Insurance, Genetic testing & Elective Bilateral Mastectomy
Insurance, Genetic testing & Elective Bilateral Mastectomy Hi all
I have posted this on behalf of ashley
Kind regards
Forum Host
Breast Cancer Care
Hi
Im wondering if anyone has any ideas on this…
My wife was just diagnosed with breast cancer, had surgery to remove 4.5cm sq lump which turned out to be DCIS and results show margins are clear and now radiotherapy is imminent. We have a small blip in finding enlarged lymph nodes but fingers crossed they are simply post op trauma.
My wifes mum had bilateral mastectomy and my wifes aunt died from breast cancer so the consultant suggested seeing a genetic specialist for testing and assessment of likelihood of recurrence. If the risk is high, it has been suggested that she could (possibly should) elect to have a bilateral mastectomy now in order to reduce chances of recurrence later.
So, my wife spoke to the insurers who told her that they would not cover the genetic investigation and would not cover elective bilateral surgery. She seemed to accept this as quite reasonable - as it was put to her in that way - ie: that it wasnt part of the cancer treatment and therefore not covered but that if she did get cancer again then they would pay for that. I dont think its reasonable at all.
So - now i will deal with them. My feeling is that this is just typical insurance company bluff since surely they cant be so callous as to prefer that she does get cancer again and simply treat that again. And surely, this is all part of the treatment of the initial cancer. Even on a strictly commercial basis (assuming that she didnt die next time) it woudl be cheaper for them to foot the bigger bill now and avoid multiple potential recurrances.
So if anyone knows what the insurance company should be doing in this situation or can otherwise offer any advice or ammunition i would love to hear from you.
Many thanks
Ashley
Hi Ashley I am a man who had breast cancer, diagnosed in June 2005. I am surprised that you Insurance company is taking this line on a care basis and I fully agree with you that it is a commercial response.
I had similar circumstances to your wife, but being a man I had a full mastectomy and no evidence of transit. I under went Radiotherapy and was put on Tamoxifen for five years. Concurrently, I was referred to a Genetic Consultant on the grounds that there is a considerable history of cancer in my family. I have since been tested and await my results. Follow up discussions with my surgeon covered the elective removal of my other breast, which was carried out last December.
All my treatment has been provided by the NHS and each step is considered “continuity of care” from the original diagnosis.
Because of the almost limitless effects of being diagnosed with cancer and particularly something that will give rise to your wife possibly feeling uncomfortable with her appearance, I would suggest that your Insurance company is blinkered that care stops when surgery has been performed. Its sad to say but the treatment of cancer is a long term issue not a couple of weeks.
If you Insurers continue with this line, perhaps it may be worth you considering transferring you wifes care into the NHS. I cannot fault their efforts, nor their constant support.
I hope everything turns out well for you and your wife.
Best wishes
Brian