Jump to content

Insurance Approval for Avastin


Recommended Posts

Just got back from the oncolgist. They delayed my dad's scheduled chemo for a week due to his heart attack last week.

I asked the doctor about avastin, he responded favorably, but stated that insurance likely won't cover it. My dad has medicare and Unitedhealthcare. Doctor was certain that medicare would not cover it. I am going to try to get Unitedhealthcare approval.

Has anyone gotten insurance approval for this drug? I would appreciate any help or suggestions as to how to proceed.


Link to comment
Share on other sites

The onc may have to write a letter to the insurance company. Someone in his office should know how to deal with new chemo meds and insurance companies.

Is the onc concerned about using the Avastin with your dad's recent heart attack? I ask because it is an inhibitor for new blood vessel growth.

Good luck with the insurance company.


Link to comment
Share on other sites

My husband just started on Avastin. At this point we had to commit to paying for it. They are sending it to Medicare but they will probably deny it. However, the case manager helping us said she had just heard that Medicare is considering it for NSCLC. If they deny it we have it set up to apply to Genetech (the drug manufacturer) for their replacement plan. The program is SPOC. You will need your doctor to help with this.

Unfortunately, since your father had a heart attack, I think it is highly unlikely he will be able to receive this drug. There are certain factors that prohibit its use and this is one of them. His doctor may not be familiar with this drug since it is so new.

I hope they can find something that will work, good luck.

Link to comment
Share on other sites

I am friends with a lurker whom I "met" when she sent me a recipe. We correspond via e-mail b/c we have a lot in common, she is neurotic like me.

Anyway, she joined this board to get info for her friend who was diagnosed and thanks to what she read on this board about people asking for coverage, her friend talked to his dr, and was the first patient of the dr approved for Avastin :):)

I would say push and push the drs to write letters advocating for it.

Just wanted to share that it worked for one person that I know of

Link to comment
Share on other sites

I am on avastin/carb/taxol. My 6th treatment is in a couple weeks.

For insurance companies:

"Avastin/carboplatin/taxol is the new standard of care for frontline therapy for NSCLC" This is from the study done by Dr Sandler at Vanderbilt. His report was in May 2005.ASCO meeting in Orlando.

You cannot have brain mets and heart problems may cause concern as someone posted. Frontline therapy means the first treatment regime of chemo beyond radiation level chemo.

just keep at them, pm if i can help any more.

good luck.

avastin seems to be effective everywhere they try it.


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. We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.