Insurance battles continue :-(

The oncologist issued a prescription almost 3 weeks ago for a new cancer treatment….which my current insurance provider has denied.    I will never understand why we have given our insurance companies and our government this kind of control over our health and lives.

You have a patient with known, proven cancer running wild….and a drug that could possible halt that progression at the very least.   And yet,  some desk bound twirp with a pencil gets to review the case for the insurance company…and says…patient doesn’t need to be treated with this drug…and denies the claim.   Wouldn’t one think that the oncologist would have a better idea of what drugs might possibly work to provide a better quality of life?   Maybe to halt the progression and buy more time?

I am so disgusted with the whole medical field….there has to be a better way.    Granted,  I’m the patient at the end of the road on the denial…and I understand the medication is going to run about $10,000 per month and the insurance company doesn’t want to pay up….

Within 2 weeks,  I will go on Medicare with a new Part D (prescription program).    We get to start the process all over with a whole different insurance group…who knows where that’s going to lead.  Please keep us in prayer.

I hear about socialized medicine, but after talking to international friends,  I’m not sure that’s the best option available either.   They cannot get the level of treatment, some of the newer testing and medications aren’t even available for them.   When we were talking about Gamma Knife surgery,  that wasn’t even an option for the friend with brain cancer.   What a horrible shame that we cannot have a level playing field and share techniques, new treatments, drugs, and advancements in the medical field across international borders.  How many lives could ultimately be saved?  Maybe that’s the problem.   They would just as soon those of us with terminal diseases just curl up and die so they don’t have to treat us…save that money,  to hell with saving lives.

Anyhow,   I’m on a rant today.  Just totally hacked over insurance doings.

Susan ~ Patchkat




11 responses to “Insurance battles continue :-(

  1. I know the feeling. We lived over saws and it was so sad to see people die for the had socialized medicine and there you get on a waiting list to be seen so you might be gone before they see you. We have gone thru what you are going thru and it’s only getting worse and our government is helping it along. I’m sick of our government deciding what is better for us. I thought that is why our doctors had to go to college for so long. To learn how to treat the I’ll something our government has never done. My prayers are with you and yours.

  2. I think you are right…it’s all about the $$$$$. I went for years without insurance and was lucky that I was healthy. I’m now old and on Medicare with a secondary insurance that keeps wanting to “change the deal”. I don’t like Obuma and his care package. I think they just want us to away so they can give the $$$ to others (congress, The House etc.) and of course other countries. Now you have me ranting. There goes my blood pressure. I’ve been reading your “adventures” for several years and you and your husband deserve better. Lynn

    patchkat posted: “The oncologist issued a prescription almost 3 weeks ago for a new cancer treatment….which my current insurance provider has denied. I will never understand why we have given our insurance companies and our government this kind of control over our hea”

  3. I feel for you and others going through the same thing. With Obamacare, those that make it to 75 and then get cancer, are basically told to go home and die. It won’t even cover them. It’s all about me me me if you’re in the government. If you don’t qualify for the wonderful medical care the biggies in Washington get, they couldn’t care less. It really IS disgusting! Lots of prayers going out to you and yours. Blessings!!

  4. So sorry they are giving you problems. I feel there is a cure for Cancers but that would stop the money trail……its all about the money….with everything. Have you and Ernie in my prayers everyday. Love to you both, Joanne Date: Thu, 24 Apr 2014 19:09:49 +0000 To:

  5. My husband was just diagnosed with lung cancer with asbestosis surrounding the mass in his lung. He turns 70 next week so i too am wondering just how far our insurance company will be willing to pay. For years he has not been a candidate for any type of surgery because of heart and lung condition and now all the sudden they want to operate and take part of his lung out. Not sure what he will end up letting them do, but i’m not informed as much as I would like to be either. Prayers for peace and comfort!!

