Help... I'm scared...
 

My bc mets progressed in my liver and nodes apperared a little larger so we ablated the kidney again and have been trying to get approval for different chemo.
Perjeta and herceptin were denied last Thur. and now gemzar and herceptin were denied?????
Nurse says she will schedule me tomorrow for gemzar at least while we figure out what to do. Insurance doesn't want to restart herceptin since I stopped receiving it with the halaven.
I know people on this board have had perjeta even though it's not first line and any experience with denial of herceptin.
I don't get it. I know the Dr.s office is doing what they can but in the meantime it's 3 weeks since any chemo and will the gemzar do any good without herceptin?
I am dealing with so many family things and then this on top, maybe I am overeacting but I think I need someone to talk me down. I feel like the insurance company would rather me die, probably, cheaper for them.

Re: Help... I'm scared...
 

Have your onc fight the insurance company for Herceptin and you fight too. A denial is not the final verdict. Appeal! Call your onc and the insurance company now and demand the appeal paperwork to be sent asap.

Re: Help... I'm scared...
 

It's so frustrating that insurance companies are in charge of our lives.

I know about dealing with family things-seems like there's so much on our plates already and can't someone in our healthcare make us feel like we matter? We shouldn't have to fight doctors and insurance companies on top of dealing with cancer and treatments. Half the time I feel like my doctors want me to go away-I can't help it if I react badly to things and don't fit in the "normal" box.

I'm with you, Cat, in the frustration department. I hope your doctor can get the Herceptin back for you. You need all the help you can get, especially just coming out of the ablation. Appeal, keep trying. I agree with Becky, contact the insurance company yourself. Geez, you shouldn't have to do this!

Love,

Caroline

Re: Help... I'm scared...
 

Thank you Becky and Caroline. I see dr. tomoorow to discuss Treatment and at least receive gemzar. I have talked to insurance agent who has stood by us before against insurance and will appeal too. I have been told the insurance cos. follow NCCN guidelines or don't cover rx. I just wonder, how are others getting covered? Does everybody have to fight?
Hopefully tomorrow comes quick and I happen to have a 2nd opinion scheduled next week so maybe he'll have some ideas.
Thanks all,
Cathy

Re: Help... I'm scared...
 

Hope and prayers you have a new plan tomorrow. Gods blessings

Re: Help... I'm scared...
 

"Overreacting"?? Of course you're not!!!!
It seems when we are most vulnerable and fragile is when we are called on to step into unfamiliar and hostile territory. There should not have to be any fight to get what is indicated
I'm glad you have people in your corner. Keep up the pressure so they will act on your behalf. I don't have specifics about the drugs. Just my support
Keep the faith

Re: Help... I'm scared...
 

Dear Cat,

I'm so sorry you have to deal with this crap, I have never experienced anything like it so I have no advice. Stay on top of the insurance agent, somebody has to help you. Did you speak to the insurance's supervisor? Nurses at the hospital, social workers- - they know how to deal with insurance paperwork.

Thinking of you, Cat. Go to the movies, don't just sit at home, the least take short walks, it will take the stress out of you- - I do it all the time, otherwise I would go crazy.

Love and a BIG cyber Hug.

Adriana

Re: Help... I'm scared...
 

Cat,

Keeping you in my thoughts and prayers. Keep fighting and pull in all the allies you can.

Re: Help... I'm scared...
 

Gods be with you.prayers can move mountains.have faith.

Re: Help... I'm scared...
 

Thank you all for your love, support and prayers. Will update when something is decided. Hugs to all,
Cathy

Re: Help... I'm scared...
 

Cathy, so sorry you have to deal with all this stuff. As if the journey isn't hard enough! Thinking of you..... Pam

Re: Help... I'm scared...
 

I hope and pray you get a positive response from the insurance company. I have found that I have to go to battle for each BC treatment I get!!
Let us know how it's going.
Loren

Re: Help... I'm scared...
 

See if your doctor can get the drug company to donate the drug for compassionate use because your insurance has denied.
Joanne

Re: Help... I'm scared...
 

Kathy prayers from California that the insurance company finds it's error of ways and reconsiders their decisicion with the help of a nice luck in the booty by your doctors!

Re: Help... I'm scared...
 

Thank you all. I'm using all areas. We submitted forms for patient assistance / compassionate care (? Same thing?). I've got the ins agent on my side and checking into it. Feel better about just gemzar for now with other possibilities for herceptin and/ or perjeta. On the road and feeling a bit calmer after talking with onc and nurses today. Asked him if the people making these decisions are bean counters or actually looking patients in the faces. Said he has gotten so frustrated over the restrictions and nearly got written up arguing for someone. He said they can be tough and not necessarily make decisions base on patient care that seems reasonable to us. Will plug away and hopefully get results.
Thank you, thank you, thank you,
Cathy