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10-09-2011, 06:59 PM
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#21
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Senior Member
Join Date: Apr 2007
Location: Mississippi
Posts: 539
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Re: can people chime in as to what insurance companies they have and what troubles
Oh, by the way, I just found out last week what my part (after insurance) of the DIEP surgery will be if I have it in NOLO. I cried.
__________________
In the world of destiny, there are no statistics.
Jan. 26- mammogram and ultrasound- suspicious lump
Mid-February- lumpectomy, infiltrating ductal carcinoma ~4.5 cm and a 1 cm DCIS, did not get clear margins, did not check lymph nodes
ER+/PR+, her2 +++, nuclear grade 3 of 3
February 20-PET scan showed something on liver. No biopsy.
March- Started carboplatin, herceptin, taxol on a four week cycle
May 3- Pet scan, with intent to do a biopsy, found nothing, liver or breast- no biopsy because there is nothing to biopsy
June 21- new onc, very concerned that there had been no biopsy,
June 18th-CAT scan, bone scan-negative
August 7th - Brain MRI-negative
August 9th- mastectomy, all pathology negative
January 2008 still NED! New oncologist -herceptin for full year after chemo- until July, and tamoxifen---negative scans since May '07
July 2008-Finished Herceptin!
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10-10-2011, 08:57 PM
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#22
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Senior Member
Join Date: Apr 2011
Posts: 290
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Re: can people chime in as to what insurance companies they have and what troubles
I have Health Net of CA. Each insurance company offers different plans, your benefit eg office visit copay, hospitalization and ect depend on what plan you have. I have an HMO and so far have had no problem with it. I wish i have a PPO incase i need it to participate in any clinical trial. I doubt HMO covers it since you are always referred to a doctor in their contract.
__________________
DX Jan 24,2011 age 36
ER/PR-, Her2 +
TCH*6, Herceptin
BMX with immediate recontruction Lattismus Flap- May,2011
Dx stage 3c 10/23 nodes
Radiation Aug to Sep , 2011
Last herceptin 02/2012
Local recurrence to skin 03/2012 stage IV
Whole body scan CLEAR 3/28/2012
Tykerb & Xeolda 04/2012
Skin mets slowly regressing
PET & Brain CT Clear 08/15/2012
Whole body PET Clear 02/04/2013
Skin mets progressing 05/15/2013
New treatment Kadcyla pending
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10-15-2011, 07:22 PM
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#23
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Senior Member
Join Date: Apr 2007
Location: Mississippi
Posts: 539
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Re: can people chime in as to what insurance companies they have and what troubles
Just wanted to bump this back up. It is interesting (and sometimes disheartening) to see the differences in coverage.
__________________
In the world of destiny, there are no statistics.
Jan. 26- mammogram and ultrasound- suspicious lump
Mid-February- lumpectomy, infiltrating ductal carcinoma ~4.5 cm and a 1 cm DCIS, did not get clear margins, did not check lymph nodes
ER+/PR+, her2 +++, nuclear grade 3 of 3
February 20-PET scan showed something on liver. No biopsy.
March- Started carboplatin, herceptin, taxol on a four week cycle
May 3- Pet scan, with intent to do a biopsy, found nothing, liver or breast- no biopsy because there is nothing to biopsy
June 21- new onc, very concerned that there had been no biopsy,
June 18th-CAT scan, bone scan-negative
August 7th - Brain MRI-negative
August 9th- mastectomy, all pathology negative
January 2008 still NED! New oncologist -herceptin for full year after chemo- until July, and tamoxifen---negative scans since May '07
July 2008-Finished Herceptin!
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10-15-2011, 08:29 PM
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#24
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Member
Join Date: Sep 2011
Posts: 10
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Re: can people chime in as to what insurance companies they have and what troubles
I work for the State of Maine and have Anthem Blue Cross. There really was no surgeon here with the experience to do bilateral DIEP reconstruction, and so I wanted to go to Boston for that surgery. Plus, I felt I would be happiest getting my treatment at a cancer center, so I wanted to go to Dana Farber for that as well. I had to FIGHT with my insurance company to make sure that happened. I kept getting the runaround, and kept demanding to speak to the medical director of the insurance company. I used my physician cred to get to there, and asked him what he would want for his mother, wife, daughter or sister. After that impassioned conversation, he promised I would have no further problems. And I haven't.
But, what if I had not been a doctor?
What an eye opener for me! Here I was in the midst of this medical/emotional crisis, when I was so overwhelmed in so many ways, and I had to fight and cry and demand in order to optimize my treatment.
And not only that, but when I could no longer work and had to pay for my health insurance at a time when I could least do without it, I realized how easily anyone could be financially devastated.
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