Insurance denied my cancer treatment

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denisel
denisel Member Posts: 12
edited February 2017 in Employment, Insurance, and Other Financial Issues

aromasin - my oncologist with Seattle Cancer Care Alliance prescribed Aromasin for ER/PR+ type cancer , insurance denied after 14 days of waiting.

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  • ksusan
    ksusan Member Posts: 4,505
    edited February 2017

    It may have been an error. Call them directly for an explanation. In addition, have your oncologist's office call.

    I was told last week by my gynecologist's office that my insurance had lapsed. I said that this wasn't the case, and among the evidence was that I had had pre-approval for a CT the week before. They insisted, so I called my HR office, which confirmed my coverage and wrote an email to my carrier. The carrier confirmed my coverage and noted that the medical office hadn't logged any inquiry with them. I forwarded this to the medical office, which magically then determined that I did have coverage.

    Meanwhile, look at GoodRx.com and other online prescription discounters that offer a free card and coupons. I've used Walmart and Costco coupons from them to get non-covered prescriptions at a discount.

    Good luck! It's frustrating.

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  • cive
    cive Member Posts: 709
    edited February 2017

    They may have denied it because femara is less expensive.  With my insurance they would want a reason why I'm taking a more expensive drug before they would cover it.

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  • denisel
    denisel Member Posts: 12
    edited February 2017

    cive thank you. I'll find out what the issue is and will start Monday. I don't know why it just bothered me so much but it's so insulting. The medicine is actually $23 for 90 days without insurance which is definitely doable, it's more the principle. I have learned so much in the past two months . Thanks again

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  • cive
    cive Member Posts: 709
    edited February 2017

    Hmm!  With my medicare advantage plan the price would be $90/month.  Perhaps I should check into buying it without using my insurance.  I think it quite likely I will be changing to it since my TMs skyrocketed this month.  Just checked goodrx and it's more than $200/month everywhere with goodrx coupon.

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  • denisel
    denisel Member Posts: 12
    edited February 2017

    Hi Cive, I was incorrect , it is Anastrozole. Maybe the insurance company has an issue with this one however I aM post menopausal,hmmmm. I'll find out tomorroe

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  • Denise-G
    Denise-G Member Posts: 1,777
    edited February 2017

    I have no drug coverage...I found to always check with COSTCO for prices. You do not have to be a member.

    My Arimidex prescription is only $27.00 for three months. Walmart was like $300.00 a MONTH!

    Anyway, do check with your insurance company. Most likely is an error. My sister's insurance company will

    only approve her AI for 1 month at a time.

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  • denisel
    denisel Member Posts: 12
    edited February 2017

    Denise-G, thank you! I'll keep that in mind for certain, I can't believe the difference for the same meds

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  • GAMomma
    GAMomma Member Posts: 197
    edited February 2017

    although I do not face this problem,I wanted to add my 2 cents 😉

    Definitely ALWAYS call your insurance company direct if ever denied anything. Sometimes it is the way the script is written. As another member stated that some insurances only approve 30 days at a time. When my Mom was in hospice her meds only would refill every 15 days. Unfortunately due to life expectancy 😢

    Hopefully you can get it straightened out.

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