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Discussion Starter · #1 ·
:( I have to have a repeat mammogram on my left breast because they saw "something" last October in my normal scan, and then in a whole slew of repeat x-rays and an ultrasound. I have to call and schedule it on April 8th or after that. What bothers me is that the form sent to me says that my insurance may not pay for it. :mad: I am on Medicare and Medicaid, this is not an uneccessary test or a mammogram done too early which they are sticklers for. It is also not like I have the money to pay for the mammograms which will be numerous nor the doctor to read them. :worried: The paper says if my insurance doesn't cover them all then I will have to pay for them or wait and schedule in two years when my next mammogram is due. :eek: How am I supposed to wait for that long when they made such a big deal out of finding something on the x-ray? I guess I will take my chances and then fight about it later, because I am not going to let something that could be cancer continue to grow while I wait for the insurance.:hissy: :screamin: Karly, sorry I appreciate having the insurance but hate the hoops that are neccessary to jump through to get what I need medically. It is a constant fight to get meds, procedures, syringes covered....it gets old really fast.:mad:
 

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I think you're doing exactly the right thing - taking care of yourself first and then vowing to fight the good fight to get it paid for later. It sounds like there is NO WAY they can say this is something they don't need to pay for!
 

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To my knowledge, if the doctor is asking for a repeat sooner, it is considered medically necessary. Therefore, they should be paying for it.

They can also ask for a pre-approval prior to your testing. It is up to the facility that you are getting it done at to make sure that it will be a covered service and provide the necessary documents showing that is "medically necessary" to have it done sooner. You really should not have a problem.

If you went to have it done because you just felt like it, then they wouldn't cover it.

Obviously they are not going to risk you having cancer (worse case and i am sure it is not that) but if it was they would paying a lot more ......... than the cost of mammogram.
 

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Hi there...before they do anything IF they find anything try to get a second opinion, they were getting ready to cut my mom open cause they SAW something and she went for a second opinion and it was those cysts you get from too much caffeine, Be sure that you schedule the appt not around the time of your period too because you swell up then too, These are just suggestions by all means do whatever is nessasary(sp):ermm: to insure your health :)
Alot of times a second opinion lends itself to a fresh set of eyes looking at something and confirming or disputing the initial findings,
I went to 4 different doctors to convince me of having lupus!! and had 2 pregnancy tests to confirm a pregnancy (that was just denial on my part)
Anyway my thoughts and prayers are with you try not to get too upset or nervous before the next ultra sound until you know exactly what it is, I am sure your body and mind are under enough stress as it is!!
:calm:
 

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Oh I just wanted to add about the cost factor:2cents:
sometimes finding what it would cost if you did a self pay, I had to go for a colonoscopy and it would have cost me over $1700 with insurance as a self pay I paid $500 out of pocket for the procedure and anesthsia (my spelling is bad today sorry:unsure:
anyway it may be an alternative to get what you need done if you can afford it, they tend to bill insurance companies more than what they would charge a self pay!!:)
 

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Discussion Starter · #6 ·
Unfortunately, there is no way I could pay anything close to that, they'd be getting their bill paid five dollars a month!:lol: Karly
 

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Discussion Starter · #7 ·
Got the test scheduled today, usually they check to see if the insurance will cover it, they passed it on through so I hope it is ok, I am getting it in about a week. Karly
 

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Discussion Starter · #9 ·
Got The Mammogram Test Results Back

;) Well, I had to have both the mammogram and ultra sound, so far I guess whatever they saw six months ago is in the same place, has not changed, stable, but who knows what it is they don't say anything specific, maybe it's this maybe it's that. Oh well six more months to have a mammogram again. The stupid taxi driver was late, I was one minute earlier than my appointment, and he had to pick someone else before he took me and dropped her off first, the crazy ride cost $11.00!!! Karly
 
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