PET scan coverage

You might be able to find it on your insurance company's website, in their list of exclusions.

Maybe someone who knows Highmark will have a more concrete answer.

I work in a medical office (not oncology), often times insurance companies seem to work very hard at denying coverage for anything they can get away with.  Certainly they are not shy about taking your premiums though.  I would insist they pay for it, if they deny you might tell them that you want a letter from their medical director assuring you that he will take responsibility if you are later diagnosed with breast cancer related disease/ reoccurance or mets.  We all know the value of early diagnosis.  Usually authorizations are obtained a month before the scan, and have an expiration date, so the nurse is probably correct on this.  Hope this helps!  I just had a second PET scan within 8 weeks of my 1st, my onc was not sure if it would be approved (it was), if it had not been, I would have protested big time. 

Last December, my insurance (Aetna) denied my Pet Scan. My onc immediately contacted them and they approved it. I get the feeling that the insurance companies are just trying to see if you really want it.

Juli