So, I've been lurking on this forum for quite a while now... but today I’m actually posting because we’re facing a massive headache. It’s about my mom—she was diagnosed with colon cancer about a year and a half ago. She had surgery back then, which seemed like a win, but it turns out the doctors didn't quite get all of the liver metastasis. After a year, those cells basically "woke up" again, and she had to go back under the knife for a second operation.
She’s already been through the ringer with chemo using Campto, and now her oncologist is recommending Avastin. She started the new chemo regimen in February and has already had two doses of Avastin, but—get this—she just got denied coverage to continue the treatment. The reason? Apparently, it doesn't meet the specific criteria on the insurance formulary since they're classifying this as "second-line" treatment for metastatic colon cancer... 🤷
I honestly don't know what we're supposed to do. 😕...She’s planning to file a formal appeal because, let's be real, she had that metastasis present from the very first surgery—it just wasn't fully cleared out. We have the proof, too; her tumor markers were climbing steadily even when everyone kept telling us everything was fine. How are you even supposed to fight this kind of red tape? Avastin is incredibly expensive, and there's no way we can just shell out the cash for it ourselves... 😳
She’s already been through the ringer with chemo using Campto, and now her oncologist is recommending Avastin. She started the new chemo regimen in February and has already had two doses of Avastin, but—get this—she just got denied coverage to continue the treatment. The reason? Apparently, it doesn't meet the specific criteria on the insurance formulary since they're classifying this as "second-line" treatment for metastatic colon cancer... 🤷
I honestly don't know what we're supposed to do. 😕...She’s planning to file a formal appeal because, let's be real, she had that metastasis present from the very first surgery—it just wasn't fully cleared out. We have the proof, too; her tumor markers were climbing steadily even when everyone kept telling us everything was fine. How are you even supposed to fight this kind of red tape? Avastin is incredibly expensive, and there's no way we can just shell out the cash for it ourselves... 😳