Topic: Insurance denied my cancer treatment

Forum: Employment, Insurance, and Other Financial Issues — Employment, insurance, and financial concerns are common. Meet others here to discuss and for support.

Posted on: Feb 24, 2017 10:42PM

Posted on: Feb 24, 2017 10:42PM

denisel wrote:

aromasin - my oncologist with Seattle Cancer Care Alliance prescribed Aromasin for ER/PR+ type cancer , insurance denied after 14 days of waiting.

Dx 12/2016, IDC, Right, 1cm, Stage IA, Grade 3, 0/5 nodes, ER+/PR+, HER2-
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Feb 25, 2017 01:46AM - edited Feb 25, 2017 09:08PM by ksusan

It may have been an error. Call them directly for an explanation. In addition, have your oncologist's office call.

I was told last week by my gynecologist's office that my insurance had lapsed. I said that this wasn't the case, and among the evidence was that I had had pre-approval for a CT the week before. They insisted, so I called my HR office, which confirmed my coverage and wrote an email to my carrier. The carrier confirmed my coverage and noted that the medical office hadn't logged any inquiry with them. I forwarded this to the medical office, which magically then determined that I did have coverage.

Meanwhile, look at GoodRx.com and other online prescription discounters that offer a free card and coupons. I've used Walmart and Costco coupons from them to get non-covered prescriptions at a discount.

Good luck! It's frustrating.

Mutant uprising quashed. Dx 1/2015, IDC, Right, Stage IIA, 1/1 nodes, ER+/PR+, HER2- Dx 1/2015, DCIS, Left, Stage 0, Grade 3, 0/2 nodes, HER2- Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Lymph node removal; Mastectomy; Mastectomy (Left); Mastectomy (Right) Radiation Therapy Whole breast Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Feb 25, 2017 05:18AM cive wrote:

They may have denied it because femara is less expensive.  With my insurance they would want a reason why I'm taking a more expensive drug before they would cover it.

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Feb 25, 2017 08:21AM denisel wrote:

cive thank you. I'll find out what the issue is and will start Monday. I don't know why it just bothered me so much but it's so insulting. The medicine is actually $23 for 90 days without insurance which is definitely doable, it's more the principle. I have learned so much in the past two months . Thanks again

Dx 12/2016, IDC, Right, 1cm, Stage IA, Grade 3, 0/5 nodes, ER+/PR+, HER2-
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Feb 26, 2017 06:51AM - edited Feb 26, 2017 06:54AM by cive

Hmm!  With my medicare advantage plan the price would be $90/month.  Perhaps I should check into buying it without using my insurance.  I think it quite likely I will be changing to it since my TMs skyrocketed this month.  Just checked goodrx and it's more than $200/month everywhere with goodrx coupon.

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Feb 26, 2017 08:12AM denisel wrote:

Hi Cive, I was incorrect , it is Anastrozole. Maybe the insurance company has an issue with this one however I aM post menopausal,hmmmm. I'll find out tomorroe

Dx 12/2016, IDC, Right, 1cm, Stage IA, Grade 3, 0/5 nodes, ER+/PR+, HER2-
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Feb 26, 2017 01:34PM denise-g wrote:

I have no drug coverage...I found to always check with COSTCO for prices. You do not have to be a member.

My Arimidex prescription is only $27.00 for three months. Walmart was like $300.00 a MONTH!

Anyway, do check with your insurance company. Most likely is an error. My sister's insurance company will

only approve her AI for 1 month at a time.

www.denise4health.wordpress.com my BC Blog with over 200 informative posts about all aspects of BC - stop by! Myself, my mom, and sister were all diagnosed with BC within 3 years. What a ride! Dx 10/10/2011, IDC, Left, 6cm+, Stage IIIA, Grade 2, 9/14 nodes, ER+/PR+, HER2- Surgery 11/22/2011 Lymph node removal; Lymph node removal (Left): Underarm/Axillary; Mastectomy; Mastectomy (Left) Chemotherapy 12/26/2011 AC + T (Taxol) Targeted Therapy 2/27/2012 Herceptin (trastuzumab) Hormonal Therapy 10/10/2012 Arimidex (anastrozole)
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Feb 26, 2017 02:59PM denisel wrote:

Denise-G, thank you! I'll keep that in mind for certain, I can't believe the difference for the same meds

Dx 12/2016, IDC, Right, 1cm, Stage IA, Grade 3, 0/5 nodes, ER+/PR+, HER2-
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Feb 28, 2017 06:40AM GAMomma wrote:

although I do not face this problem,I wanted to add my 2 cents 😉

Definitely ALWAYS call your insurance company direct if ever denied anything. Sometimes it is the way the script is written. As another member stated that some insurances only approve 30 days at a time. When my Mom was in hospice her meds only would refill every 15 days. Unfortunately due to life expectancy 😢

Hopefully you can get it straightened out.

Dx 1/1/2017, DCIS, Right, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+ Surgery 1/16/2017 Mastectomy: Left, Right

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