Oncotype DX Gene Testing

Hello Everyone,
This is my first posting to this site, and the reason is to share my success in getting my insurance company to pay for the new Oncotype DX test. The test helps to determine who is at a greater risk of cancer recurrance in the next ten years, but, it also helps those women, like me, who are borderline for needing chemo, to make the decision to have the therapy or not. Most insurance companies still consider the test "investigative" and will deny the payment for it, and it costs $3,450. Well, after two weeks of my constant pressure on the insurance company, hours and hours of investigation on the internet, and documentation of my cancer being the perfect fit for this test, Premera Blue Cross has agreed to pay for it. It is the first case to be approved, and I am so pleased. It has delayed my possible treatment by a couple of weeks, which we all know is mental anguish, but I believe it has been worth it, not only for me, but for the hundreds of women who find themselves in my position of whether chemo is beneficial or not. Maybe now they can have this test and possibly not have to go through chemo. I won't know about myself for 10 to fourteen days (the time the test takes to run), and I may still need to make the decision to go ahead with chemo, but at least now I will know that I have done everything medically possible to make the right decision. So, for those of you out there whose doctors have recommended this test, but your insurance has refused payment, there is hope. Refer them to Premera Blue Cross of Washington and Alaska. We must all take charge of our own bodies....we are our best advocates!
Take care, Jean

Jean,

I am SO happy for you!!!  Congratulations on getting the test approved and for your persistance!  That is exactly what it takes to get these insurance companies to recognize the innovative, cutting edge technology that is becoming available to us.  You are a pioneer for many other people who will have the test in the future, give yourself a pat on the back!

 

I also had the Oncotype DX done last month and we worried our insurance would balk, but they didn't (United Healthcare).  (My test results came back in 10 days from the day of approval.  I'm not sure where their lab is so maybe that has something to do with it.)  And I scored a 3 on a scale of 0 -100 with the low numbers meaning less chance of recurrence, not necessary to have chemo.  My oncologist said that was the lowest number they've seen yet.  So I'm having radiation for 6 weeks (M-F) and then the standard 5 years of tamoxifen.  I just started treatments this Monday and so far so good.

 

Please keep us informed of what you learn.  And be proud of yourself, you are strong and have already shown you can fight the fight!!!  Way to go!!!!

 

Hugs,

Thank you all for your comments...and yes....my husband and I agree that this is important for the future of women who will be getting an early diagnosis of breast cancer, with digital mammography catching the cancer at such early stages. No one wants to go through chemo if it is not going to improve their chances of survival. I did want to tell Gail in the Tri-Cities that I too live there! Very small world... If you would like to e-mail we have set up a special account to accept your e-mail. It is [email protected]. I assume that is alright to put here(?). If not, sorry! I will let you all know the outcome of the test and hopefully it will be in less than two weeks. Take care everyone!
Jean