Esophageal Cancer Support Group
Esophageal cancer is malignancy of the esophagus. There are various subtypes. Esophageal tumors usually lead to dysphagia (difficulty swallowing), pain and other symptoms, and is diagnosed with biopsy. Small and localized tumors are treated with surgery, and advanced tumors are treated with chemotherapy, radiotherapy or combinations.
Tomorrow I was scheduled to have a PET scan the first since my surgery. My surgeon's office called me today at work and told me my insurance won't cover the PET scan.
Why??? Because the most recent CT scan ordered back in January which was to take the stent out of the esophagus which had been added by the surgeon as there was a bit of tightening where the stitches were meeting at the bottom of the esophogus and the stomach and it was looking good and fine and 2 weeks later my oncologost ordered a routine 3 mth CT scan and the techs found "something" on my thyroid gland which then resulted in an ultra sound on my thyroid gland. I am still waiting to hear the results on that one. Because there were no signs of cancer on the CT scan they therefore believe that because there is no sign of cancer then I don't have EC.... try and figure that one out. The surgeon's office has given them all the info relating to my case and even the date of the EC surgery. Hellllooooooo people - anyone home !!!!!!!!!!!!!
My Surgeon is on vacation this week and will be back next week so Denise his nurse said she will have all my papers at the ready for him to look at and we'll take it from there.
She was really fired up when she spoke to me and apparently told Med Solutions (part of Aetna) that she was not having a patient of hers bring treated like that. Have a funny feeling if I have to pay for it myself it will probably bancrupt me :( So we'll have to wait and see what the surgeon says when he gets back next week.
The papers I have been reading about PET scans were saying that they are done to determine if cancer is there and biopsies are taken to make sure and if needed then chem/radiation or surgery. Well been there, done that, got the scars to prove it and they still don't believe me.Whee!!!!!!!!!! When I had BCBS ins there was never any question about having tests done especially about EC and now this??????????? wonders will never cease.
To say I'm a little miffed is putting it mildly but am not raising the roof about it - yet - will wait till my surgeon gets back and see what he suggests. I have complete faith in him and also my oncologist...........
Anyways will let you know the continuing sage lol
Why??? Because the most recent CT scan ordered back in January which was to take the stent out of the esophagus which had been added by the surgeon as there was a bit of tightening where the stitches were meeting at the bottom of the esophogus and the stomach and it was looking good and fine and 2 weeks later my oncologost ordered a routine 3 mth CT scan and the techs found "something" on my thyroid gland which then resulted in an ultra sound on my thyroid gland. I am still waiting to hear the results on that one. Because there were no signs of cancer on the CT scan they therefore believe that because there is no sign of cancer then I don't have EC.... try and figure that one out. The surgeon's office has given them all the info relating to my case and even the date of the EC surgery. Hellllooooooo people - anyone home !!!!!!!!!!!!!
My Surgeon is on vacation this week and will be back next week so Denise his nurse said she will have all my papers at the ready for him to look at and we'll take it from there.
She was really fired up when she spoke to me and apparently told Med Solutions (part of Aetna) that she was not having a patient of hers bring treated like that. Have a funny feeling if I have to pay for it myself it will probably bancrupt me :( So we'll have to wait and see what the surgeon says when he gets back next week.
The papers I have been reading about PET scans were saying that they are done to determine if cancer is there and biopsies are taken to make sure and if needed then chem/radiation or surgery. Well been there, done that, got the scars to prove it and they still don't believe me.Whee!!!!!!!!!! When I had BCBS ins there was never any question about having tests done especially about EC and now this??????????? wonders will never cease.
To say I'm a little miffed is putting it mildly but am not raising the roof about it - yet - will wait till my surgeon gets back and see what he suggests. I have complete faith in him and also my oncologist...........
Anyways will let you know the continuing sage lol
I was nodding my head while reading your post as I have learned thru my husbands EC saga that, sadly, healthcare is not driven by patient needs but rather by the insurance companies!! I can't count the number of times my husband needed a scan done but had to wait til the exact number of days had passed before insurance would pay for the required scan! I don't need to tell you how much each and every scan costs! To have insurance say that getting a scan today is an unallowed treatment but if we wait X number of days, it will be a covered benefit! How ridiculous.
Anyway, I'll get off my soapbox about insurance companies. Put your belief in your Doctor and his staff as they fight these absurdities every day. Your energies need to remain invested in your health!
Susie
Although working with my insurance company has been anything but fun, I've certainly never had the runaround like you have. I also have to "count the days" before taking certain tests again.
My doctors took this burden off us by understanding our insurance company's requirements, and scheduling us accordingly.
Most of our (mainly my wife, Roberta's) time was spent submitting, re-submitting, and documenting claims that were denied seemingly "automatically".
Let your doctor assume the insurance burden. You focus on healing best that you can.
Also, if you do wind up having to pay for a procedure, I understand that many doctors can arrange the cost of the procedure to be close to the fee they receive from the insurance company for the same procedure. Ask your doctor.
Good luck!
Fred
Yes I am going to let my dr and his staff take on the insurance company I'm pretty sure they are used to it lol.
Fred thanks for the info about the cost of procedures if I have to pay for one so be it........ my health is too important to me now to let $$$$ get in the way.
Will keep you all updated.......
Cheers Annie