INSURANCE DENIED MY CHEMOTHERAPY...WE NEED TO FIGHT FOR OUR RIGHTS!

meena1
meena1 Member Posts: 1,003
edited March 2014 in Breast Cancer #1
Not only do we have to fight Breast Cancer, we also have to fight our insurance company to authorize our treatment. Some may be familiar with my story, i have stage 4 breast cancer which has spread to my liver. My liver is swollen which is causing extreme pain. My doctor is prescribing Abraxane and Avastin and my insurance is denying the drugs. I went to the office for treatment today and they could not start it because of insurance. I am not sure why they are denying the claim, maybe not medically necessary. In fact they would not authorize any chemo. They finally did authorize Taxol. My insurance company is Independence Blue Cross, and yes i also work for them. So, they are denying life saving treatment for their employee. I hope that i have enough strength to fight this, not just for me, but for all Breast Cancer survivors who have a reoccurance. They do what ever they dang well want. Take care
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Comments

  • 2Floridiansisters
    2Floridiansisters Member Posts: 384 Member
    #2
    You've got to be kidding me.................
    Holy Crap, this pisses me off like you wouldn't believe, I pray that somehow this gets fixed asap. I don't know what else to say....................other than I am sorry to hear this.

    Love Ronda
  • New Flower
    New Flower Member Posts: 4,294 Member
    #3
    2Floridiansisters said:

    You've got to be kidding me.................
    Holy Crap, this pisses me off like you wouldn't believe, I pray that somehow this gets fixed asap. I don't know what else to say....................other than I am sorry to hear this.

    Love Ronda

    Meena
    Sorry. I am speechless. I am sure your doctors are in shock. Avasin has been made Genentech. It is a new drug. They have patient assistance.http://www.gene.com/gene/products/access/. I do not details but maybe be they can help you. Please try them out along with pressure to your insurance. You need to scare them by lawsuit, requesting a written explanation why it was denied. I think for urgent care they suppose to answer appeal with 48 hours. Please fight and be your own advocate.
    Keep us in the loop
  • meena1
    meena1 Member Posts: 1,003
    #4
    New Flower said:

    Meena
    Sorry. I am speechless. I am sure your doctors are in shock. Avasin has been made Genentech. It is a new drug. They have patient assistance.http://www.gene.com/gene/products/access/. I do not details but maybe be they can help you. Please try them out along with pressure to your insurance. You need to scare them by lawsuit, requesting a written explanation why it was denied. I think for urgent care they suppose to answer appeal with 48 hours. Please fight and be your own advocate.
    Keep us in the loop

    I knew you were going to
    I knew you were going to respond, New Flower. I am requesting a copy of the letter tomorrow. Then will figure out where to go from there. This is also the company i work for, which i have had problems with since i was diagnosed. Hopefully, they will reconsider.
  • aisling8
    aisling8 Member Posts: 1,627 Member
    #5
    meena1 said:

    I knew you were going to
    I knew you were going to respond, New Flower. I am requesting a copy of the letter tomorrow. Then will figure out where to go from there. This is also the company i work for, which i have had problems with since i was diagnosed. Hopefully, they will reconsider.

    Oh, my
    That is so horrendous, so awful, so inhumane. Please fight fight fight.

    Victoria
  • New Flower
    New Flower Member Posts: 4,294 Member
    #6
    meena1 said:

    I knew you were going to
    I knew you were going to respond, New Flower. I am requesting a copy of the letter tomorrow. Then will figure out where to go from there. This is also the company i work for, which i have had problems with since i was diagnosed. Hopefully, they will reconsider.

    Good that you are fighting
    still please look at Genentech side. You might find something useful there.
    Unfortunately, insurance is my specialty, along with employer's relationships and legal matters. I wish I would not have an experience with this stuff, but I do. Still have some claims open since july of 2008.
    Good luck
  • carkris
    carkris Member Posts: 4,553 Member
    #7
    New Flower said:

    Good that you are fighting
    still please look at Genentech side. You might find something useful there.
    Unfortunately, insurance is my specialty, along with employer's relationships and legal matters. I wish I would not have an experience with this stuff, but I do. Still have some claims open since july of 2008.
    Good luck

    It makes me angry and sad.
    It makes me angry and sad. New Flower has a great idea. I wish I had answers, just empathy and anger! You shouldnt have to deal with all this!
  • Megan M
    Megan M Member Posts: 3,000
    #8
    2Floridiansisters said:

    You've got to be kidding me.................
    Holy Crap, this pisses me off like you wouldn't believe, I pray that somehow this gets fixed asap. I don't know what else to say....................other than I am sorry to hear this.

