Lack Of Insurance Coverage

My husband was diagnosed with pancreatic cancer August of 07.  Since then his insurance co. has paid for everything.  Now our doctor wants him to start Cisplatin and cpt-11, and even with a lettter to the folks at PBC, he has not heard one word from them about coverage.  We have since started Xeloda as a back up.  What Can I do to encourage the insurance co. to ok the coverage for the Cisplatin and cpt-11?

Terry's wife

Have your doctor get on the phone with the nurse care manger at your insurance company. He/She are the one's who should be dealing with getting treatments authorized for their patients. One thing I found out, trying to deal with the insurance companies can become a nightmare and who needs the aggraviation. The insurance companies are looking to save money anyway they can. Having the doctor or someone from the office be involved helps. I found that out. If they deny you can fill an Appeal.

Wishing you the best of luck

I also agree. My wife has brain cancer and we were just approved for CPT 11+ Avastin which is not FDA approved. We were warned that we may have challenges with the insurance company but our doctor's team got it approved in a few days and her appointment is tomorrow. The total costs of this treatment is $20,000 each treatment x every 2 weeks. The doctors handled everything including getting the medical records, persistantly calling the insurance company, etc.. I agree with the previous posting and find a doctor's office that will help expedite the approval process. It is a lot to handle on your own and you may hit several delays dealing with the stalls from the insurance company.

Best wishes to you,

EL