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Blood Cancers & Disorders | Last Active: Sep 30 1:00pm | Replies (31)
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Replies to "I saw my hematologist today. My platelets are over a million. He said we had to..."
Hi @preacherswife1977, Considering that you have already tried HU and Anagralide and both medications were not tolerated well, this may be a situation where your insurance may pay for the interferon treatments.
You can try contacting the insurance company yourself or have your oncologist office write a narrative to justify the treatment.
Here is an article from Cancer.org regarding getting preauthorization for medications and writing appeals if treatment is denied.
https://www.cancer.org/cancer/financial-insurance-matters/managing-health-insurance/getting-medical-pre-approval-or-prior-authorization.html
One of my chemo meds was over $22,000 per 3 week dosage. At the time of the prescription my oncologist informed me there might be potential grants for funding this medication, often from the manufacturer. A representative from Speciality Pharmacy called me to set up the med order and to see if I qualified for the discount or grant. I didn’t qualify, but after my doctor talked with a case manager from my insurance company, I was finally approved for the med. I only had to co-pay the first month, after that it was paid for.
You will learn more Wednesday at your appointment. Make sure you talk to the doctor about the insurance denial. This won’t be the first time they’ve seen a denial for a treatment. So your doctor will be your best advocate for getting this approved.
You may also want to call the doctor’s office tomorrow to let them know your insurance is denying the prescription. That may be the better approach than waiting until Wednesday.
Good luck! Let me know what you find out, ok?
There are also potential grants whic