Brenda,
I had insurance difficulty too. I have a BLUE CROSS PPO that gives me a 20% responsibility on ALL chemo drugs. I fought with my ONC who insisted that I could not afford the chemo, which infuriated me. She kept insisting that I would be responsible for 20% of all charges under the contracted price of the IV drugs and radiation. I looked at what they charged me for the first course and saw a $28,000.00 charge. Iamgine my expression and hysteria! What she failed to see on my insurance policy was that I have an out of pocket maximum of $3000,oo per year and an unlimited lifetime benefit. I do not know why she did not recognize this but for over two weeks, we fought about it. I called my insurance carrier who told me that after my deductible and out of pocket had been met... they would cover 100%of all charges at the contracted price and I would not be responsible for any other charges. Go over your policy again... I am not familiar with HMO but would not be surprised if they did not have the same clause.
WHile I was fighting with the business office of my ONC, she did tell me that after the "write off/ adjustment " that the office would make based on what the insurance company would pay... my portion would be (20%) $1500.00 be course of chem and that included herceptin. Which means that the total charge paid by insurance would be 7500.00. I will know more when they pay for the herceptin charge to give you an idea of what the insurance company pays.
Reread your policy and last but not least there is a book that you can download on line... here is ther link... its called BREAST CANCER COVERED OR NOT> AN INSURANCE HANDBOOK
http://www.pabreastcancer.org/insurance_book.html.
Hope this helps, youcan download this free!
Melinda