Update, good news, bad news
 

Update!

Good news first. My scans remain stable! Hooray!

Bad news, I was denied treatment. Still no input from Genentech, they say 48 hour decision but it's been longer than a week. I have an open case with the Maine Insurance Commissioner and they are in direct contact with Aetna. Harold Alfo Center for Cancer Care is on its second appeal and my MO has had her say. I did get a response from Senator Susan Collins's office Ginger Kieffer is going to be back in touch with me. I have heard nothing from Senator Angus King or Congressmen Pingree or Poloquin. I just contacted the Governor's office two days ago so it's early to hear back from them. Maine AG is a friend of mine and my former Lawyer and she has my back and is prodding for information and connections. I've taken to social media too. Other than notifying Mass Media Outlets, I have covered all of my bases. It's hard to believe I have had to do this. It's kind of daunting.

Did I tell you my scans are STABLE? Yipeeee!

Re: Update, good news, bad news
 

Thrilled your scans are stable, Tracy!!

Bummed that you are being denied treatment. Keep on fighting and being "out there" on social media.

all the best
caya

Re: Update, good news, bad news
 

So Maine Insurance Commissioner reported back to me that my plan is self funded so does not fall under their jurisdiction, enter the United States Department of Labor. <sigh> this feels never ending.

Re: Update, good news, bad news
 

Great news about your scans, but I find it hard to conceive of your insurance predicament. Fight them with all you've got.
Best wishes..... Pam

Re: Update, good news, bad news
 

Tracy,

Glad to hear the news about your scans! I'm still shocked about Aetna denying H&P. I feel like I must be missing something. You were receiving H&P on Aetna insurance and then for no reason they just sent you a letter stating they were no longer going to cover it? It just seems so unbelievable that I'm wondering if I missed something along the way. A lot of us do have Aetna insurance (myself included) and H & P were covered. You need this drug regardless of how much it costs. It seems Aetna would have to pay for it. I'm just shocked that this could happen.

I know you'll keep pressing to get this worked out. It is just such a shame that you need to fight to get what you need.

Take Care,
Brenda

Re: Update, good news, bad news
 

I know, Brenda, it was unfathomable to me and everyone else I spoke to. A couple of compounding factors may be: I am on COBRA and still have 13 months to go. My Employer (well, formal but I'd go back in a heartbeat if I were well enough) has a self funded plan. I don't know if they can pick and choose what's in the formularly or how that is decided.

Great news, Aetna approved H&P through February so I have some time to regroup. I'm not sure if the call from Senator Susan Collins's office or the call and open case with The US Dept of Labor compelled them to change their minds. I plan to keep pushing, this should never happen to another patient, being denied standard of care drugs.

Re: Update, good news, bad news
 

Oh, such good news. It was unbelievable these drugs we're denied.

Re: Update, good news, bad news
 

Tracy, wonderful news that your insurance will pay through February. You have been brave and wise in contacting all the senators and departments that you have. Sorry that you have to keep on them to get approved past February. Geez!! So happy to hear your scans were clear. Sending good vibes your way!

Re: Update, good news, bad news
 

Hi Tracy,

How insane is that? I'm so glad your recent scan show stability.

I'm still dealing with Regence (Blue Cross) wanting to deny payment on Avastin from October 2016-January 2017. I had three policies with Regence during that time and they are only applying the appeal to the most recent policy. I've got a medical attorney working on it for me as it is a lot of money they are tying to avoid paying. Same patient. Same doctor. Same drug. Shown to be effective and yet they are claiming that it was experimental -- while they are also accepting that it worked in my case. Ugh. Makes my head spin.

Still, yeah for clean scans.

Ann

Re: Update, good news, bad news
 

Great news on both fronts, Tracy