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10-09-2011, 06:59 PM
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#21
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Senior Member
Join Date: Apr 2007
Location: Mississippi
Posts: 600
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Re: can people chime in as to what insurance companies they have and what troubles
Oh, by the way, I just found out last week what my part (after insurance) of the DIEP surgery will be if I have it in NOLO. I cried.
__________________
In the world of destiny, there are no statistics.
Jan. 26- mammogram and ultrasound- suspicious lump
Mid-February- lumpectomy, infiltrating ductal carcinoma ~4.5 cm and a 1 cm DCIS, did not get clear margins, did not check lymph nodes
ER+/PR+, her2 +++, nuclear grade 3 of 3
February 20-PET scan showed something on liver. No biopsy.
March- Started carboplatin, herceptin, taxol on a four week cycle
May 3- Pet scan, with intent to do a biopsy, found nothing, liver or breast- no biopsy because there is nothing to biopsy
June 21- new onc, very concerned that there had been no biopsy,
June 18th-CAT scan, bone scan-negative
August 7th - Brain MRI-negative
August 9th- mastectomy, all pathology negative
January 2008 still NED! New oncologist -herceptin for full year after chemo- until July, and tamoxifen---negative scans since May '07
July 2008-Finished Herceptin!
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10-10-2011, 08:57 PM
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#22
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Senior Member
Join Date: Apr 2011
Posts: 403
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Re: can people chime in as to what insurance companies they have and what troubles
I have Health Net of CA. Each insurance company offers different plans, your benefit eg office visit copay, hospitalization and ect depend on what plan you have. I have an HMO and so far have had no problem with it. I wish i have a PPO incase i need it to participate in any clinical trial. I doubt HMO covers it since you are always referred to a doctor in their contract.
__________________
1/11 age 36 DX
ER/PR-, Her2 +
TCH*6, Herceptin
BMX with immediate recontruction 5/2011 Lattismus Flap- Dx stage 3c 10/23 nodes
9/11 Radiation
3/12 Local recurrence to skin stage IV
Whole body scan CLEAR
4/12 Tykerb & Xeolda Skin mets slowly regressing
8/12 PET & Brain CT Clear
5/13 Skin mets progressing
6/13 PET scan chestwall recurrence in contralateral anxillary,internal mammary and ipsilateral subpectoral nodes
6/13 kadcyla
10/13 whole body scan -clear NED. previously resolved skin rash gone but 3 new lesions. Biopsy confirmed for skin recurrence
11/13 to 02/14 tykerb & herceptin
02/14 add abraxane/gemzar, 2 weeks on 1 week off at reduced dose
05/14 whole body PET clear/ brain CT clear but skin mets are getting worse, ready for new chemo
05/14 navelbine perjeta herceptin
07/14 skin mets progressing red rash worse
08/14 wide local excision with diep flap to close wound. Final path shows 2 positive margins showing inflammatory carcinoma Going back to surgery in 2 weeks
09/01/14 resection- clear margins
3 weeks after 2nd surgery, a new nodular rash found near drain incision with 2 small red spots behind the chest wall biopsy on 10/1. Positive for breast cancer
Radiation 11/2014 with xeloda then weekly cisplatin
11/14 brain MRI clean
12/14 finished 33 radiations burnt and very painful. Bedridden for 1 week
12/14 t current Herceptin and perjeta only
02/15 rash on upper back right side skin mets radiation planned
02/15 staring electron radiation *35
Stopped at 30 due to severe skin burn, resumed 10 days later
05/15 red patches appeared in between previously radiated area, skin mets. Ct and brain Mri clear. Simulation planned, radiation to start after trip to Alaska.
05/24 new spot identified in scar line on previously radiated reconstructed breast- electron on both side chest wall area and scar line
07/15 multiple skin and lung recurrence begin halaven
11/15 cough much better but very tired on halaven and starting to see some new red skin blotches-suspicious
11/15 heading to China for immune therapy
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10-15-2011, 07:22 PM
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#23
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Senior Member
Join Date: Apr 2007
Location: Mississippi
Posts: 600
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Re: can people chime in as to what insurance companies they have and what troubles
Just wanted to bump this back up. It is interesting (and sometimes disheartening) to see the differences in coverage.
__________________
In the world of destiny, there are no statistics.
Jan. 26- mammogram and ultrasound- suspicious lump
Mid-February- lumpectomy, infiltrating ductal carcinoma ~4.5 cm and a 1 cm DCIS, did not get clear margins, did not check lymph nodes
ER+/PR+, her2 +++, nuclear grade 3 of 3
February 20-PET scan showed something on liver. No biopsy.
March- Started carboplatin, herceptin, taxol on a four week cycle
May 3- Pet scan, with intent to do a biopsy, found nothing, liver or breast- no biopsy because there is nothing to biopsy
June 21- new onc, very concerned that there had been no biopsy,
June 18th-CAT scan, bone scan-negative
August 7th - Brain MRI-negative
August 9th- mastectomy, all pathology negative
January 2008 still NED! New oncologist -herceptin for full year after chemo- until July, and tamoxifen---negative scans since May '07
July 2008-Finished Herceptin!
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10-15-2011, 08:29 PM
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#24
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Member
Join Date: Sep 2011
Posts: 12
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Re: can people chime in as to what insurance companies they have and what troubles
I work for the State of Maine and have Anthem Blue Cross. There really was no surgeon here with the experience to do bilateral DIEP reconstruction, and so I wanted to go to Boston for that surgery. Plus, I felt I would be happiest getting my treatment at a cancer center, so I wanted to go to Dana Farber for that as well. I had to FIGHT with my insurance company to make sure that happened. I kept getting the runaround, and kept demanding to speak to the medical director of the insurance company. I used my physician cred to get to there, and asked him what he would want for his mother, wife, daughter or sister. After that impassioned conversation, he promised I would have no further problems. And I haven't.
But, what if I had not been a doctor?
What an eye opener for me! Here I was in the midst of this medical/emotional crisis, when I was so overwhelmed in so many ways, and I had to fight and cry and demand in order to optimize my treatment.
And not only that, but when I could no longer work and had to pay for my health insurance at a time when I could least do without it, I realized how easily anyone could be financially devastated.
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