reporting in from Nashville

snommintj said:

How will you pay?
I've been doing some research on the interferon he's using. If I've been told correctly it is interferon-2a. I was also told that it was very expensive. Will your insurance cover it? If not, does he get some kind of discount. I was told that one treatment for me would be 7000. I hope this is incorrect, did he say which interfeon he's using?

KFen725 said:

Great!
Hi, Lisa! I have been keeping my eyes on the boards looking to see your update on the Teneessee trip. Praying that mighty and wonderful things happen for you with this new treatment! Like Diane, I am also praying for a wonderful and complete healing for your body.

Love,
Kelly

lisa42 said:

Hi Brooks
Hi Brooks,

Thanks for the reply and I made it home yesterday (Saturday) afternoon. Slept in this a.m. and am still sitting here in my robe as I type (yikes- it's almost 1 in the afternoon- better go get dressed and get going with my day)
We'll do the lunch sometime- probably sometime after the holidays & maybe we can get others in the area together too.

Take care-
Lisa

lisa42 said:

snommintj & Kim & to anyone interested in cost and insurance cov
Hi,

snommintj- I'm not sure where you got the $7,000 figure- maybe that was figuring with having to pay for the interferon cash, along with the Dr. visits over time?
This first initial visit, which consisted of two days of visits, two hours each (and he spent a total of 4 hours with me with his undivided attention & no one else even sitting out in the waiting room)- cost me a little over $900 (with a 7% discount for paying it all at once and for paying with a debit card or check). He gives a 5% discount of the main price for paying right then with a credit card and an additional 2% discount for paying with a debit card or a check. He has no control over the cost of the drugs, but he does recommend the type of interferon that is the most cost effective and the most likely to be covered by insurance. The Lovastatin is not covered by my insurance because it is FDA approved for cholesterol, not cancer (if you have high cholesterol, then your insurance probably would cover it). Anyhow, it is VERY CHEAP even just paying cash. I called Rite Aid first, because that's where I get my medicines when at home, and they quoted me $65.99 for my first month's worth. Next, I called the Wal Mart pharmacy there... $8, literally just eight dollars! Cheaper than what my insurance copay for medicines! Wal Mart is where I'll be getting it from.
It was just Friday that the info for the interferon was submitted to my insurance, so I'll be following up Monday and Tuesday to see about coverage. It is covered for cancer, but not specifically colon cancer, so it is actually possible that they'll deny it. The cash cost of it varies (depending upon your dosage, which depends upon your weight) anywhere from $800-$1300 a month, is what I was told. Dr. Cantrell also said that some insurances will deny it outright, but may end up covering it after all when reasons are submitted as to why it is needed. He said many states have laws now that when a patient has gone through all standard treatments and has "failed" on standard treatments that the insurance companies must pay for clinical trials and "reasonable off market treatments" (which this qualifies as). It just may take a little convincing by the doctor writing a letter, etc. to convince them that this is a reasonable "next step" treatment that should be covered.
I have Aetna HMO and Dr. Cantrell said it may do nothing, but it certainly couldn't hurt to try to submit a form to my insurance for reimbursement of what I'm paying for these Dr. visits. I hadn't even thought of trying since it's an HMO, but you never know, so I'm going to try to submit for reimbursement.
I also have heard about from Dr. Cantrell and DAN R. (who went earlier in Nov) about how the company that makes the interferon (can't currently remember what it is) has a foundation that helps out when people's insurance companies don't pick up the cost. The help they offer is based on your income. I imagine I wouldn't qualify for that, but if it comes down to me not getting coverage, I will definitely seek them out to see if I could at least get at least some financial help, even if it isn't for the full amount.