My wife was diagnosed with stage IIIB lung cancer. She is 44 years old and has never smoked. We can't figure that one out.
Her doctor has started her on Tarceva. It is considered a second line option to the insurance company. Our doctor indicated that it has been very effective in first line treatment. My wife has the non small cell type of cancer.
Here is my problem. We have Blue Cross of Georgia and they suck! They have refused to pay for the drug. I have already purchased the first 30 pills. The drug Tarceva costs 4300.00 for 30 pills. The drug company will give us the drugs for free however we exceed the income level.
Blue Cross has made decision on how to treat my wife out of the doctors hands. We have been denied two times. The first by a clerk at Blue Cross and second when our doctor did a peer to peer. What is sad during the peer to peer Blue Cross had a regular MD on th other end of the phone. It seems like they just go thru a flow chart and make decisions. What is sad is other insurance company's have approved the use of Tarceva for first line.
I can pay for the Tarceva for a short time but it will begin effect my family and my business long term.
If anyone has ideas please let me know.
Thanks in advance.
Our next steps that are in process are as follows:
Demand an a outside board of review with a oncologist sitting on the board.
I have hired an attorney that deals with the health insurance company's.
Thanks for listining. Hopefully I posted in the corrrect place.