Proton Beam denied by insurance

In 2012 BCBS said if medicare would pay they would, about half way through treatment BCBS said they wouldn't after posting every where I could they gave in and paid

I live in Scottsdale, AZ. My brother came here for the proton beam at Mayo Clinic. He had head and neck cancer. Blue Cross denied payment on his treatment. One of the reasons was that it cost more than photon beam therapy. Mayo Clinic in Arizona does not charge a penny more whether you use proton or proton beam therapy for cancer. We did an appeal and fought this. One of the reasons they said they denied it was because of the extra cost when the Doctor Who sent them information about proton specifically said there is no extra charge. We wondered if Blue Cross even read with the doctor had sent them. Blue Cross then approved the charge. This was about six years ago and he has cancer free.

@agevm, glad to hear your brother remains cancer free. It is precisely for this reason that Mayo Clinic charges the same rate for proton and photon radiation -- so that patients get the treatment they need and not dictated by cost. This is also true for imaging tests. The decision of CT scan, PET scan, MRI etc should be made on what is best for diagnosis, not cost, so Mayo charges the same for all.

Did your brother eventually win the appeal with his insurance?

@colleenyoung
Yes, they covered his treatment completely. One of the reasons they denied was because of the extra cost, which didn’t apply. They obviously didn’t read the appeal. So we brought it to their attention. He is doing really well and we are grateful to the Mayo oncology team for their personal and outstanding care he received.