Blue Cross/Blue Shield Members in Sacramento/Grass Valley Area!!

• By PattyKey
• Posted August 2, 2008 at 5:45 am

Hi Jeanie. I don't know how Bc/Bs differs around the country, but that is what we have in Florida. And they pretty much go by medicare standards in approving tests. In other words, since medicare won't approve Pets for ovarian cancer, BC/BS doesn't either. BUT, I have two CT-scans a year that they do pay for.
I am curious if Keiser pays for your Pets because of your problem with the CA-125, or if they just normally pay for pets. I started the discussion on OvaSure that you replied to - thanks. I am still waiting for results - I believe it takes four business days, and I still don't know if BC/BS will pay or not.
When I was diagnosed nine years ago, I had a doctor tell me that cancer shows up in blood tests long before it can be seen, so he was a big believer in the CA-125. So I put all my faith in that test as well. And then when I had a recurrence four years ago, my CA-125 still never went above eight or ten, and another blood screening test was normal as well. But the cancer did show up in a CT-scan. I don't even call any more to get the results of my CA-125, and if they call to tell me the results, I just say oh, that's nice.
Good luck in your move, and best, best, best wishes for good health. I'll let you know when I hear something more about the OvaSure. Patty

• Reply
• Report post

• By momanderson920
• Posted August 2, 2008 at 7:48 am

I am getting a PET scan because I can't get the CT with contrast due to my kidneys but my oncologist prefers the CT with contrast so if you can't get the PET, the CT with contrast is a good diagnostic tool and most insurances will pay for that. The CT without contrast is not a good tool at least was not for me. I was given one after surgery and cancer had been left behind in my lymph nodes which had shown up on the first CT with contrast before my kidney problems. The one without contrast showed no cancer which was false. The PET done a month later showed the cancer in the lymph node.

• Reply
• Report post

• By linden
• Posted August 2, 2008 at 7:33 pm

Hi Jeannie, I am also on Blue Cross/Blue Shield, and I live in the Yreka area, Northern Ca. From my experience Bc/Bs refused to pay for my Pet scan, but hopefully will pay for any CT scan. I just had the last of my eight chemo treatments a month ago and go bak to Dr. on Monday and will see what is up next. I am being treated out of Redding. The Pet was requested as I had second opion appointment at Standford who wanted everything. Good luck and good health. Linden

• Reply
• Report post

• By SuziQ
• Posted August 2, 2008 at 9:48 pm

I have BC/BS, but I live in Utah. I have genrally had a great experiance with what they cover. They have covered CT's, MRI's, x-rays, blood work, plus lots of other stuff. I haven't ever had a PET scan so I am unsure if they cover it or not. My only complaint is they won't cover genetic testing for my daughter (since I was 22 when I was oficially diagnosed). But still, I have found them to be a good provider.

Good luck!

• Reply
• Report post

• By jeaniet
• Posted August 2, 2008 at 10:44 pm

To Patty.....yes, Kaiser pays for my PETS due to inability to use CA 125, which has always been under 35. But that may change in CA, who knows. New Oncologist may prefer CT scans.
We have decided to live with family who are in Kaiser coverage area so I can hopefully continue to get PET Scans. Plus Kaiser just paid for my genetic testing, even though I am adopted and have no children of my own. So I really will do everything possible to keep Kaiser, although if I have to switch to BCBS I guess I will. Jeanie

• Reply
• Report post

• By Brandi
• Posted August 3, 2008 at 8:41 pm

Hi Jeanjet

I am a Blue Shield subscriber in the Los Angeles area and I am trying to get them to approve a PET scan. I should know next week if I am successful. I just finished chemo in May '08 and my CA-125 was 8 but it jumped to 39 in July '08. A CT scan in July showed a couple of areas of "stranding" that were inconclusive as to whether they were a recurrence or not. The doctors would prefer a PET scan to confirm. It seems crazy that insurance would not pay for this test but then would have to pay for more chemo if the doctors order it. This is the first time that I have been frustrated with insurance, which is pretty good I guess.

• Reply
• Report post

• By Brandi
• Posted August 3, 2008 at 8:43 pm

Sorry, I also meant to wish you luck in your move and to tell you that I also would be hesitant to switch to Blue Shield given that they really do not like to cover PET scans. I have an attorney friend who will write a letter for me to try to get them to change their mind. It seems like it is such a valuable test, it is ridiculous that insurance can even consider not covering it.

Best,
Brandi

• Reply
• Report post

• By energygirl
• Posted August 4, 2008 at 8:40 pm

Hello Jeaniet,
I used to live in Nevada City (next to Grass Valley) for 18 years. We recently moved to Sacramento where our business is, but we miss the area a lot. You will love the close knit community of Grass Valley, and I think you would have to travel to Roseville for any treatment if you stayed with Kaiser. I am with Blue Shield and have had OC since 2005. I used to go to UC Davis here in Sacramento, but this fall changed to Los Angeles due to the Dr.s they had there and the more advanced treatments there. I am currently only taking Tamoxifin and it seems to be keeping my CA 125 down to 8. I have had lots of Pet Scans and CT scans, and Blue Shield has paid for only 2 of my Pet Scans. It seems that if something is seen on the CT scan then they will pay for a Pet. This seems strange to me, but it seems to be the norm. We have had to pay for 2 of them ourselves, but it was good information for my Dr. and she could act quickly on my treatment decissions too. I hope you really like GV, and anytime you need any help. let me know. Take care- energygirl

• Reply
• Report post

Add to the discussion