BRCA+ & deciding whether to do surgery - Will Insurance Pay?

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heathR
heathR Member Posts: 1

Hi.  I am 31 yars old & was recently diagnosed with BRCA2 gene mutation.  My mother has tested positive for the mutation, so the insurance company did pay for the test.  My GYN says I should have a complete hysterectomy & double mastectomy.  To me this is an easy decision to make since it could greatly reduce my chances of getting cancer.  I was wondering if anyone has had experience with insurance company paying for these procedures in someone with BRCA gene mutation even thought they weren't diagnosed with cancer.  From what I've read here, these procedures can cost up to $100,000.  I don't have that type of money, so this will be a big factor in my decision to do the surgeries.  Any experiences?

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  • leaf
    leaf Member Posts: 8,188
    edited October 2008

    I can't give you experiences, but I have read on the FORCE website that they have found that eventually they have had all/almost all insurance companies pay for BPMs for BRCA women. That's because BPMs are cheaper than (lumpectomy+rad or mast)+ chemo.

    If you don't get a satisfactory answer here, you might want to check on the FORCE website.

    http://www.facingourrisk.org

    Explore all your options thoroughly. Then make the choice that is right for YOU.

  • WB36
    WB36 Member Posts: 11
    edited October 2008

    Hi,

    I am 37 and am BRCA 2+ and just had a pbm which insurance paid for.  I think most will pay but it depends on what insurance you have.  When you find the procedure and doctor you want to use the billing office will know if your insurance will pay for it. 

  • WB36
    WB36 Member Posts: 11
    edited October 2008

    Oh and I have never had cancer.  Good luck.

  • gmakidd
    gmakidd Member Posts: 25
    edited October 2008

    Please tell me you are getting a 2nd opinion before you tear your body apart.

    I may get flamed for posting this but these tests are not all conclusive, they are an indicator of what may happen!

    The National Cancer Institute stress in bold letters that not all women who test positive on the gene will get cancer. http://www.cancer.gov/cancertopics/factsheet/risk/brca. Please read what they wrote.

    Just my opinion.

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