ins. doesn't cover typing

[Lolam]

They would like me to proceed with the BMT but now my ins. will not pay for the HLA typing for my sister. We are getting a new ins. company June 1st. I guess we will have to “waste” the month of May. We don’t know what else to do. If the new company does not pay for typing we have decided to let MDS take its course without the transplant.

Lots of decisions with this disease eh? Makes my head hurt…

[doreen]

Lola, You are such a fighter. I am not sure how much the typing costs but there may be grants that help cover the cost. Someone more knowledge on this may know more. They initially told me that they would not cover my typing but did anyway. I wish you the best, this disease is not an easy one to deal with emotionally.
best regards, Doreen

[Neil]

Hi lola,
Look for a patient advocate at your docs office or at the hospital you are dealing with. An advocate can provide you with plenty of good information and make it easier to battle with the insurance co.

[frank]

Hi, lola,

ask your insurence which hospital will be covered by them, some insurence have a contract with one hospital, but doesn’t have contract with others. i got the same case now, my insurence Unitedhealthcare doesn’t cover for the unrelated HLA with Johns Hopkins University, and i have to goto another hospital to do it. My insurence suggest me Duke, since they will cover it if i am doing it there…

Frank

[Jimbob]

Lola – and Frank,
My insurance is thru UnitedHealthCare, too. They have a backup policy administered as United Resource Network. They have covered almost everything, including the type testing of all four of my brothers at different hospitals or clinics in the Chicago area. They have been great about meds, doctors, labs, physical therapy and more. I had no idea there was such coverage but the benefits office were I work made the connections for me. So glad I worked there. Ask again.
Jim

[Suzanne]

I never received any bills for my sisters testing or the tranport of her blood from Arizona or someplace to Hopkins.

[frank]

related donor and un-related donor is a totaly different story, most insurence cover the related not the un-relsted, and cover the full-bmt not the mini-bmt, like the unitedhealthcare. they only have contract with certain hospital and facilities, not all. for me, they cover the related in Johns Hopkins University, not the unrelated, so i have to find a hospital which they cover for the unrelated… especially they only have contract with Johns Hopkins from last year, my first bill from the Johns Hopkins is still pending–just because the cover of the contract…

insurence have option for you, the case manager of insurence will give you advice on it.

[Lolam]

If I try to fight this now, it will take the month of May before it is resolved. Then we will be switching to Aetna. It doesn’t seem feasible. The only other thing I could do to get the typing from my sis. this month is to pay for it myself. I think we will take the risk that I will stay stable one more month, at least we are praying and asking God to help in that regard. I have a concern that Aetna will try to find a loophole, like a preexisting condition or something and deny benefits. I try to live one day at a time in that regard though. I just don’t know the future and if I try to live there I get so anxious. So I will let tomorrow take care of itself.

Today I feel okay and that is a blessing to me. Each day will have to be precious now. I always say, “Don’t just be alive, but really live!” That means that I spend time in worship and prayer, and reading God’s word. If my spirit is filled up I can face anything. Then I need to meet the needs of those around me, in big and small ways. It helps to care more about others than I care for myself.

Sometimes I cry because I am disappointed with This impending illness and all that will involve. It is a fearsome thing! But then I try to say “What is right with this picture!” I can always find something to be thankful for.

My heart goes out to all of you in whatever stage you are going through, caregivers and fellow strugglers. This is hard, isn’t it? No denying that. But we will get through it. This support here is so helpful. Thanks for the advise and care……

[Binnie]

Lola, My husband was covered by Aetna and they covered the testing for his brother. His sister was also tested, but was covered by her husbands insurance. It is so unfair to have to worry about insurance at a time like this. Stay positive–things have a way of working out. Will keep you in my thoughts and prayers.

[Terri]

Lolo We have Aetna, We did not go through what you are going through, but When Bob was first Dx and in and out of hospitals they assigned me a Case Manager who I was able to talk to and She could find out all the ins and outs about which hospitals, when I needed referrals etc etc.

[Suzanne]

I had a case manager also. They assigned one as soon as they saw tests being done for something as expensive as a transplant.She was able to negoiate reasonable coverage on treatments by my insurance company. She stayed in place until I had been in remission for a while. My insurace company is Mega Life and Health(I was self employed) but they use the alliance network and I have not had any problems with anyplace I wanted to go not being in network-I have a PPO. I have seen plicies that require a wait peroid of about 6 months for covering preexisting conditions. Hope yours will not be that way but you might ask now so you know what you are facing.

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