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Medical Professional Which cancer and what case that most insurance covered in United States ? |
I know most insurance companies pay for PET scan or PET/CT scan for certain clinical situations. I need to know exactly which clinical condition and purpose and which case insurance companies do not pay for PET scan or PET/CT scan. From my experience with Anthem Blue Cross they have covered the entire costs of CT, PET scans. There is an independent company that looks at all requests for scans and they determine whether to recommend approval or not. Sometimes they will deny the coverage because they do not recognize my sons rare type of cancer, but than all I need to do is ask my sons oncologist to intervene. Apparently, it is the second tier response that can get the scans approved. My son has a very rare cancer and the insurance company too will often deny him benefits based on his treatments being 'experimental'. There is no set protocol for his disease and the insurance company does not quite know how to handle this. Thus they will deny benefits based on treatment being 'medically unnecessary'. We have always appealed the decisions and been approved eventually. It's really annoying though. Source(s): Experience. Teen son diagnosed with rare stage IV abdominal sarcoma. The only way is to ask the insurance companies as they are all different in policy and proceedure. My insurance covers all that but those from the same company, Blue Shield who have a different policy cover way less. So only the company knows when you decide on a particular policy. |
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