OVCA and health insurance in US

• By jeaniet
• Posted April 22, 2009 at 12:35 pm
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Depends on your insurance.....who would be your insurance carrier here in the US?
Speaking for 2 of the major plans here in the US....I had Kaiser In Colorado and now on Blue Shield in California.
Kaiser was great at diagnosing, surgery and giving me as many PETS as i wanted and the doc requested. Chemo was fine, but they don't have Oncs who specialize in OC so I was lucky that first line chemo worked, becuase there is no specialist to guide you after that. Financially it was great, and follow ups every 3 months, and an easy to navigate in house system, and so I have no complaints about Kaiser.
Due to new location (plus the lack of Kaiser OC specialist Oncs) I am on BS---since Dec 1. I get to go to UC Davis Cancer Center, with a large Gyn Cancer team. And I am in remission, so it is easy to say I have had no real problems. Can't get a PET though, although Onc is working on it. But like Kaiser, there have not been any financial issues, and I am scheduled for follow ups every 2 months. Like Kaiser, all docs have been great.
So for me, insurance has not been a tremendous hassle or an issue.

A caveat about Kaiser though----they refused to do surgery on my Stage 4 friend, saying they don't operate on stage 4 OC---but they paid for her to have it done at the leading cancer center in Denver......then did the chemo themselves. Needless to say, she got out of Kaiser as soon as she could.

Hope this helped a little.......
Jeanie

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• By youngmom
• Posted April 22, 2009 at 5:37 pm
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I have my insurance through Highmark Blue Shield (PA), and there have been some issues. My insurance doesn't pay for PET scans unless there would be a rise in my CA-125 or to get a better picture of something that appears on my CT scan first. So far, I've only had CT scans. Also, they didn't want to pay for some of the preliminary testing through Oncolink after diagnosis ( DNA, Chemo Assays, etc ), but both my doctor and I fought it and finally got it paid. Also, my insurance has a $1 million lifetime cap, so that weighed on my decision to not have any maintenance chemo after my inital treatment.

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• By Shearaw
• Posted April 22, 2009 at 9:35 pm
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Dear Soma,

The answer to your question is "it depends." Mostly, it depends on what state and which insurance policy you choose. In the US each state is allowed to mandate its own minimum coverage requirements that insurers in that state must provide. For example, in some states all insurers are required to cover clinical trial drugs and normal medical and monitoring costs. Other states have will mandate coverage only for the clinical trial drugs, but not the associated medical costs (extra scans, etc.) I suggest that you contact the California insurance commissioner's office to get an understanding of what must be covered. Also, if you can get a contact at Scripps, try to find out what health coverage plans they offer. (They might have this published on a website for prospective employees.) Good luck to you in achieving your professional dreams!

Sheara W

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• By momanderson920
• Posted April 22, 2009 at 11:23 pm
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One thing you should know is that with a medical history of cancer your health insurance if you purchase individual health insurance and do not have it through an employer group can be very expensive. If it is through a large employer group that should not be a problem. You should be able to call several companies to ask questions based on where you may be moving to and find out what your options are. There are many different plans and many of them have lifetime caps of 3 and 5 million now. If you will be under an employer health insurance plan, most companies either offer it as part of your employment package for free, subsidized partially by the company, or you pay the group rate which would be cheaper for you than individual because of your health history. You can call your prospective employer and ask for their benefits administrator who manages all the employee benefit programs and ask him/her questions about the health insurance. Personally I think we have excellent healthcare in the US because we have so much choice and great availability of doctors, facilities, testing equipment, etc. in most places. When I was initially diagnosed, I called and had an appointment to see my nurse practioner at my gynecology office within 2 days, had the transvaginal ultrasound in the office that day, the bloodtest the next day, a CT scan within 2 days, and surgery was within 2 weeks of diagnosis and could have been several days sooner. I am very blessed to have very good health insurance as my husband is retired military.

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• By sbender3
• Posted April 23, 2009 at 10:38 am
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we have the best medical technology inthe world, and the highest level of care. we do not have to wait for months to get cat scans and other tests. we have freedom to see any doctor. there is no other place i would rather be, no other type of care i would rather have. if you have an hmo in the us, you may have hoops to go thru, but if you have a ppo, you have total freedom to use all their providers. blue cross blue shield is huge in the us, and there are many others. alot of people choose not to carry health insurance, then make the news when they get sick, that is kind of like driving without car insurance, and then loosing your drivers license, or not having insurance on your home, but then it burns down, of course you make the nes. there are people who cannot get health insurance with some health issues, but it is not that they cannot get it, i should reframe, it is very expensive, we need help in that area for sure. but even if you do not have insurance in this country, you will not be turned down for care, when you go to the er, they have to treat you, and then government has to help out on the costs.

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• By katie52
• Posted April 24, 2009 at 2:50 pm
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Hi Soma,

I am the VP of HR for Cold Spring Harbor Laboratory and I would say that the Scripps Institute has very good health insurance because they are larger than we are and research institutes are usually very supportive of their post-docs. If you want I can contact the appropriate people at Scripps to find out more about their insurance coverage for post-docs. Don't they have a web site for their post-docs where you can review your benefits or did they send you a package?

During my treatment the Lab went out of their way to be supportive and I would think that the Scripps Institute would be the same way.

Let me know if I can help.

Katie

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• By FavoriteAunt
• Posted April 24, 2009 at 3:59 pm
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It probably depends on who is providing your insurance coverage. I've been fighting ovca for almost 8 /12 years and have never had one problem with insurance coverage. Everything I needed has been covered, including surgery, doctors, tests, chemo, cancer center/hospital, medications.

The thought of socialized medicines terrifies me because of all the problems we've heard about from our sisters in other countries. As a rule, I'd say most insurers and the Medicare program in the US covers everything and there are lots of choices available. In general, I think we have the best health care and research options in the world. It may not be perfect for everyone, but I would not trade it for coverage given anywhere else.

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• By soma
• Posted April 27, 2009 at 11:36 pm
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Thank You all so much for your responses which really gives me a lot of hope. So much that I finally wrote to my prof. in US confirming it.

Love you all,

Peace,
Soma

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• By soma
• Posted April 27, 2009 at 11:38 pm
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Dear Katie,

I will definitely like to get the informations as I didnot get much information in the scripps institute, San Deigo website.

I will be waiting eagerly to hear from you. You can also email me at maumaz@gmail.com

Loads of love,
Peace,
Mausumi

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• By OvCaMom
• Posted April 28, 2009 at 6:55 am
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Just a word of caution. Many insurance plans still have a pre-existing condition clause. And while the insurance plan may be a very good one, be sure that cancer care is covered immediately. My daughter had to wait a full year before any care associated with her cancer was covered. Luckily, that was the time she was on a trial at NIH.

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• By esther3kids
• Posted April 28, 2009 at 7:38 pm
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Dear Soma,
Our insurance is Pacific Care, when I was diagnosed with OC my husband printed out the page that breaks down our coverage. It states that for the chemo treatments we only have to pay a $50.00 co-pay. But before the chemo drugs are ordered we were told by the pharmacy that the drugs have to be paid for first. So being that my husband kept getting the run around from the insurance co., he decided to pay for the drugs to get me started on the chemo.

My husband has been talking to someone at Pacific Care about this problem and he was told that the problem that we're having was due to some mis-entry into the computer. So far we have paid out of our own pockets for two treatments of chemo. We're waiting to see if this problem will be corrected for my next treatment. Just keeping our fingers crossed for now.
Love, Esther

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