Insurance coverage for Foundation One Testing

Snowfall
Snowfall Member Posts: 90
edited November 2017 in Stage IV/Metastatic Breast Cancer ONLY

My insurance (Blue Cross Blue Shield Federal Plan) is generally good, and I have not had to dispute coverage decisions thus far. However, payment for Foundation One testing has been denied as experimental. Do any of you have any suggestions on how to argue otherwise? I am working with my oncologist's office, but the two statements they have submitted to the insurer about the medical necessity of the test have both been rejected. Any thoughts welcome!

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  • jamiemarie
    jamiemarie Member Posts: 73
    edited November 2017

    Hi Snowfall, I have the same insurance and was also recently denied. I was a bit upset when I found out and emailed Foundation One. They responded really quickly and said they would also file an appeal. I haven’t heard more from them or insurance - so have been trying not to worry about it. But if you havent talked to foundation one, it is worth an email or call.

    Andinterested to hear other suggestions too! Like you, this was the first denial of coverage I had too.

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  • keetmom
    keetmom Member Posts: 432
    edited November 2017

    My insurance doesn't cover it but I did qualify for patient assistance through them, one thing to look into.

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