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Pancreas and spleen removal: how is life afterwards?
Pancreatic Cancer | Last Active: Dec 19, 2023 | Replies (42)Comment receiving replies
I have Kaiser HMO in Georgia. It took roughly 4 months of fighting, but I was eventually approved for Mayo. I did not have to pay out of pocket. Basically, I had to had to be seen by an in-network surgical oncologist first. That MD declared he was unable to perform the surgery, and he referred me to Mayo. Kaiser told me they have a working relationship with Mayo, so it was approved. Several people had told me that legally your insurance provider cannot deny coverage for services not available within your network. Meaning, once the in-network surgical oncologist said he was unable to perform surgery, that Kaiser was obligated to cover the procedure at an outside facility.
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Hi Ashley2235,
Thank you for your quick response! That is amazing about your situation. I had Kaiser last year before I turned 65 and told them (most likely it was stage 1) and the primary didn't even order an ultrasound, much less any CT when I complained of back pain and my blood sugar suddenly went bonkers from taking no metformin to blood sugars in the 300 and 400 range and had to take metformin, but then that didn't even work (and my dad had pancreatic cancer)! I switched to Blue Shield and went with Hoag Hospital. I knew nothing about Centers of Excellence until I joined this online group which I think has been a month or two now. Hoag does have access to surgeons that can do the surgery, but it's not just about the surgery, it's about the entire plan of care (i.e., chemo before or after surgery, radiation, etc., taking the entire pancreas, etc.) that can make all the difference in the world. Good for you that you were such a strong advocate for your health as going through this process, I really do wonder about these doctors relative to pancreatic cancer. They tried to make me "drink the Kool-aid" that I was cancer free because my margins were clear and my antigen low after chemo, and they kept telling me to be positive and seemed a bit annoyed that I was so cautious in saying or feeling that I was cancer free and now that it seems to have come back, I no longer feel guilty for not singing Kumbaya.