Insurance

July 2, 2005

Hi! I just mostly monitor postings now, I am just a hair over a year

from my diagnosis. I went thru chemo, rad and surgeries and am doing

ok. Mine was rectal cancer - T2N1, but downstaged after the

rad/chemo. Having the usual issues getting the body back to regular

after all that and I realize it will never be " normal " again. I

recently had cT scan again - since my resect area is showing

some " shadow " or inflammation - frankly they're not sure what it is.

That's why your post caught my eye. My bloodwork, and the

colonoscopy came back good so I wasn't expecting any bad news with

the ct scan. Haven't yet talked with the surgeon who wanted to look

at the films himself before talking with me. I'm fairly certain this

is not a cancer return but found our similarities interesting. I

was interested too in their comments about the balloon. I have not

brought that up with my surgeon yet..and he hasn't either. I'm seven

months out from the resect and it's been a long road. A year out is

when they say that it will probably be like whatever it ends up being

at that point. Most days I'm fine...others, well...let's just say

I'm tired of things hurting and of worrying.

Like you I am trying different doctors too. Some successul some not

so. But I keep trying...and your post is an inspiration to keep

doing so. I know I don't post much now..but I still keep tabs. Our

communication with each other is probably one of the most valuable

tools we have in this war. Wishing you well and good results.

Sheila

July 2, 2005

oh - and ps - I was diagnosed at age 42 ... and I recently did the AMC

Relay for life and sent my first survivor photo to congressmen with

comments that they need to work on getting folks scoped earlier than

the standard age 50...there are just too many younger than that are

getting CRC

July 2, 2005

oh - and ps - I was diagnosed at age 42 ... and I recently did the AMC

Relay for life and sent my first survivor photo to congressmen with

comments that they need to work on getting folks scoped earlier than

the standard age 50...there are just too many younger than that are

getting CRC

August 8, 2005

In a message dated 8/8/2005 3:36:12 PM Eastern Standard Time,

hilsshop@... writes:

I wonder if the insurance companies have any idea how much money they would

save just paying for colonosopy and not cancer!!!!!

Hil

I surely wish I understood their reasoning, Hil...just doesn't make sense

unless they don't want to wipe it out!!! Maybe no one in their families has

suffered ?? Maybe greed is even stronger than seeing someone, anyone suffer??

Lots of hugs and prayers, Donelle

Caregiver to Glenn

August 8, 2005

It's not colonoscopy that's not paid it is the virtual one.

While virtual may be best it is not usually ordered since the medical

community still sees regular colonoscopy as the gold standard.

The more ordered the more likely it is to get paid. We are quick to blame

insurance but if doctors don't order the procedure and/or provide reasons why

it is no longer experimental they bare just as much to blame.

Narice

August 8, 2005

My doctor did one with no problem Regular not virtual though.

My insurance will pay for age 40 and up but that only started this year

With the big Cancer agencies still using 50 as the age to begin

and primary care doctors seldom arguing this is more complex than some

imagine. That's why we all need to keep writing all physicians, agencies, and

insurance companies and demand better care.

Narice

August 8, 2005

Aetna/US Health they covered mine anyway since my Paternal Grandfather died

of colon cancer and some of my brothers and sisters and my Mom have had

polyps.

I was clean though and go back again in 2006 or 2007 2-3 years for a recheck.

While we are on the subject how does testing work on the kids as far as

preexisting condition etc. Is it better to do it on our policies or wait until

they have their own?

My brother was diagnosed with Wilm's Tumor over 35 years ago and he still

cannot get his own health insurance.

Narice

In a message dated 8/8/2005 4:45:00 PM Eastern Standard Time,

psavary@... writes:

What is your insurance company?

Priscilla A. Savary

Executive Director

Colorectal Cancer Network

PO Box 182, Kensington MD 20895

psavary@...

www.colorectal-cancer.net

_________

Screening for All. Colon Cancer for None.

____________

Like to help CCNetwork? Go shopping!

