SP Premium
750,000-999,999 SparkPoints 974,285

Prayers Requested

Monday, January 30, 2012

One of my dear friends who helps me with the gardens in our park has been diagnosed with pancreatic cancer. Just getting the diagnosis is bad enough, but she is covered by a Medicare HMO and they are denying her the right to have a biopsy. Her doctor has pleaded with the insurance company and they told him to appeal the decision and he told them she just doesn't have time for their bureaucratic crap but it didn't change anything.
This morning she entered the hospital thru the ER and the doctor is trying to get around the denial so please keep Karen and her family in your prayers. They need to find out what is going on and how best to treat this. Our understanding is one type is more aggressive than the other and the doctor wants to find out more. Her grown children are coming in from up north to support her and I am happy they are here She has not felt well since last summer and has been going to dr but he has only been doing the tests the insurance would authorize and it was only after a scan that this was discovered but it took several weeks to get approval for the scan.
So please pray that she can get the care she needs and anyone who is enrolled in one of these HMO's start asking questions while you are well. Until this happened, they were quite happy with this insurance but now they are really questioning themselves and wondering how this company can deny a basic service.
We listened to the spiel from the salesman, but I told my DH there was no way I was changing his coverage even if we paid a lot more, piece of mind was worth it to know with all his health issues he would be covered and now I am really glad I didn't change. I would have hated for them to tell us if and how we could treat his prostrate cancer which we didn't know he had when we went to the presentation!
Share This Post With Others
Member Comments About This Blog Post
    Praying for your friend and her family. I am so sorry that she has to be treated so unfairly by her insurance company.
    3321 days ago
    I will pray that your friend gets the tests and care that she needs.
    3322 days ago
    Consider it done
    3323 days ago
  • LILLI56
    I will keep her in my prayers.
    3323 days ago
    I will pray that the test can be done. And her husband will be OK.
    I shudder at the thought of any insurance company denying a need test or procedure.
    What is this country coming too?
    Of course if you have "money" you can have all the test you want. But that should not matter. Everyone should be treated equal.
    Take care,
    Tisha emoticon
    3323 days ago
  • no profile photo CD8667808
    Yes, prayer are for Karen. I hear these stories about health care companies but I have such a hard time believing people can do that and still live with themselves. I would not make it in that business. I'm praying hard for your friend.
    3323 days ago
    Prayers going out for Karen, her family and for you.
    I do hope the doctor can continue to treat her so that
    she can get the proper treament. HUGS!
    3323 days ago
  • DOODIE59
    I will keep Karen in my thoughts, and hope her HMO will do the right thing and cover her expenses.
    3323 days ago
    Shall keep your frined in my prayers, also you and family . This is so sad.
    3323 days ago
    You and your friend are in my prayers. I am so sorry you are all going through this.
    3323 days ago
    Praying for your friend and her family,
    it's so sad. emoticon
    3323 days ago
    emoticon for you and your friend.
    3323 days ago
    How frustrating that must be! I hate how the insurance companies deny things the doctor feels is medically necessary. It has been my experience as a nurse that if an insurance claim for a procedure is denied it can go to peer review. That is where the doctor calls an 800 number and speaks to another doctor. I have never seen a claim denied when the doc I work for does the peer review. Maybe you can suggest this to your friend? Have her call the managed care department of the clinic her doctor is at to see if they can help her with this.

    On another note, scans are not always accurate (or possibly God performs miracles in making tumors disappear). I had a CT scan that showed a golf ball sized tumor in my pancreas about 8 years ago. This was found on a routine surveillance scan looking for metastasis from the kidney cancer I had. I went to have a biopsy via endoscopy. When I woke up I got the news that it wasn't there. I thought they meant they just couldn't see it via endoscopy but the doc said,"no it is gone". I was too scared to believe it so I insisted on another CT scan. It was confirmed it was gone! I had people praying for me. I like to believe it was a miracle. The doctor could not explain it any other way. I'm praying the same thing happens to your friend.

    3323 days ago
    I will keep you in my prayers. Your friends story sounds much like my dads. Once he finally got a diagnosis, it was too late. He was to several doctors throughout the state, but when they finally decided what to do, he was too far gone. He was diagnosed with pancreatic cancer in Feb and died in May 2009. Unfortunately I was not close to my father, but we still kept in touch several times a year. Now he's gone, but I can relate to your friends situation. God bless, and may your friend get the help and the answers she needs.
    3323 days ago
  • ANNIE924
    Praying for your friend. It's too bad that people's lives are held in the balance by red tape and bureaucracy.

    3323 days ago
  • Add Your Comment to the Blog Post

    Log in to post a comment

    Disclaimer: Weight loss results will vary from person to person. No individual result should be seen as a typical result of following the SparkPeople program.