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Insurance and PET scans ?


bart ziggie ( Greg )

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Hi everybody i just posted a rather lengthy message in the new general general section regarding my experience with not getting a PET scan done because its not a covered procedure for SCLC patients with " limited stage disease " i am not sure about any other type of lung cancer. Is there anyone else who has encountered this problem ? What if anything can be done about this ? I feel it is costing lives as we speak by denying people these scans. At the very least it is tremendously impacting our survival rate. It seems to me that insurance companies would spend a little extra now to prevent even an outside shot at spending ten fold later. Not to mention the fact that these test are crucial in staging disease as well as being a god send for detecting possible disease in patients that have been declared NED. As i indicate in my post in the general section i am so wrapped up in my new battle with my recurrance i may not have time or energy to try to push for this and thats why im here asking for any feedback,info, help,etc.... i can get. This to me is absolutely crazy ! Not just because it has effected me but i know this has effected lots of people and will continue to. Anything at all from anyone will help ease my mind. Am i wrong or what ? This really ticks me off bad. Looking forward to hearing your opinions.

Regards

Greg

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I have extensive sclc and I have had a CT about every 2-3 months since Feb. 2001. My insurance has payed for it. My insurance co. does have ppo with the hospital I am going to so I do not have to pay for any of it. I thought all ins. paid for the CT to be done. Does not seem like a smart move for the ins. co. :shock:

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My insurance covered 60% of the PET Scan. I have had occasions where the insurance has refused to pay for a CT Scan and I have the hospital resubmit. For some reason the insurance reacts to the 2nd submission and pays for the CT Scan. I have found, also, that insurance companies seem to react positively to telephone calls from their clients. Don't be afraid to pick up the telephone and make that call. I am my own advocate and I will speak up when I believe there has been an error. My wife supports me as well and she has been loyal in attending doctor appointments with me. She is quick to point out something the doctor that I may have forgotten to mention.

The point is: we must be or own advocates whether it is with insurance or the doctor.

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