Serri330

I recently had bloodwork done to determine if I had signs of potential cancer, after a 25cm ovarian cyst was discovered. I received a letter from my insurance stating that the claim for coverage of those tests was denied, as they considered it "unnecessary for treatment/investigational". I'm pretty sure it's necessary to know if I potentially have cancer, but I digress.

I am in my mid 20s and have never had anything medically wrong with me. No stitches, no broken bones, no hospital visits. I have used insurance purely for routine yearly checks, dentists visits, and eye exams. Therefore, I have no idea what to do about making insurance cover this, as I can't afford the $600 after paying $2,000 for the surgery to remove this cyst. Any advice on appealing the decision and how that process even works?

This 100%. While definitely not at serious as what some people go through, this process was terrifying, and being told by your doctor that they want to run bloodwork to check for potential cancer is earth-stopping. Why would I argue with my doctor, when they're telling me this is a test that they need done? Shouldn't insurance companies appreciate the attempt to get advance notice, rather than waiting until it's later in the process? If it's profits they're after, Is imagine they'd prefer saving money by having such a test done, rather than waiting until things like chemo or radiation are needed.

Just so sad and frustrating that people have to deal with such things.

I'm anticipating a similar fight with my situation. Luckily, my procedure went smoothly and I came back cancer free. As you mentioned, I can't imagine opening that bill/notice had I had complications or just learned I was riddled with cancer.

A healthcare advocate would be amazing. Frankly, that should be the job of your doctor and insurance company, but we can all see how well that's working out.

I appreciate your response! I've also been told I can speak with my clinic and ask them to rebill under a different code, but I haven't reached out yet to see if that's possible/if they'd be willing. Right now I'm still just focusing on healing, as I'm only a week out from an exploratory laparotomy. Arguing over bills can wait until I feel a bit more human.