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Insurance has denied coverage

Blood Cancers & Disorders | Last Active: Jan 11 8:45pm | Replies (14)

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@colleenyoung

@snakebite, your medical team may be able to help with contesting the decision made by your insurance company. If the medication is deemed medically necessary, I recommend talking with an oncology social worker. At Mayo Clinic, helping to navigate access to treatment is something our social work teams help patients with. You can read more here:
– How an Oncology Social Worker Can Help https://connect.mayoclinic.org/blog/cancer-education-center/newsfeed-post/how-an-oncology-social-worker-can-help/

Is your oncologist aware of the denial by the insurance company? Do you have an oncology social worker?

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Replies to "@snakebite, your medical team may be able to help with contesting the decision made by your..."

Hello @colleenyoung. Thank you for you response. Yes, my Oncologist is aware. One of the folks in his office at the California Cancer Center called me and suggested that I contact my secondary. I did, however, it only got me one extra months approval. I have an appointment with Dr. Rao on Jan 9 and am hopeful something can be done. There is a lady in the Pharmacy that does the ground work for getting Grants, coupons and such. When I picked up my last bottle she was aware of the situation. She indicated that if the Doctor insist that I need the drug, that the insurance won't be able to drop me. Humm, I hope she is right. A month ago I was told that I would be getting an Oncology Social Worker, but I have not heard any more about it. I was also told that my secondary insurance would be putting me on Medicare part D. This was suppose to be in addition to their prescription drug program. I had the option to decline it, and ask if it would effect any of my current drugs or coupons etc. They told me it would not..... BUT... the first thing that went through my mind when this all happened was that BCBS was trying to divest its self of the cost burden and somehow place it on Medicare. I will certainly do some more checking. I also have another ZOOM appointment with Dr. Palmer at Mayo, but it's not until March. I was hooked up with her at my local Oncologist request. He wanted a "Second" opinion and having come from the Mayo himself, he has great respect for Dr. Palmer's input. I'm very lucky to have two top tier Oncologist in my corner. Thank you again for your excellent suggestions.