Insurance not wanting to cover oncotype

Dovely

They are appealing it even though BS and MO signed off in it. Any ideas why? Has that happened to any of you?

Lula73

is there any family history on either side of your parents

Dovely

Lula73, no there isn’t. And all of my genetic testing was negative (tested for 11 gene mutations).

MLAnne

My insurance is also 'investigating' whether they will cover the Oncotype. Which is probably a nice way of trying not to pay.

My surgeon only ordered after the pathology from the lumpectomy turned up 2 different cancers which was unexpected.

They haven't officially asked me to cover the cost but since that test is the lynchpin of the treatment plan, I don't see how they can deny it.

Dovely

MLAnne, that’s interesting. I had bi-lateral tumors, but all three were grade 1 and stage 1. They fought back on the genetic testing too but it went through

edwards750

My MO ordered the Oncotype test because I had a micromet in my SN that showed up in the Path report. BC approved it initially with Genomic Labs on the phone and then reneged later but not until I had already had it done. Genomic Labs says they did that all the time and they were used to it and would appeal. Never heard another word. It was 5k at the time. They did say if it was denied they would work something out on a sliding income scale. My BS was furious because he said it was beneficial to them and me if I didn’t have to have chemo. Thankfully my score was 11 so dodged chemo.

Diane

coraleliz

Initially my insurance wouldn't said they would't pay. But then they paid every penny.