed for her diagnosis of endometrial adenocarcinoma.  My patient was diagnosed with endometrial adenocarcinoma, Stage II.  She had tumor invading 80% of the myometrium, extensive lymphovascular invasion, lower uterine segment involvement, and she underwent radiation treatment in our department.  CA-125's are used to screen ovarian cancer as well as endometrial cancer for ruling out recurrence.  The patient had a risk for having a recurrence of her tumor and therefore we are using every screening modality possible to be able to detect this if it should occur.  She does have her physical exams and the screening CA-125 is used as a marker because if it becomes elevated then it means we would need to look for recurrence and this would lead to earlier pick-up of recurrence than with physical exam or CT scans. 

Even though it is not specific for endometrial cancer, it does become elevated in some cases.  As seen in the refresher course from the American Society of Therapeutic Radiation Oncology (attached), CA-125 is also considered as part of the work-up and diagnosis.  Usually these markers are used afterwards for following patients, ruling out tumor regrowth.  As you can see also from the attached Follow-up of Cancer Handbook for Physicians, Fourth Edition, when following patients with endometrial cancer, CA-125 is also used as indicated.  Therefore, this patient's CA-125 should not be denied for payment.  I hope you will provide payment for this tumor marker which could potentially save my patient's life." 

After my insurer received my rad-onc's appeal letter and supporting documentation, they reversed their denial and paid for all my subsequent CA-125s.  Good luck in getting your rad-onc to provide the necessary information to your insurer to get your denial reversed!!

If your doctor asks for it, you need him to be your advocate. I have not nneded to focus that with my cancer treatment yet but I did with knee replacement. When I maxed out my physical therapy, the therapist and Dr said I needed 2 more months. They argued with the insurance and I got it Reversed so I could continue. Let the advocate but ask to be on the line so you can follow and prod ur Dr if need be. Good luck. It sux.