What to do if UPMC insurance won't pay for larger cancer treatment centers?

Has anyone had any experience with Magee Hospital in Pittsburgh...good or bad? This is the only option my sister has for her care, and so far, we aren't impressed.

 My sister's insurance (UPMC) makes it impossible to go to any of the large cancer facilities (Cancer Treatment center of America, Mayo clinic, etc)  What can we do when insurance won't pay for better care in a larger treatment center? I don't think she is ready for trials yet....she just wants care from people with experience and knowledge. 

Hi Karen, I'm not familiar with the hosp. but I did find a website with contacts to financial aid. Try networkofstrength.org or komen.org  They might offer some places that offer financial aid if you qualify. Good luck to you. Wish you the best always.

Kathy in Ohio

My sister just compeled a year of chemotherapy along with 3 surgeries (2 minor ones and 1 MAJOR one) at UPMC Magee. I am her caregiver and I never even considered taking her to another Cancer Center nor would she have been willing to go anyplace else had I even considered that action. I have complete confidence in her medical team. She had some other problems caused by her cancer and her Oncologist is an expert in managing those also. I have a somewhat of a medical background and I also a licensed Health Insurance Sales Agent in PA. Her insurer is also UPMC Health Plan and they have covered every single treatment, visit, etc to the tune of $248,000+ in paid claims since her problems began. She has a UPMC Health Plan Medical Case Manager along with a Social Worker. I have been impressed by both.

I am guessing that your sister in the HMO product-no out of network benefits. My sister is in the PPO product that has out network benefits but we saw no need to go out of network. 

If I can help you out in any way let me know.

Steve

Many insurers don't cover CTCA for some reason, but often cover other facilities, unless you have a plan that has to stay in network. So many variables in insurances. Will they cover another facility in the UPMC system? Maybe you could find a different facility or oncologist you click with more. Have treated at the local cancer center 5 minutes away, then moved to a center closer to Boston that's 40 minutes away on a good traffic day, and now we go to Erie for scans and consults, which is 600 miles out because we love our oncologist and she has moved twice since we started with her. I would take closer anyday...in fact we plan to move to Erie so we will be back to a 5 minute drive when he is treating. We have been battling metastasized esophageal cancer for almost 4 years. Like ovarian, it's a tough one to beat, so you want someone you feel very confident with to be guiding your care. Hope you are able to make a switch you are comfortable with.