Fighting for MRI

obbosmel

if any of you have had to fight to get an MRI after your treatment can you please share your experience and results.  My doctor ordered a bilat MRI along with my bilat mamo six months after my radiation.  Insurance has turned down the MRI.  Doctor to have one on one with insurance doctor in two weeks.  The mamo missed my cancer twice, and when they compared this mamo to my last one (when I did have cancer that they missed), they said, well it looks the same to us!!!  Great makes me feel good, so your telling me the one where I did have cancer and the one you did today look the same???  Does anyone know what the insurance companies use as the definiation for high risk?

rdrake0

Who is your insurance company?  Sounds like your doc is in your corner.  Do you think it is the economy?

just_mary

 My doc requested an MRI to see if I needed a lumpectomy or mastectomy-- well, the MRI showed that the lump.  was only necessary.  While doing the lump.and the following biospy showed I would have to have a mastectomy.    I was told the MRI was only 90% accurate!!!!  

Good Luck, your doc is at least trying to help you, these Insurance Companys really could care less, there all about making money. 

God Bless you, I'll be praying for you,  Mary

jrgolomb

Ya know, I think I am going to have to fight for that too.  I don't even want to trouble with the mammograms-it missed my cancer and I have 5 cancerous tumors. 

obbosmel

I have UnitedHealth Care.  Had Blue Cross Blue Shield when I was diag., have it thru my hubbie's work.  I know I caused their rates to increase so having BC is considered a high risk when they dish out the premiums but not when they come to paying for testing

dlb823

obbosmel ~ I just bumped a thread from several months ago for you.  It's called Insurance company will not cover my MRI.  It's full of great information, including at least one post from a member who is very familiar with how insurance claims work and knew exactly how to get an MRI approved.  If you go to Active Topics, it should be on the first page.  Let me know if you find it, otherwise I'll bump it again later for you.   Deanna

obbosmel

found it, thanks!!  I knew there was one out there just couldn't find it

Anonymous

I think the new guidelines recommend MRI for anyone with risk greater then 20 to 25%, but I'm not sure. It took me more than 3 years to get my oncologist to OK MRIs for me (I am high risk due to LCIS and family history), but I haven't had any problem with my insurance covering it yearly. Good Luck

Anne