  6. I’m also so sorry you are having to go through all this. It’s bad enough that you (and your family) are going through this without being slapped down by insurance. I agree with Joanne, I believe there is a cure for cancer out there, the money people don’t want it to get out.
    I have been on SSI disability, and Medicade, for about four years now. I’m 53, and I worked a lot in my younger years, but I had been unable to work long enough when I applied for my dissability that it didn’t count. I know that the health problems I have pales in comparison to cancer, and a lot of other terminal illnesses, and I’m not one of the many people that are paying a high price for “Health Care”, but I know the run-around of that pencil pusher deciding what you need or don’t need.
    I have the same ‘rant in my heart’ that you do. I will remember you and Ernie in my prayers, and I pray hard for a cure, and meds to get us there.
    Lisa in Alabama

  7. We live in Canada and and have socialized medicine, well socialized insurance really – our provincial insurer is Blue Cross. We have one of the world’s foremost cancer centres here and have access to gamma knife surgery and several others in that same family. When my husband had a seizure and there was concern he might have a brain tumour he had an MRI as quickly as they could prepare him for it.

    I’ve just seen a research geneticist (twice) to confirm a diagnosis. A specialized Falls Team (doctor, physiotherapist, occupational therapist) is coming here to the house to assess my husband for risk of falling, and begin therapy/install grab bars, provide aids to lessen his risk. He has daily homecare to help him shower, shave and do meds, and she helps with housekeeping chores I have trouble managing.

    His medications are blister-packed in individual doses and delivered to the door every other Friday. We attend a specialized clinic a five minute drive from here which sees ONLY patients with complex medical issues, so our visits are always 30 minutes to an hour long. And Canada spends LESS per person on health care than the US does while caring for *everyone*.

    Compared to what my client patients in the USA tell me of trying to access care it sounds like a nightmare. We *never* have to fight for care. If a treatment (say Gamma knife) is not available where we live we can ask to be sent to a centre where it is available. Because my disorder is rare I was sent to a specialist at Duke University in 1993 who was researching new testing equipment, and I’ve been offered chances to see specialists in the US if I wanted.

    The ACA does NOT ration care for older patients. It makes rationing illegal based on age or pre-existing illness. The e-mails that started going around in 2008 that claimed the ACA would introduce “no treatment for those over 75 with cancer” were hoaxes motivated by political and monetary interests. See:

    Susan, I hope and pray your pencil-pusher at the insurance company will come through for you. This is not the way insurance companies should be treating veterans and their families. Thankfully Medicare is not far off.

    Love you so very much,
    Auntie Deb

    • Auntie Deb….we were told again today that we’ve been denied. Dr is still appealing that decision. Maybe with the new changes in insurance for us, that will bring a more hopeful decision from the new carriers. We’re praying for improvement and of course, for good, advanced treatments. Dr office is also researching trial studies that might work for me so I could receive the meds. Just have to wait and see. The Lord has taken care so far…. Love to you both.

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  9. Dear Susan, I’ve never responded to a post of yours before but I’ve been following you by e-mail since about the time of your diagnosis. You and your family are frequently in my thoughts and prayers. I admire your bravery and positive outlook on life. I also want to thank you for a couple of your patterns that you had on-line shortly after I started following you. One was donated locally to a “Relay for Life ” raffle. The other one was made into a quilt top by my 10 year old granddaughter. She almost 13 and one of these days she’ll visit long enough to get it quilted.

  10. Susan, my heart aches for you. I live in Canada, and we do have health care for most things. There are still medications that cost hundreds/thousands of dollars that are not covered by health care, especially when it comes to cancer. I lost my husband, in Jan., at age 61 to metastasized colon cancer, that had spread to his brain, lungs, kidneys, liver, and probably other places. The worst part of our journey was the errors and attitudes of some of the doctors we dealt with. We had at least 2 of them that basically said, why don’t you just accept it, that you are going to die, and quit fighting it. I managed to keep him alive for another 6 months, by not listening to them. We had good days and very bad days during that six months. I just hope that I wasn’t being selfish, by keeping him at home with me, even though I know he was in severe pain. I know that it was also his wish to not die in the hospital with them, as neither of us trusted them. We also believe there is a cure, but because of the money, we will never see it. You are in my prayers.