HER2 Support Group Forums - View Single Post - HELP!!!!!! Pertuzumab denied by insurance! iN PANIC MODE AND DON'T KNOW THAT TO DO

Becky · 08-30-2012, 02:31 PM

Dear Chris

It shouldn't be so hard but you are stronger. You and your oncologist need to appeal - both of you. Over and over again if necessary. I do know one thing, the greasy wheel does get the oil even though it might take awhile. Go through their process and call, call,call - everyday - all the time.

I did this for my daughter and although not life threatening, they relented and gave her treatment (took about 2 months and 2 doctor interventions) but it did work. You have a local onc too who can join the party. The insurance companies just want to know how serious you are (duh - like we aren't if we have cancer). It's alot to ask when you are having chemo (use that sweetly when talking to them - I used "my child can't breathe and I never got angry with the messenger - cry if you want but don't get angry). I know your team will secure it for you. Use every doctor you know

08-30-2012, 02:31 PM	#23
Becky Senior Member Join Date: Sep 2005 Location: Stockton, NJ Posts: 4,179	Re: HELP!!!!!! Pertuzumab denied by insurance! iN PANIC MODE AND DON'T KNOW THAT TO Dear Chris It shouldn't be so hard but you are stronger. You and your oncologist need to appeal - both of you. Over and over again if necessary. I do know one thing, the greasy wheel does get the oil even though it might take awhile. Go through their process and call, call,call - everyday - all the time. I did this for my daughter and although not life threatening, they relented and gave her treatment (took about 2 months and 2 doctor interventions) but it did work. You have a local onc too who can join the party. The insurance companies just want to know how serious you are (duh - like we aren't if we have cancer). It's alot to ask when you are having chemo (use that sweetly when talking to them - I used "my child can't breathe and I never got angry with the messenger - cry if you want but don't get angry). I know your team will secure it for you. Use every doctor you know __________________ Kind regards Becky Found lump via BSE Diagnosed 8/04 at age 45 1.9cm tumor, ER+PR-, Her2 3+(rt side) 2 micromets to sentinel node Stage 2A left 3mm DCIS - low grade ER+PR+Her2 neg lumpectomies 9/7/04 4DD AC followed by 4 DD taxol Used Leukine instead of Neulasta 35 rads on right side only 4/05 started Tamoxifen Started Herceptin 4 months after last Taxol due to trial results and 2005 ASCO meeting & recommendations Oophorectomy 8/05 Started Arimidex 9/05 Finished Herceptin (16 months) 9/06 Arimidex Only Prolia every 6 months for osteopenia NED 18 years! Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"