Dear friends,
Dr. Lenz needed to change my chemo as the last, fulfox stopped being effective.
He changed to folfiri/Avastin and the Avastin was denied. He then put me on folfiri /tarceva. The tarceva and irinotecan were both denied after one treatment of folfiri/irinotecan. I’m so upset. I talked to dr. Lenz and Taline/PA and insurance wants cases that show proof of the effectiveness of these drugs. this is not easy to find, as these are off label for cc.
Taline called me yesterday and said they will cover Folfori/irinotecan if I pay $100 before each infusion. She said not to let them bill me, as going through billing and insurance will cost more than the $100. Absolutely ridiculous.
I am going to fight BC/BS until I get it. I’m trying to gather facts from other cases. If any of this applies to you please post and let me know.
Fondly,
Jtoro