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Testing for Vitamin D Levels

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Katdoll View Drop Down
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    Posted: Aug 24 2016 at 9:27pm
My insurance company denied coverage for a blood test to measure my Vitamin D levels. According to my oncologist, low Vitamin D levels can increase risk of breast cancer, especially in those who have been diagnosed with breast cancer (which I have been). I intend to appeal the denial. If your provider recommends testing to monitor vitamin D levels, can you tell me (a) the hospital or institution where you are receiving care and (b) have you had a breast cancer diagnosis. This information may help me convince my insurance company that Vitamin D testing is the standard of care. Thanks in advanced for your responses!
Tested positive for BRCA1 mutation (187delAG) in 4/09 @ age 44; BSO 9/09; diagnosed w/TNBC in 10/09; 1 cm Stage 1 TNBC IDC, grade 3 + 1.5 cm DCIS; BMX 11/09, nodes clear; chemo (AC/T).
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123Donna View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Aug 24 2016 at 9:52pm
I'm so sorry.  My oncologist and now my primary care doctor orders the Vitamin D test as part of my annual routine exam along with CBC, Metabolic Panel, Vit D, Cholesterol, etc.  I've never had any problems with insurance covering the test.  Do you think if your primary doctor ordered it, they would approve it?

You can also order the Vitamin D test kit.  It's $50 for the test.   


Here's a link to a thread on Vitamin D3.  Lots of good information and possible something you can use in your appeal.

http://forum.tnbcfoundation.org/vitamin-d3_topic5338_post129610.html

Good luck!  Let you know if you succeed in the coverage.

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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mainsailset View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mainsailset Quote  Post ReplyReply Direct Link To This Post Posted: Aug 25 2016 at 6:03pm
I'm in WA state as well and when I have my annual the D is included and covered as part of the testing. I have Premera, used to have Assuris. Which carrier do you have?
dx 7/08 TN 14x6.5x5.5 cm tumor

3 Lymph nodes involved, Taxol/Sunitab+AC, 5/09 dbl masectomy, path 2mm tumor removed, lymphs all clear, RAD 32 finished 9/11/09. 9/28 CT clear 10/18/10 CT clear
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Katdoll View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Katdoll Quote  Post ReplyReply Direct Link To This Post Posted: Aug 25 2016 at 6:37pm
I have Premera too. It's possible the reviewer did not make the connection that my levels were tested because of my cancer history. I've gotten coverage in the past for the Vitamin D test. In my experience, the first line claims managers sometimes make really stupid mistakes. They are probably overworked and bored out of their minds. I've gotten some denials in the past that were even more ridiculous (for example, denial for having my ovaries removed due to being high risk for ovarian cancer). I pushed back and got coverage.
Tested positive for BRCA1 mutation (187delAG) in 4/09 @ age 44; BSO 9/09; diagnosed w/TNBC in 10/09; 1 cm Stage 1 TNBC IDC, grade 3 + 1.5 cm DCIS; BMX 11/09, nodes clear; chemo (AC/T).
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mainsailset View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mainsailset Quote  Post ReplyReply Direct Link To This Post Posted: Aug 26 2016 at 2:46pm
I'll be curious what you come up with as I'll be having mine retested next year.
dx 7/08 TN 14x6.5x5.5 cm tumor

3 Lymph nodes involved, Taxol/Sunitab+AC, 5/09 dbl masectomy, path 2mm tumor removed, lymphs all clear, RAD 32 finished 9/11/09. 9/28 CT clear 10/18/10 CT clear
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