Hello Ladies,
I have been absent from this site for quite some time now. Guess now that I am feeling better, I am not as alert to others' needs. Sorry about that!
On the Oncotype DX test fees...my insurance company finally paid the entire bill! As I said, I kept pushing and wouldn't take no for an answer, and they really could not call the test "investigational" any longer. My insurance company is Premera Blue Cross of Washington and Alaska.
Good luck, and you might want to refer your company to Premera.
Jean in WA
Nice to see you stop by and offer support and information. I hope you won't be missing for so long again. You have good experiences to share just like this one. Hope 2006 is a great year for you and yours, MK
Hi Everyone!
I wanted to update you on my insurance appeals regarding the OncotypeDx test. United Healthcare of Florida agreed to pay 70%!!!!! I was thrilled upon receiving the news today.
My persistence finally paid off!
Genomic Health is still going to appeal for the remaining 30%.
Good luck to all of you who are currently in the appeals process. Don't give up too easily.
Happy New Year to all,
Marianne
Great news, Marianne! I'm thrilled for you. Thank you from all of us still in the "fighting" process since you have definitely helped many women with your persistence! Kudos!
Happy New Year to You!
Laure'
The finger of God touches your life when you make a friend.
----Mary Dawson Hughes---
Happy New Year to You!
Laure'
The finger of God touches your life when you make a friend.
----Mary Dawson Hughes---
Congratulations, Marianne, on getting your insurance to pay. I haven't sent in my third appeal yet - holidays, etc.
For those of you still fighting (like I am), I found something that might help. The National Cancer Institute (www.cancer.gov) produces a bulletin and I found a write-up on the Oncotype Dx test in the December 14, 2004, issue (vol. 1, Number 48).
I figure I've had enough time to "cool off", so I am going to go over the letter I wrote in early December and edit it. I plan on telling my insurance company that other insurances have paid (I will include names of companies), another copy of the articles I received, as well a copy of the NCI Bulletin. Hopefully, this will work.
I also contact my HR person back in December to see if they could help. I hadn't heard anything as of today, so I e-mailed them again - still waiting.
Pattie Morgan
Peace I leave with you, my peace I give unto you: not as the world giveth, give I unto you. Let not your heart be troubled, neither let it be afraid. John 14:27
Thanks Pattie. I wish you luck with your third appeal.
There is a lot of stuff out there from December 2005 you may want to include with your appeal. E-mail me if you have any questions.
Marianne
There is a lot of stuff out there from December 2005 you may want to include with your appeal. E-mail me if you have any questions.
Marianne
Jean,
Sorry, it's seems I missed the post where you stated your insurance paid for your OncotypeDx test. Congratulations!!! I would have been jumping for joy with you had I not missed that post. But we can still jump, right?
Seems I'm following in your footsteps, I'm where you were a few months back. My insurance has decided to pay 70% of the cost which put a big smile on my face. An even bigger smile will emerge on my face if I get word they paid the whole thing.
Again, congratulations on the good news and on a job well done.
Marianne
Laure',
Thanks! I sure hope that I helped in some way so other women will have an easier time of getting this test covered by their insurance companies.
Happy New Year!
Marianne
Thanks! I sure hope that I helped in some way so other women will have an easier time of getting this test covered by their insurance companies.
Happy New Year!
Marianne
Hi everyone,
I just got a really great phone call from Genomic lab....I am an excellent canidate for the Oncotype DX test and (drum roll please...) my insurance Avmed will pay for it!!!! I am sooo happy right now. The lady at Genomic labs said that Avmed starting pay for this test as of Nov 1st For those of you still battling the insurance red tape, keep on fighting!!!! We B/C sisters are stong and will fight until the end!!!!!!!
Love & prayers
Meg
Hi Meg,
That really is great news. Congratulations on both counts.
Marianne
Hi All,
I haven't been on here in a while (again) but got on here to research something completely different (my first mammogram after the cancer) and had to participate in this discusssion.
Some of you might remember that I had the oncotype DX test early last year to determine if I should have chemo in addition to rads. Well my onc. office did the leg work to see if my insurance company would cover it and they contacted me (the onc. office) and told me United Healthcare said yes. I had the test, scored a 3 and went on with rads to be followed by tam. Sometime last summer I was notified that United Healthcare denied the claim! I was furious and baffled at how this happened. My onc. office suddenly doesn't have the documentation to back up the clearance from UH. ???? I've been battling with appeals to no avail. So it is encouraging to hear Marianne's news.
Could any of you that have battled this please keep me up to date on what course I should take now. I thought the appeals process was exhausted, how long can you continue to appeal this? And what methods should I use; any template for a letter would be helpful. I am returning to work (finally) tomorrow and my time will be limited until I get adjusted to this.
Thank you all for giving so much of your time to keep us all up to date. I've been terrible about that lately. Sorry.
Mia
Snowflakes are one of nature's most fragile things, but just look what they can do when they stick together.
-Vesta M. Kelly
-Vesta M. Kelly
Here's an interesting article. I'm sure many others will follow suit.