    Love Ronda

    I am so sorry Meena. This
    I am so sorry Meena. This is not fair, not at all. I hope and pray that you can find someway to get your treatment paid for. Please exhaust all possibilities that you can.

    Good luck, Megan
  • survivorbc09
    survivorbc09 Member Posts: 4,374 Member
    #9
    meena1 said:

    I knew you were going to
    I knew you were going to respond, New Flower. I am requesting a copy of the letter tomorrow. Then will figure out where to go from there. This is also the company i work for, which i have had problems with since i was diagnosed. Hopefully, they will reconsider.

    This is horrible Meena!
    This is horrible Meena! Please fight your insurance company and keep us posted!
  • Chickadee1955
    Chickadee1955 Member Posts: 356 Member
    #10
    Megan M said:

    I am so sorry Meena. This
    I am so sorry Meena. This is not fair, not at all. I hope and pray that you can find someway to get your treatment paid for. Please exhaust all possibilities that you can.

    Good luck, Megan

    Use all the tools in the arsenal
    Meena,

    I, too, work for an insurance company. I highly recommend writing a letter and copying every conceivable person/agency you can think of. Start with your state's department of insurance, then the president of the insurer, then the local newspaper, the local television news show consumer advocate, then the better business bureau, then Presiden Obama. Believe, me, these days insurers don't want a news reporter showing up asking questions about why they are denying life-saving and "standard" treatment for someone like you. The more people you cc the quicker the response will be.

    Go after them!

    Chickadee
  • jnl
    jnl Member Posts: 3,869 Member
    #11
    New Flower said:

    Meena
    Sorry. I am speechless. I am sure your doctors are in shock. Avasin has been made Genentech. It is a new drug. They have patient assistance.http://www.gene.com/gene/products/access/. I do not details but maybe be they can help you. Please try them out along with pressure to your insurance. You need to scare them by lawsuit, requesting a written explanation why it was denied. I think for urgent care they suppose to answer appeal with 48 hours. Please fight and be your own advocate.
    Keep us in the loop

    I am sure you know this,
    I am sure you know this, but, contact the ACS too. I bet they can help you.

    Hugs Leeza
  • MyTurnNow
    MyTurnNow Member Posts: 2,686 Member
    #12
    Meena, this just plain SUCKS
    Meena, this just plain SUCKS and really pisses me off, too. Considering that this is also your employer, can't you contact someone within the company and perhaps escalate the issue? I think New Flower's suggestion of contacting the drug company directly is also a great idea. I am just appalled that an insurance company has the power to deny lifesaving drugs for us. This is WRONG!! If there is anything I can do to help you, please let me know. We are all on your side. Keep us posted.
  • padee6339
    padee6339 Member Posts: 763
    #13
    HOW AWFUL!
    You go get 'em Meena!!! Fight like a girl! I agree with everyone above - and send as many cc's to as many people as you can!
    Hugs - Pat
  • DebbyM
    DebbyM Member Posts: 3,289 Member
    #14
    MyTurnNow said:

    Meena, this just plain SUCKS
    Meena, this just plain SUCKS and really pisses me off, too. Considering that this is also your employer, can't you contact someone within the company and perhaps escalate the issue? I think New Flower's suggestion of contacting the drug company directly is also a great idea. I am just appalled that an insurance company has the power to deny lifesaving drugs for us. This is WRONG!! If there is anything I can do to help you, please let me know. We are all on your side. Keep us posted.

