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PET scan with BCBS What is this ?

 
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philt1861
New User


Joined: 12 Oct 2006
Posts: 5
PostPosted: Sat Oct 21, 2006 8:25 am    Post subject: PET scan with BCBS Reply with quote
hi, I recently began requesting tests for lymphoma, 2 cat scans and a ton of blood tests. they found enough swollen lymph nodes in the cat scans to warrant more tests, (some 2 cm under my heart) and have been tested for everything else related to the lymphatic system (neg). the surgeon said he didnt have a lymph node prominent enough to biopsy, so my oncologist suggested a PET scan. For some reason BCBS said they wouldnt cover it. I have ALL the symptoms of lymphoma. Has anyone else had problems with BCBS? I thought they were the best provider. Not sure what to do now
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brainman
Site Admin


Joined: 13 Oct 2005
Posts: 3457
Location: Tennessee
PostPosted: Sat Oct 21, 2006 9:00 pm    Post subject: Re: PET scan with BCBS Reply with quote
Denial of coverage is something common with all health insurance providers… not just BCBS. The first step is to tell your doctor and get him/her involved. Sometimes it only takes a phone call or a letter from your doctors explaining why this test is needed. If that does not work, find a good lawyer who has experience dealing with health insurance companies.

Good luck and I will be thinking about you.
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Site Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendoglioma grade 3, same location.
My Story Part 1: http://cancerforums.net/viewtopic.php?p=7350
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cptmac
Regular


Joined: 19 Apr 2007
Posts: 41
PostPosted: Thu Apr 19, 2007 1:42 pm    Post subject: Re: PET scan with BCBS Reply with quote
As someone who has used BCBS since '05, they used to cover PET scans. Unfortunately some study came out stating that PET scans aren't more effective than CT's to find colon cancer. With that study, BCBS has not covered my PET scans. My doctor tried to get it covered, because he liked using it as a routine at the 3 year mark.

Unless I was willing to pay for it, I would not get it. I've done great with my stage IV cancer, so I chose not to. However, I did initially pay for my colonoscopy out of pocket because I had no symptoms and I am too young for colon cancer. A walk in doctor suggested I get one, because he said my food allergies may be Chron's or IBS. Once the colonoscopy detected cancer, my insurance company ponied up the cash.
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