Looking For Advice On Insurance Coverage, Grants, or Studies

KLJ

Ladies, I am looking for some advice! My oldest daughter was diagnosed with Triple Neg BC in 2011 at the age of 30. I was diagnosed in Dec. 2013 with DCIS and IDC. My youngest daughter is 25 and just had a baby. Her OB/GYN wants her to stop nursing at 6 months and have a mammo, MRI, and Ultrasound. Of course insurance will cover none of this. First of all I don't think she should stop nursing to have this done. I would agree with stopping at one year but not sooner if she chooses to nurse for that long. Second, any ideas on how to go about looking for a study, grant, or something to help pay for these tests? Going to see my oncologist next week and I am going to ask him but I feel like they are looking at me like I am just looking for free advice, which I am! Neither one of us can afford what those tests would cost! I feel like we are chasing our tails here trying to find a way to get her checked since we have such a family history of this.

keepthefaith

Go to the social worker at your medical office/facility/hospital.  Maybe try looking online also. Call the American Cancer Society also. Good luck!

MelissaDallas

Have you or your daughter with breast cancer had genetic testing?

KLJ

MelissaDallas, my daughter had the genetic testing and it was negative. My insurance would not cover the cost of me having it done.

pajim

I agree that the social worker at your or her local cancer center should be able to help.

Alternatively, try these folks:  http://www.cancercare.org/

No reason not to ask your onc.  He or she should be happy to give advice.  They don't want any more cancer patients either.

Or, lastly, if her Ob/Gyn recommends and issues a request for a mammogram, why wouldn't her insurance pay for it?  Call it a baseline due to family history.

FYI my cousin waited to have her mammo a year whilst breastfeeding.  So long as she doesn't feel lumps or anything she should breastfeed as long as she likes. 

BrooksideVT

KLJ, congratulations on your brand new grandbaby!  It sounds as though your daughter has several months to weigh the benefits, for herself, and for her baby, of testing in six months vs the benefits of continuing to breastfeed for another month, six months, year, or however long she and the baby want to continue.  Along the way, I hope she will be in touch with her very caring and careful doctor for a bit of clarification.  Perhaps the ob/gyn suggests breastfeeding for at least six months? 

When your daughter is ready to schedule the imaging, her doc should be able to code the request in such a way that insurance will cover it. 

 

  

SpecialK

KLJ - I am not sure a mammo would reveal much due to your daughter's age and likely breast density.  I would focus on US or MRI since they are likely to show more, if you are forced to choose between the modes of imaging.  Here is a link to a site that is specifically for younger women:

http://www.brightpink.org/i-am-high-risk/financial-resources/

Also, here is a link for screening trials:

https://www.breastcancertrials.org/bct_nation/browse_trials.seam?categoryString=screening

Hope this is helpful!

KLJ

Thanks SpecialK! Both of those sites have lots of information. Including the fact that because she has a sister who was diagnosed at 30 and a mother who has cancer she is definitely considered high risk and 4 to 5 times more likely to have breast cancer herself. Getting factual information from experts is a huge help and gives us better grounds to fight with! I appreciate everyone's help!

vlnrph

As far as genetic tests, if they were done more than a year or two ago, updates and checking larger panels is a possibility. It might be a good idea to call your daughter's clinic/counselor. Ask about the most recent developments like Ambry's BreastNext or others that go well beyond the basic BRCAs and rearrangement assessment.

Depending on when your denial was, costs have come down because of the Supreme Court decision invalidating the Myriad company patent. Insurance may be more willing to provide coverage now because it's cheaper for them if someone doesn't need close follow-up!

KLJ

Thank you robo47! I appreciate this!