New Feature: Fill out your Profile to share more about you. Learn more...

Waiting on Oncotype DX results - insurance wont pay for test

MaineJen
MaineJen Member Posts: 148
edited May 2021 in Waiting for Test Results

So in the last 3 weeks I've had 2 surgeries. I was told that the oncotype info is super important because the information will help us determine if I need to have chemo, and which concoction to use for chemo. Anyway, I was told it would take 2 weeks or so to get those results. I'm still recovering from surgery #2 and have an appointment this Friday to discuss oncotype info and next steps. But I just got a call from the doc office saying my insurer refuses to cover the oncotype test, which is why - here we are 3 weeks later - we don't have the information yet. They're filing an appeal to my insurer. I'm so angry and upset. They told my doc that there's no reason to need oncotype info, I had a couple of positive lymph nodes, that should be enough info to make decisions. WHAT? I have heard horror stories about insurance companies doing stuff like this before, but WOW. So at this point, an insurance company gets to decide my life/death cancer care and not my oncology team? Has this ever happened to anyone else here? What if they deny the appeal. I looked it up on google - it's expensive to pay directly for that test. I'm so scared and stressed out as it is - and now this too?! I know we live in a crazy country when it comes to insurance coverage issues. But WOW. I'm truly over -the-top upset. We need that info, don't we? He says we do. He says the oncotype DX info is the latest standard for care and decision making. I know it happens to people all of the time. But here I am in the scariest moments of my life and an insurer is telling my doctor what to do??