Insurance refuses to pay for Life Saving Operation for Ovarian Cancer

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I am seeking any way I can to get the word out about insurance companies giving death sentences to women diagnosed with Ovarian Cancer. I have Horizon Blue Cross and Blue Shield N.J. health insurance.

Three and a half years ago (October of 2014) I received a diagnosis of Stage 3 Ovarian Cancer. Ovarian cancer, according to the Cancer Treatment Centers of America, is usually diagnosed after menopause. However, some have been diagnosed as early as their 40’s or 50’s. This is not what you would label an “old person’s disease”.

I began treatment with IV chemo, surgery (complete hysterectomy) followed by more IV chemo. By June of 2015 I was in remission.  I was in remission for two years. Two weeks before Christmas in 2017 I was told the cancer was growing. It had now spread to the liver, spleen and diaphragm. My doctors at Cancer Treatment Center of America, Chicago told me my best (and only option quite honestly) is a procedure called HIPEC Surgery. Without this procedure, the cancer will continue to spread. Our insurance pre-certification was submitted and surgery was scheduled for Tuesday, March 20, 2018. On Friday, March 16, after a day of pre-op testing, BCBSNJ notified the hospital the claim was being denied. This was an hour before everything shut down for the weekend. The reason? BCBSNJ is calling it experimental. This procedure was approved by the FDA in 1999. Two appeals have been filed and denied. As an alternative, my doctor wanted to perform surgery to remove the tumors (called debulking). Now we are being told this will not be approved because it was part of the original request for pre-certification. The part of this procedure they are labeling as experimental is a heated chemo placed in the abdominal cavity for two hours.

How can they say no to a life-saving operation that has been performed for 20 years?! I have spoken to others who have had the same diagnosis, received the procedure and are living healthy lives today. So yes, there are insurance companies that do approve this.

My husband and I are middle class people. He has worked for the same company for 38 years and always thought his insurance would be there when he needed it for either of us. We are currently trying to figure out a way to finance this procedure out of our pockets.

BCBSNJ needs to update their coverage!  Please sign my petition and share it. Ovarian Cancer is a devastating disease, but there are procedures that can eradicate it. Insurance companies should be in business to help save lives – not condemn women to a death sentence because of outdated policies!

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GET THE WORD OUT AGAINST THESE INSURANCE COMPANY'S....

Thank you!

 My friend Joyce started a Fundraiser to help pay for the HIPEC part of the surgery that the insurance wont cover ($35,000). Here is the link. Any thing will help and thank you for sharing this and if you helped with the Fundraiser.   

https://www.gofundme.com/lifesaving-surgery-for-janine-may

 

 

 


 



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