Got HOPE?

[SoCalGal]

Today, at my consult with Dr. Glasby @UCLA, he handed me such hope. I hadn't realized how much hope I had lost with the chemo not working.

He's recommending HERCEPTIN with AVASTIN and TYKERB. He says I'm going to have to fight with my insurance for the Avastin which runs about $1600 every 3 weeks.

Any ideas or advice on how to fight that fight?
Thanks for the feedback!
xoFlori

[Mary Anne in TX]

Get your gloves on, Flori! Whatever it takes, you can do it!

[Sheila]

Flori
Amazingly enough, I got the Avastin with no questions asked from BCBS...but they refused Abraxane...so I get Taxol....Avastin is wonderful...just be prepared for high B/P, as many get it from Avastin....
I hope it is no problem for you to get it!

[SoCalGal]

Sheila,
Thanks for the reply - that's great news. Maybe I'll get lucky. He warned me about the blood pressure. My pressure runs low, so maybe this won't be too bad. As he said, they can control the pressure if it keeps the cancer in check. I have Blue cross - ppo - so we'll see. Thanks.

[Lolly]

Flori, my onc wants me to start Avastin/Taxol next week, along with my Herceptin, as Taxotere/Xeloda have run their course. I will probably have a fight on my hands also, so we'll have to cheer each other on. I"m on Medicare, with a MedAdvantage plan run by BCBSO, so I'm encouraged by Sheila's report, although the infused chemos are run through Medicare and since Avastin isn't FDA approved for BC yet, that's where the problem may be. Good luck to both us :)

<3 Lolly

[tousled1]

Flori,

I'm glad to hear that your oncologist gave you such hope -- we all could use some. I wish you luck with the insurance company and Avastin. The last thing you need is to fight with an insurance company to get a chemo drug. I'll keep you in my prayers.

[IRENE FROM TAMPA]

I have Blue Cross Blue options and my onc had no problem at all getting the Avastin ok'd for me. When I thought about taking it about a year ago before I starte the Tykerb trial I had United Health at that time and they also approved.

So good luck Flori. Have your doctors duke it out for you. That should work

ALSO - I am so happy for you with your options. Didn't I tell you that there would be something else out there for you?

[kareneg]

I have no idea how to fight the insurance but I am sure you will give it everything you have. I am so glad you have a renewed HOPE! Keep the hope my friend you have my prayers also. Please let us know how you make out. All my best!

[Vanessa]

So glad you have a new tx plan. As far as fighting with the insurance, I don't have a clue. Isn't there someone in your dr's office that takes care of that. That is why I don't have a clue. The insurance advocate at my dr's office is great. Good luck with your new plan. I will be rooting you on.

[suzan w]

I finally won an insurance battle with BlueX over the oncotype DX test. Turns out that the state of FL (where I had a cobra Blue X policy at the time of my diagnosis) would pay for the test through their medicare system...so after a year of appeals, Blue X paid. The rep from the lab that does Oncotype did battle with Blue X for me and I know that she used the 'medicare card' as proof that if medicare covered it, then Blue X should. My point here...(yes I do have one!!!) is that we have to fight fight fight these insurance companies to get the care we deserve. We cannot give up the fight!

[Jean]

I thought Avastin is soon to be approved by the FDA....real soon?

Jean

[SoCalGal]

I am pretty sure it is an approved drug - just not for met. br ca

I am still hoping blue x will okay it and it will be a non-issue. Otherwise, will make them sorry they turned me down and will start the treatment anyhow.

I will sell ??? for the avastin money - a new sideline for me:)

[hutchibk]

Hey Flori- http://www.reuters.com/article/health-SP/idUSN1340139420070914?pageNumber=1&virtualBrandChannel=0&sp=true

[SoCalGal]

This is why I love you guys. Thanks Brenda. Just the ammunition I was looking for!

[Sheila]

Flori
I am sure you will be able to get it...and when you do, just keep a close eye on the B/P....mine has alwasy been super low...104/60....I had to go on meds with Avastin as did Chrisy...mine was running 180/94! The meds keep it in check pretty well!

[dhealey]

Flori, Glad your onc has given you some hope. Get you boxing gloves on with your insurance company. I had to fight mine to pay for my herceptin treatments. Took me six months of harrassing them and finally I threatened to get a lawyer as hercetin is an approved drug, after that they started paying for it. Best of luck. I will continue to keep you in my prayers.

[Believe51]

Cannot offer advice but can tell you that 'There is no place like Hope' and it is so refreshing to hear that in your voice. So lace up them gloves and jump in, we will all be routing you on. Glad you are feeling better, that you regained hope and that you have things in order. Go get 'em>>Believe51

[hutchibk]

Git your fight on girl! The ins companies expect you not to fight, so when you do, they tend to buckle if you stick with it. Of course you know this, but if they deny you, appeal. And copy your/your doc's appeal to the consumer protection division of the California State Board of Insurance (including details of necessity), noting the cc: on the bottom of the letter to the insurance company. This shows them that you are very serious and helps move things along.

[Jean]

for the article....I was a bit confused, on my last visit with my onc.
he had mentioned that it would be approved very soon and he was
rather happy and excited....does this now mean that Flori will not
have to fight with the insurance company?

I would think so...
Flori, best wishes with the new treatment....

Hugs,
Jean

[hutchibk]

I don't know what it means really, except that they have re-applied with the FDA and that the FDA is supposed to decide between Dec and Feb about approving it... I know so many friends who have been on Avastin, I didn't realize it wasn't approved for b/c.