Adenocarcinoma - newly diagnosed

Hello, a comment about molecular testing. I had 2 lung surgeries, different lungs. Caris did molecular testing on first tumor. Went to Mayo for second tumor removal, their labs did molecular testing on that tumor. I also had blood analysis early in my cancer journey (Guardant). Results completely impacted the next steps/options for my treatment (Tagrisso). My advice – BE SURE YOU UNDERSTAND WHAT YOUR INSURANCE COVERAGE WILL PAY! Mine denied all claims. Rationale given included, "There is not enough evidence found in the medical literature to show that this testing is effective for managing your condition. The health plan does not cover tests that are not considered to be medically necessary for your care." The denial states the exclusion in my benefit plan (provided by a nationally recognized insurance company – thru my employer, but they are also huge as a Medicare provider) "…the fact that an Experimental or Investigational or Unproven Service, treatment, device or pharmacological regimen is the only available treatment for a particular condition will not result in Benefits if the procedure is considered to be Experimental or Investigational or Unproven in the treatment of that particular condition."

This is just a heads up. I had assumed the information garnered from the tumor analysis to be vital and a standard of care. I was wrong and paying the price for my ignorance!

Thanks @kkckkjm. Geeze, sorry you had to go through that. I have just changed my health insurance which will cover chemo and radiation. I did have a maximum out of pocket copay of around $3600. I have $1241 left which I will have as a copay until it's met... Once that is met, it will take care of my chemo and radiation.

Sadly, we have to go through so much, and when health insurance becomes a nightmare it just adds to our stress.

I had a robotic lobectomy; upper left lobe at the Mayo Clinic in Rochester, MN. I live in MN. Stage 1ac at the end of December 2022. Lymph nodes removed were negative for malignancy. Technically cancer free but will be watching it closely because I am still nervous. I was told at the Mayo Clinic that a lobectomy is the gold standard treatment for this stage. They also told me that my breathing capacity after surgery would be 80%. Recovery is a process and takes patience. Follow up CT in May.

Hello, I had lobectomy 10 days ago for same. Lymph nodes negative as well. Considered cancer free. I have so much pain from the robotic surgery. When does this improve? Drs say is expected but wow!

Hello, a comment about molecular testing. I had 2 lung surgeries, different lungs. Caris did molecular testing on first tumor. Went to Mayo for second tumor removal, their labs did molecular testing on that tumor. I also had blood analysis early in my cancer journey (Guardant). Results completely impacted the next steps/options for my treatment (Tagrisso). My advice – BE SURE YOU UNDERSTAND WHAT YOUR INSURANCE COVERAGE WILL PAY! Mine denied all claims. Rationale given included, "There is not enough evidence found in the medical literature to show that this testing is effective for managing your condition. The health plan does not cover tests that are not considered to be medically necessary for your care." The denial states the exclusion in my benefit plan (provided by a nationally recognized insurance company – thru my employer, but they are also huge as a Medicare provider) "…the fact that an Experimental or Investigational or Unproven Service, treatment, device or pharmacological regimen is the only available treatment for a particular condition will not result in Benefits if the procedure is considered to be Experimental or Investigational or Unproven in the treatment of that particular condition."

This is just a heads up. I had assumed the information garnered from the tumor analysis to be vital and a standard of care. I was wrong and paying the price for my ignorance!

Hello, a comment about molecular testing. I had 2 lung surgeries, different lungs. Caris did molecular testing on first tumor. Went to Mayo for second tumor removal, their labs did molecular testing on that tumor. I also had blood analysis early in my cancer journey (Guardant). Results completely impacted the next steps/options for my treatment (Tagrisso). My advice – BE SURE YOU UNDERSTAND WHAT YOUR INSURANCE COVERAGE WILL PAY! Mine denied all claims. Rationale given included, "There is not enough evidence found in the medical literature to show that this testing is effective for managing your condition. The health plan does not cover tests that are not considered to be medically necessary for your care." The denial states the exclusion in my benefit plan (provided by a nationally recognized insurance company – thru my employer, but they are also huge as a Medicare provider) "…the fact that an Experimental or Investigational or Unproven Service, treatment, device or pharmacological regimen is the only available treatment for a particular condition will not result in Benefits if the procedure is considered to be Experimental or Investigational or Unproven in the treatment of that particular condition."

This is just a heads up. I had assumed the information garnered from the tumor analysis to be vital and a standard of care. I was wrong and paying the price for my ignorance!

I had a Video Assisted Thoracic surgery on right lung with wedge resection. While I was off pain meds in 5 days (and those only needed to cough), the side "strangeness" took months, but that side finally normalized.