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Katdoll
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Joined: Mar 13 2012
Location: WA
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Points: 214
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Topic: Testing for Vitamin D Levels 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!
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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
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Joined: Aug 24 2009
Location: St. Louis, MO
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Points: 13509
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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.
Good luck! Let you know if you succeed in the coverage.
Donna
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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
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Joined: Jul 27 2008
Location: Washington State
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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?
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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
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Joined: Mar 13 2012
Location: WA
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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.
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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
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Location: Washington State
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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.
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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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