Jump to content

Need help dealing with insurance company?


Recommended Posts

Hi everyone!

I am currently researching info so I can put together a dynamite appeals letter to my insuance company. They (Blue Cross/Blue Shield) won't pay for my Tarceva because I haven't had and failed two rounds of standard chemo. I understand why they won't cover it as first line treatment (I have had only Iressa before Tarceva) - a big expense for them vs.percentage of people who respond successfully and, we all know PROFIT is their first priority!

But I was treated first with Iressa because I was diagnosed with stage iv BAC at the same time as being admitted to the ICU with respiratory failure, was given a 5% chance to survive the respiratory failure and doctor felt regular chemo would kill me at that point. He happened to have a bottle of donated Iressa, so everyone said, "Well, give it a try."

Well, it worked like gangbusters for me - dramatic response within 2 days - so my oncologists decided I should stay on it. Why have more severe chemo if the Iressa worked so well and allowed me to feel great physically?

The insurance company disagreed, however. I have been lucky enough to have to pay for only one month of Iressa out of pocket (still making $100 a month payments on the $1850 dollars owed to Walmart Pharmacy) and have received donations of the med since then. But the anxiety of not knowing from month to month if I would have my Iressa (and now Tarceva) was the worst part of my experience since getting past the initial fear and shock.

Anyway, I found a great group that helps people deal with insurance companies and helps find other funding sources for uninsured people or as well as insured. It's:


Hope this info will someone else!


Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Reply to this topic...

×   Pasted as rich text.   Restore formatting

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

  • Create New...

Important Information

By using this site, you agree to our Terms of Use.