Click here to join: http://www.iGive.com/CCNetwork

Re: Insurance

My doctor did one with no problem Regular not virtual though.

My insurance will pay for age 40 and up but that only started this year

With the big Cancer agencies still using 50 as the age to begin

and primary care doctors seldom arguing this is more complex than some

imagine. That's why we all need to keep writing all physicians, agencies,

and

insurance companies and demand better care.

Narice

August 8, 2005

Almost forgot

Whenever you file an insurance claim make sure you include information as to

why the charge is MEDICALLY NECESSARY. This is especially important if other

tests and treatments are considered the norm or if you are younger than the

standard recommendations. If you can PROVE medical necessity your claim will

almost always be paid.

A little insurance stuff I learned from my Dad who used to manage and at one

time WROTE the Postal Worker's Health Plan which was loosely based on Blue

Cross and Shield (actually he HATED Blue Cross as he thought they were not

looking out for patients but profit and he said that in the 70's!!)

Narice

In a message dated 8/8/2005 5:08:11 PM Eastern Standard Time,

flipper759@... writes:

Aetna/US Health they covered mine anyway since my Paternal Grandfather died

of colon cancer and some of my brothers and sisters and my Mom have had

Polyps.

I was clean though and go back again in 2006 or 2007 2-3 years for a recheck.

While we are on the subject how does testing work on the kids as far as

preexisting condition etc. Is it better to do it on our policies or wait

until

they have their own?

My brother was diagnosed with Wilm's Tumor over 35 years ago and he still

cannot get his own health insurance.

August 8, 2005

Just an FYI. With the latest findings about colonoscopies, technically the

virtual colonoscopy is now more accurate - according to the published findings

in peer reviewed journals. Makes me crazy that they won't cover this fact. And

makes me crazy that they want to call it experimental.

Priscilla A. Savary

Executive Director

Colorectal Cancer Network

PO Box 182, Kensington MD 20895

psavary@...

www.colorectal-cancer.net

_________

Screening for All. Colon Cancer for None.

____________

Like to help CCNetwork? Go shopping!

Click here to join: http://www.iGive.com/CCNetwork

Re: Insurance

Hil,

Mind if I ask how old you were when you were first diagnosed?

The reason I ask is that your children should be tested AT LEAST 10yrs

before you were first diagnosed, if your 36yrold daughters doc refuses to let

her have one she needs to find a doc that will!!!!!!!! My husband is only 33yrs

old and diagnosed passed Sept with Stage 4!!!

Kick that doc for me will ya!!

Deb

August 8, 2005

I may have posted but can't remember. Not had chemo yet either:) Our local paper

had a large 1/4 page ad advertising the Virtual Colonoscopy being given at our

local hospital. It did say check with your insurance company. We only have two

major ones here so somebody is covering them or the ad would not have been in.

I had checked with my insurance a few months back and she told me they

considered it experimental. A nurse from the insurance company did call me the

other day as they have been notified I will be having surgery. She said she

would call me back on the 18th to go over the surgery with me and answer any

questions. I think I just did that Wed at the surgeons office:) Anyway I asked

her if they covered virtual colonoscopy and she said she would find out and call

me back. The message she left stated they would not cover them for me which is

understandable. I was really trying to find out for a daughter. She explained

that they already knew I had a striture and would require surgery so a virtual

colonoscopy would be of no use for me.

I just had long conversation with a friend last night explaining colonoscopies

and why everyone should get them early and we could wipe colon cancer right out.

I wonder if the insurance companies have any idea how much money they would save

just paying for colonosopy and not cancer!!!!!

Hil

Re: Insurance

Hil,

Mind if I ask how old you were when you were first diagnosed?

The reason I ask is that your children should be tested AT LEAST 10yrs

before you were first diagnosed, if your 36yrold daughters doc refuses to let

her have one she needs to find a doc that will!!!!!!!! My husband is only 33yrs

old and diagnosed passed Sept with Stage 4!!!

Kick that doc for me will ya!!

Deb

August 8, 2005