    This does suck and makes me
    This does suck and makes me mad too. Hard to believe this happened since you work for the company. New Flower does have a great suggestion. I hope it helps. Praying that something works to help you!
  • meena1
    meena1 Member Posts: 1,003
    #15
    padee6339 said:

    HOW AWFUL!
    You go get 'em Meena!!! Fight like a girl! I agree with everyone above - and send as many cc's to as many people as you can!
    Hugs - Pat

    I called my insurance this
    I called my insurance this morning requesting a denial letter. I advised them that i am contacting the news media and a lawyer. Imagine the headline "Large Insurance denies approved Chemotherapy treatment for one of its employees". I told her that this is an Obama dream, considering all the news about healthcare right now. Well, that was 3 hrs ago and she has not getting back to me. I called and said they are reviewing it. I explained I want the denial letter, they can review it later. still waiting. lover Meena
  • DebbyM
    DebbyM Member Posts: 3,289 Member
    #16
    meena1 said:

    I called my insurance this
    I called my insurance this morning requesting a denial letter. I advised them that i am contacting the news media and a lawyer. Imagine the headline "Large Insurance denies approved Chemotherapy treatment for one of its employees". I told her that this is an Obama dream, considering all the news about healthcare right now. Well, that was 3 hrs ago and she has not getting back to me. I called and said they are reviewing it. I explained I want the denial letter, they can review it later. still waiting. lover Meena

    Good for you Meena! I pray
    Good for you Meena! I pray that they will reconsider and cover your chemo. Thanks for keeping us updated! This is so important to all of us!
  • Ritzy
    Ritzy Member Posts: 4,381 Member
    #17
    Chickadee1955 said:

    Use all the tools in the arsenal
    Meena,

    I, too, work for an insurance company. I highly recommend writing a letter and copying every conceivable person/agency you can think of. Start with your state's department of insurance, then the president of the insurer, then the local newspaper, the local television news show consumer advocate, then the better business bureau, then Presiden Obama. Believe, me, these days insurers don't want a news reporter showing up asking questions about why they are denying life-saving and "standard" treatment for someone like you. The more people you cc the quicker the response will be.

    Go after them!

    Chickadee

    This is horrible Meena and
    This is horrible Meena and so not right! I pray that you get your insurance to cover your treatment. You go girl!


    Sue :)
  • Kylez
    Kylez Member Posts: 3,761 Member
    #18
    aisling8 said:

    Oh, my
    That is so horrendous, so awful, so inhumane. Please fight fight fight.

    Victoria

    This truly is inhumane! I
    This truly is inhumane! I can't believe it! You fight Meena!
  • susie09
    susie09 Member Posts: 2,930
    #19
    New Flower said:

    Meena
    Sorry. I am speechless. I am sure your doctors are in shock. Avasin has been made Genentech. It is a new drug. They have patient assistance.http://www.gene.com/gene/products/access/. I do not details but maybe be they can help you. Please try them out along with pressure to your insurance. You need to scare them by lawsuit, requesting a written explanation why it was denied. I think for urgent care they suppose to answer appeal with 48 hours. Please fight and be your own advocate.
    Keep us in the loop

    OMG Meena. I am speechless
    OMG Meena. I am speechless too. This is unbelievable! I pray that you will get the help that you need and soon! Be your own advocate in this and fight hard! We are with you!
  • camsgram
    camsgram Member Posts: 106
    #20
    meena1 said:

    I called my insurance this
    I called my insurance this morning requesting a denial letter. I advised them that i am contacting the news media and a lawyer. Imagine the headline "Large Insurance denies approved Chemotherapy treatment for one of its employees". I told her that this is an Obama dream, considering all the news about healthcare right now. Well, that was 3 hrs ago and she has not getting back to me. I called and said they are reviewing it. I explained I want the denial letter, they can review it later. still waiting. lover Meena

    I think if they don't come
    I think if they don't come thru for you and I mean ASAP we all go to the media in our own areas! I will so just say the word. Take care
    Kathie
  • Sunrae
    Sunrae Member Posts: 808
    #21
    camsgram said:

    I think if they don't come
    I think if they don't come thru for you and I mean ASAP we all go to the media in our own areas! I will so just say the word. Take care
    Kathie

    Oh Meena, Your situation is
    Oh Meena, Your situation is unbelievable. On top of everything else to be denied a medication that can help you fight on, its just totally wrong. Its hard enough to fight the disease, you don't need to have to fight for your medications or treatment. This makes me so mad, I wish I could be there with you and go up against those miserable souls who are causing you such grief. Keep up the good fight and you'll surely win because you're on the right side. Let us know how it goes.

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