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Old 10-16-2006, 10:03 AM   #1
Sheila
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Join Date: Aug 2003
Location: Morris, IL
Posts: 3,507
Mary
I have BCBS of Illinois, PPO, and it has been wonderful as long as I go to a PPO Provider and Hospital...you can call or go on their web site and find out what Dr's etc are "on the list" as PPO Providers. The most I ever Pay is a 15.00 co-pay. Hope this helps. Oh, and the important thing is as long as I am going to a PPO provider, I have NO lifetime max on insurance bills...that is a big relief.
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"Be kinder than necessary, for everyone you meet
is fighting some kind of battle."



Hugs & Blessings
Sheila
Diagnosed at age 49.99999 2/21/2002 via Mammography (Calcifications)
Core Biopsy 2/22/02
L. Mastectomy 2/25/2002
Stage 1, 0.7cm IDC, Node Neg from 19 nodes Her2+++ ER PR Neg
6/2003 Reconstruction W/ Tissue Expander, Silicone Implant
9/2003 Stage IV with Mets to Supraclavicular nodes
9/2003 Began Herceptin every 3 weeks
3/2006 Xeloda 2500mg/Herceptin for recurrence to neck nodes
3/2007 Added back the Xeloda with Herceptin for continued mets to nodes
5/2007 Taken Off Xeloda, no longer working
6/14/07 Taxol/Herceptin/Avastin
3/26 - 5/28/08 Taxol Holiday Whopeeeeeeeee
5/29 2008 Back on Taxol w Herceptin q 2 weeks
4/2009 Progression on Taxol & Paralyzed L Vocal Cord from Nodes Pressing on Nerve
5/2009 Begin Rx with Navelbine/Herceptin
11/09 Progression on Navelbine
Fought for and started Tykerb/Herceptin...nodes are melting!!!!!
2/2010 Back to Avastin/Herceptin
5/2010 Switched to Metronomic Chemo with Herceptin...Cytoxan and Methotrexate
Pericardial Window Surgery to Drain Pericardial Effusion
7/2010 Back to walking a mile a day...YEAH!!!!
9/2010 Nodes are back with a vengence in neck
Qualified for TDM-1 EAP
10/6/10 Begin my miracle drug, TDM-1
Mixed response, shrinking internal nodes, progression skin mets after 3 treatments
12/6/10 Started Halaven (Eribulen) /Herceptin excellent results in 2 treatments
2/2011 I CELEBRATE my 9 YEAR MARK!!!!!!!!!!!!!
7/5/11 begin Gemzar /Herceptin for node progression
2/8/2012 Gemzar stopped, Continue Herceptin
2/20/2012 Begin Tomo Radiation to Neck Nodes
2/21/2012 I CELEBRATE 10 YEARS
5/12/2012 BeganTaxotere/ Herceptin is my next miracle for new node progression
6/28/12 Stopped Taxotere due to pregression, Started Perjeta/Herceptin

Last edited by Sheila; 10-16-2006 at 10:04 AM.. Reason: forgot something
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Old 10-17-2006, 09:25 AM   #2
marymary
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Join Date: Apr 2006
Posts: 46
Update and Thanks

My husband just accepted the new job offer, although much if not all of the increased salary will go to Blue Cross in the form of high yearly out-of-pocket-maximums. These are $ 4,000 per year per enrollee.

The phone rep. put me on hold, then came back and said Blue Cross covers Gamma Knife "if it is medically necessary". OK, so that piece was just plain irritating. We're not having cosmetic surgery here.

I still have a few questions. The new Blue Cross policy is small group. Medicare, if I had it, would therefore be primary. Right now I only have Medicare part A. Should I sign up for Part B to help defray the OOPM's? I'm guessing my husband's change in employment might be considered a qualifying event (even though the new employer offers insurance). It might be an administrative nightmare since Medicare would be primary payer. I'm guessing the answer is no but I hate to guess on these things.

Other question, he only just became eligible for insurance in October at the job he is leaving. We have received new i.d. cards from Health Net but they have yet to deduct a premium (clearly this was a mistake). I'm not positive if they have to offer us COBRA continuation coverage since he will not be employed throughout the month of October. Our former COBRA policy is set to expire this coming Wednesday. No pressure here.

Just got back from Washington and have been glued to spreadsheets, the net etc. since Sunday. Today it's off to San Francisco for Herceptin. The good news: I just received the third and final vaccine. Let's hope these things work, we need some miracles. Thank you so very much for your feedback; I've noticed all breast cancer survivors tend to be insurance experts.

Love,

Mary
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