[If you tried the link to this article before, it didn't work. I am changing it]
Also, don't forget to check out the Breast Cancer News blog my DH runs called Keeping Abreast. It is at:
Mia
Mia
Mia
Snowflakes are one of nature's most fragile things, but just look what they can do when they stick together.
-Vesta M. Kelly
-Vesta M. Kelly
Post Edited (MiaB) : 1/16/2006 6:28:13 PM (GMT-7)
Marianne -- I had the EXACT same pathology report as you did, which I received 2 weeks ago. My surgery was on January 19th. I am waiting for the results of the Oncotype dx test -- should come in any day now, in order to determine whether I should add chemo to the recommendation that I have tamoxifen with lupron (for ovarian suppression). I am also 48 years old. How did you reach the treatment decisions that you made? What did the oncologists recommend? Thanks! Susan
Hi Susan,
So we have twin tumors. LOL! Can't wait to hear your OncotypeDx test score. Please post it when it comes in.
Following standard protocol, my oncologist first recommended chemo but said the decision was ultimately mine. He gave me the "chemo talk" but seemed to be talking me out of it at the same time. I left the office a bit confused. Seems the reason for the chemo talk was because of 2 millimeters, other prognostic indicators were good. Honestly, I did not want to do chemo. We talked about the Oncotype test and I agreed to do it. I was the first one at this hospital to have it done.
In the meantime, I did a lot of research and talked to as many women who had been through breast cancer as I could. And I read through so many posts on the breast cancer websites. Although I didn't want chemo, I also didn't want to be stupid and not have an open mind.
The OncotypeDX score validated my decision not to do chemo. The day the results came in, my oncologist called and said no chemo. I let out a big YIPPEE!
Each situation is unique and everyone looks at the benefit/risk ratio of chemo differently. The few percentage points it gave me wasn't worth the risks to me. Will I regret my decision if the bc comes back? Absolutely not! I know there are no guarantees no matter what you do.
Here's hoping your score is a low one.
Marianne
I feel like I should put a disclaimer on this post stating I'm not advocating not doing chemo for everyone with Stage 1 breast cancer. The decision needs to be based on pathology, age, and so many other factors.
Susan,
Now I'm curious about your pathology. We really have the EXACT same pathology report? Here's mine again. I had a lumpectomy and SNB, did you?
1.2 cm. IDC, Stage 1, Grade 2; Nottingham Score of 6 (mitotic count - 1; nuclear pleomorphism - 2; and tubule formation - 3)
highly ER/PR + 90% for both
HER2 -
low s-phase (I believe mine was 2%)
Ki-67 showed low proliferation rate
diploid tumor
no necrosis, no vascular, no perineural and no lymphatic invasion
node negative
Marianne
Hi Marianne -- the only difference is that my Estrogen receptor is positive 95, other than that, it is an exact match, including the grade and our age. Still waiting for the results of the oncotype dx test. I've seen two oncologists -- very prominent in their field -- one from Hackensack Hospital, in NJ -- known for agressive treatment....pushing four founds of AC together with ovarian removal and arimidex -- and one who only specialized in breast cancer from NY Presbyterian....she favors only hormonal therapy with ovarian suppression. (starting with tamoxifen). The oncotype dx test will be the great decider........
Susan,
Please keep me posted on your Oncotype score and what you decide to do. I'm interested on how different such similar tumors might be.
This is such a difficult time when so much is being thrown your way and there are so many decisions to make. I was diagnosed last Valentine's Day and it really does get easier as time goes by.
Marianne
Thanks, Marianne, I will certainly let you know. I am assuming your score was low, and that you chose not to do chemo. Right? My doctors are recommending ovararian suppression with tamoxifen -- is that the therapy course you are doing?
Hello everyone, I havent posted in awhile but just wanted to update everyone. I got the results of the Oncotype DX test and I scored very low... No chemo!!!!!!!!!. YEAH!!!!! I just have to do radiation. I have already done the simulation and should start Rads next week. I almost qualified for the excelarated rads where you go 2x per days for 5 days but the tumor bed is too close to my chest wall and lung and onc did not want to take a chance at damaging them.
I do have a questions about rad... how do you handle the not being able to shave? Will the rads stop the hair growth? I also worry alot about getting tired during treatment. I need to work in order to keep up with the bills and cant afford to go on disability pay. Does Rads make you tired like chemo does? Also, how burned and swollen will my breast get? I am very fair skinned. Thank you for any answers you can provide for me
Meg
Meg,
Great news. Congratulations on the low score! If you don't mind me asking, how low of a score was it and what was your pathology. I like asking this question because it shows how very similar tumors can be so different.
Rads wasn't too bad at all. I did get tired but more towards the end of treatment. It's a cumulative effect so it catches up with you in the end. Everyone I know who went through it had no problems continuing to work. My guess is you'll find yourself going to bed a bit earlier as time goes on. As far as the burn, everyone handles it differently. I didn't burn til the end. Just do what they tell you do. In my case, they had me using fresh aloe (peeled and then put into a blender to make it liquify it). I was also told not to use deoderant or scented soaps. As far as not shaving, that part was difficult for me but you just sort of grin and get used to it. I did not lose my underarm hair.
Good luck on the final leg of the journey. I'm sure things are going to be just fine. Keep us posted.
Marianne