Insurance

AMomNETN
AMomNETN Member Posts: 242
edited March 2014 in Breast Cancer #1
Hi Ladies,

I just have a quick question about scans and insurance. My insurance rejected my oncs request for a PET. I kinda understand that denial. I finished chemo July 16th. Today the oncs office called and said my insurance would only pay for a chest XRay. The said there isn't a basis for any other scans. I know I can appeal but doubt I will all insurance companies see now is the bottom line. I just want to know that this cancer of any type is not in my body. This is an outside company that decides if my insurance will pay. It is a same they will shell out $$$$$$ to treat cancer but not to make sure it is gone or catch it before it gets too bad. Oh well, such is life. I do believe they will be getting letters from me tho. Won't do any good but I'll feel a little better.

Janie

Comments

  • disneyfan2008
    disneyfan2008 Member Posts: 6,583 Member
    #2
    sorry to hear
    my mom did not have cancer but saw an onolcogist for years...they wanted her to have PET scan and insurance refused so it was never done...

    I hope it gets approved...
  • LVG
    LVG Member Posts: 128
    #3
    This insurance stuff is
    This insurance stuff is messy...
    I am hoping you get yours worked out. My onc requested a muga scan prior to chemo, insurance denied saying I needed an echo 1st and if echo revealed problems... Then they'd approve muga. I went for the echo & was denied. Did it anyway. Doc's office told me they'll help me appeal.
  • cavediver
    cavediver Member Posts: 607
    #4
    just more fun stuff we have to deal with
    My insurance company refused approval of a PETscan when I finished chemo....they would only approve a ct chest scan. But then 2 months later my onc tried again and they then approved me having a Petscan. It is not us or our doctors, but the insurance companies that are dictating what treatments or follow up tests we get. Would this have been your first PET or did you have one within the prior 6 months? You could ask your onc to request again in a month or so. It is a nice feeling to hear that the PETscan results came back clean. But then again, nothing is guaranteed as we have all come to realize.
    Good luck.
  • sbmly53
    sbmly53 Member Posts: 1,522
    #5
    It's all baloney
    But, depending on your type of cancer, your stage, surgeries, etc. Some tests aren't warranted. And sometimes it is the insurance co being an *ssh*l*.

    All we want to know is that the cancer is gone.

    Sue
  • AMomNETN
    AMomNETN Member Posts: 242
    #6
    cavediver said:

    just more fun stuff we have to deal with
    My insurance company refused approval of a PETscan when I finished chemo....they would only approve a ct chest scan. But then 2 months later my onc tried again and they then approved me having a Petscan. It is not us or our doctors, but the insurance companies that are dictating what treatments or follow up tests we get. Would this have been your first PET or did you have one within the prior 6 months? You could ask your onc to request again in a month or so. It is a nice feeling to hear that the PETscan results came back clean. But then again, nothing is guaranteed as we have all come to realize.
    Good luck.

    Thanks
    Thank you for your replies. I haven't had a PET scan. My insurance like yours cavediver it will only pay for ct scan. I always wonder what their replies would be if it was someone close in their families in my shoes. I'll live with whatever because I have no choice. I can't afford it if insurance isn't paying or helping. Ya'll are right it just comes down to the dollar. Thanks for listening.
  • Marcia527
    Marcia527 Member Posts: 2,729
    #7
    it's all about almighty dollar
    My oncologists never even suggested scans after treatment. I only had them done if something was wrong. So I had a bone scan once because of hip pain and a head scan because of hand tremor. Neither was cancer. I've had three different oncs because of moving around to different states.

    I really think health care should be between the doctor and patient. Insurance companies and third parties shouldn't be dictating care given.
  • VickiSam
    VickiSam Member Posts: 9,079 Member
    #8
    sbmly53 said:

    It's all baloney
    But, depending on your type of cancer, your stage, surgeries, etc. Some tests aren't warranted. And sometimes it is the insurance co being an *ssh*l*.

    All we want to know is that the cancer is gone.

    Sue

    My suggestion .. talk with your Oncologist - Case Manager
    have him/her get in touch with your insurance Company and explain, as well as written a letter explaining how important this test is to your welfare and extended health. Also, please speak with our human resource department asking them to get involved.. Keep calling, taking notes as well as names, and DO NOT be afraid to continue calling back. If your insurance company denies your request .. ask for the denial in writting, and contact your State Insurance commissioner ..

    Do not give up .. explore all options, if possible.

    Happy Hunting and Fighting for your God given rights as a Cancer patient.

    Strength and Courage

    Vicki Sam
  • DianeBC
    DianeBC Member Posts: 3,881 Member
    #9
    AMomNETN said:

    Thanks
    Thank you for your replies. I haven't had a PET scan. My insurance like yours cavediver it will only pay for ct scan. I always wonder what their replies would be if it was someone close in their families in my shoes. I'll live with whatever because I have no choice. I can't afford it if insurance isn't paying or helping. Ya'll are right it just comes down to the dollar. Thanks for listening.

    My insurance has been great!
    My insurance has been great! They have authorized and paid for every test, so far. I hope it continues. I am so sorry that yours won't. It just doesn't seem fair.


    Good luck,

    Diane

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