ANA Discussion Forum
General Category => Insurance => Topic started by: rland on February 24, 2013, 11:27:46 am
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Has anybody been denied coverage for treatment with Gamma Knife?
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I think better questions are:
Have you been denied?
If yes, what reason was given by your insurance company?
And have you read your policy or plan to verify that the reason given conforms to the policy or plan provisions?
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Hi
I'm new to the forum and the insurance folder caught my eye because I have very minimal insurance and I expect to be denied coverage no matter what I do.
I work through a temp agency, so I have their "mini-medical" plan, which pays for very little. I get 3 doctor vists per calendar year, and I've already used those up.
I know I need to review my coverage to see if they'll cover anything that I have coming up, but I'm not hopeful. 2 years ago I had to have an Iron IV treatment and they wouldn't cover that because I don't have IV therapy coverage.
I've tried looking into Medicaid, but because I have a job and I guess because I do have some kind of insurance, apparently I'm not eligible for any aid.
I've just been diagnosed in the last month, so I'm not sure what's going to happen financially. Fortunately, my parents are going to do theirbest to help me and my sister is working on setting up a donation site for my friends and colleagues to contribute toward my costs.
Still trying to figure out my options...
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There are many doctors/clinics who will work with patients who have no insurance or poor/little coverage so be certain to ask questions of the doctor's office you choose.
Clarice
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Most hospitals have financial assistance available for people without regular insurance based on your income and asset levels, after taking into account what your policy would cover.
Check with the hospital for the program specifics and how they can help you determine if, and what, you are eligible for.
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Bringing up this subject again because I've been trying to figure out what to do.
I don't have coverage for radiation treatment so I'm looking at paying for GK or CK completely out of pocket. I've been talking to St Joseph's/Barrow in PhX because they have such a good reputation for treatment, and my sisters live there, so I could stay with them if I were to go there.
Unfortunately, the $$ they have quoted me is in the $70,000.00 to $100,000.00 range--and that is supposedly with some kind of discount (??).
They do have a financial assistance form on their website, but from giving it a quick once-over (and having dealt with such a form at a local facility) I think it's something I would turn in after I've had my treatment and start to receive the bills.
Well, in order to even walk in the door, I would need to have a downpayment of at least 20%.
My sister is in the process of helping me set up a Youcaring.com page so my friends and relatives can hopefully donate, but I don't know if I can come up with what I need that way.
It's a little mind-blowing.
One woman I talked to--a doctor's scheduler, I guess, suggested that since I was only recently diagnosed (in April) that I should wait until I could come up with the money or could acquire major medical insurance and then look into treatment. Or that I should apply for Medicaid in my state and have my treatment here.
Now, of course, I guess all those things are possible, but I'm feeling a bit depressed over it all. I don't know for sure if I qualify for Medicaid, but I really wanted to have my treatment somewhere where they have a highly experienced team, like at Barrow.
And I was hoping to have Cyberknife, since that seems to me to be the best way to preserve my hearing, but there's no cyberknife in my state.
I'm not sure what my next step is.
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Currently, unless you obtain group health insurance, you probably will not be able to obtain coverage for any pre-existing conditions. And even group coverage may have a waiting period for pre-existing conditions.