Zometa declined by regence - anyone appeal this?

I'm very interested in this question too - I am considering adding this but my doc said they haven't found any insurance company that will pay for ometa for reducing chance of recurrence, except in one case where the patient already had osteopenia.  We did a bone density to see if they can justify it to insurance based on my bone scan.  if not,t hey think they can get them to cover fosomax or one of those, based on the fact that I had my ovaries out.

I can check with my onc if he has had success in getting Regence to pay.  I'm in Oregon and Regence is here.  Where are you?  Let me know if you want me to check with him. 

hI,  i just had my expanders out Friday mooring and had silicone implants, put in. They are Alergan #20, smooth.  I havent seen anyof them, so don't know what's up. Took the rap off y am and put or sports bra for 1 or 2 weeks.  I also have drains in.  Im' sorry I've gottten off track here.  I am on a sutd y for Zomena, it will last abojut 2/12 years.  I had it once a month for six month, them once every three months.I have osterosis, (spelling), and they're trying to see if zomada will help that, but mainly they have supposedlyproven that it really helps breast cancer form entering the bones.  (dont know why this dumb computer went to bold, hope it doesn't bother you) They were hell the first 2 treatments, tho.  Surgery was a piece of cake.  Anyway, If you do get it, it's great  Ask about the study for it. Don't let them tell you there isn't one, cause I'm proof there is. Ims sorru this probable wont make any sence to you, I feel like I am a cloud somewhere and just need to get back to bed.  It is 4:45am, i just got up and couldn't sleep.  Bye  Norma

aprilgirl1,

sorry to take so very long to get back to you.  i went into a yucky period with my chemo and just climbed back out of the hole.  i hope you have already been successful with your zometa appeal.  anyway, my onc was reluctant to share which insurance companies have approved it in oregon.  i think they just get all hung up on privacy even though this obviously isn't a personal privacy issue.  anyway, my $0.02 is that you should just tell regence that you know that regence oregon has approved zometa for use in a patient who does not have metastatic disease.  tell them you can't share the name for privacy reasons but they should check their records for patients treated at OHSU.  it's a gamble but maybe worth a try.  and of course you can tell them that ODS has approved it for multiple patients including me.  good luck!