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stage 3A and frustrated with insurance
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stage 3A and frustrated with insurance

› Forums › General Melanoma Community › stage 3A and frustrated with insurance

  • Post
    • August 2, 2017 at 6:49 pm
    iskitwo
    Participant

      I was DX with Stage 3A melanoma last year in November. After talking with Melanoma Specialist (a couple of options)  I decided to watch and scan every 3 months. Now 9 months in to this journey the insurance has decided that scan for stages 2b to 3b are only necessary every 6 months. I am feeling very frustrated because I may have chosen a different course of treatment had I known that the insurance got to decide when I get scans rather than my doctor.  Is anyone else having these issues? any advice? I am currently using my local melanoma oncologist….would I get better results using my MD Anderson Team? I had been trying to stay close to home for scans and only using MD if something came up.

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        • August 2, 2017 at 8:06 pm
        jennunicorn
        Participant

          It might be worth it to have MDA order the scans and if insurances pushes back they might have more power to tell them otherwise. I go to UCSF, have had some insurance hiccups along the way, and without a really good team that knows how to tell insurance to ____ off and get things approved, I may have dealt with much more in the way of insurance approval stress.

          • August 2, 2017 at 11:36 pm
          geriakt
          Participant

            The standard of care for 3A surveillance is only on CT Scan every 6 months. That is all the insurance will cover. From my experience at 3B and on a Clinical trial I have gotten and still get CT scans every 12 weeks. The trial pays for the scans because they require CT Scans every 12 weeks which is outside the scope of standard of care. At my 3 year Mark I will move to scans every 6 months and then I expect to pay for my scans and turn over to my insurance. My hospital charges $19000 for each full body scan which my insurance negotiated rate is $5000. I will elect to go to a imaging center that only charges $2500 per full body scan. I know my Clinical trial will balk at that and then offer to continue paying for my scans through year 5 and the the trial ends. 

            Tom 

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