Barrett's Oesophagus
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GrahamB
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Quote GrahamB Replybullet Topic: LGD and (UK) Insurers
    Posted: 15 May 2017 at 9:54am
Hi all,

I have another diagnostic scope due this week to give six month confirmation of my LGD diagnosis as per NICE guidelines.

Considering the extent of LGD found last time (Feb) it is HIGHLY likely the diagnosis will be confirmed and my (private) specialist is recommending that we move forward to HALO RFA at the beginning of next month as soon as the biopsy results come back.

My insurers (through my work) have, however, asked for a medical report before the approve any treatment. As well as potentially delaying the start of treatment by having to wait for them to assess the report the insurance company nurse I spoke with said the "preventative" treatment is not covered by the plan.

I, personally, don't think treating something with a (relatively) high risk of development to a life threatening condition counts as "preventative" but I wondered if anyone had any experience of dealing with (UK) insurers around intervention for LGD.

Unfortunately my father in law died earlier this month as a result of OAC (he had a oesphagectomy earlier this year but, sadly, it appears that the cancer had already spread and he went through a fairly rapid decline) so the stress level in my household is pretty high and we want to get my risk level reduced as soon as possible!

Thanks in advance for any advice or thoughts.

G
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jcombs99
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Quote jcombs99 Replybullet Posted: 15 May 2017 at 5:04pm
G
   I'll b very happy IF the barretts and or LGD segment isn't Larger or if u Don't have HGD or cancer .The Costs are DOUBLED with HGD(Had) for like 10 years and Cancer is right around the moon in costs.. The Fools will have to do RFA @ sometime SO they should do it early and save trouble..

CHEERs Jeff
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steveb8189
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Quote steveb8189 Replybullet Posted: 15 May 2017 at 7:35pm
Hi Graham
Sorry I can't help but am also very interested to hear anyone else's experience. I have cover with Cigna at work and they have been pretty good with other things but I do wonder about Barrett's.

My only experience is with BUPA who paid for my original scope but would not pay for survelience. They would consider a re-scope but only if my symptoms changed and I was referred by a consultant.

It would be good to get a run down from each insurer.
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jcombs99
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Quote jcombs99 Replybullet Posted: 15 May 2017 at 7:46pm
steve
   Call them and ASK but is subject to Change so beware .I almost got my Colon checked and the Fools had NO RECORD of the one I had in 2008 nor 2013 and I told them so they said FINE . I'm private I would Hang the fool who is in charge of Data .I want what I paid for NUTTHING more.

CHEERs
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GrahamB
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Quote GrahamB Replybullet Posted: 16 May 2017 at 9:05am
Steve

I am also covered by Cigna. On the whole they have been pretty good so far. I have now had three scopes (original, a follow up to check LGD vs HGD as the original was inconclusive and the one this week for protocol purposes) and, bar a couple of billing issues, they have handled things well.

I get the feeling that the clinical people I have spoken to don't have a great understanding of Barrett's and progression. The first question on the medical report form is confirmation of the type of dysplasia. I am wondering if my consultant just puts LGD (and doesn't explicitly mention the NICE guidelines) they may say that the treatment counts as elective.

I have a long segment (C8M8) with dysplasia across 5 cm of that length, this isn't the "odd spot" that it will be easy to keep an eye on. Repeated surveillance scopes (which I suspect they will class as 'chronic' and therefore not covered) could, quite easily miss progression.

With my father in law's passing my wife is very unsettled by my condition. I just need to get this sorted and HALO appears to be the best way of making that happen (at least in the medium term). I already have a tentative date for the first HALO treatment (2nd June) I just need to make sure that I manage Cigna properly to support making that date (or consider self funding as a switch to NHS would blow that date out of the water).

G
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Bobib
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Quote Bobib Replybullet Posted: 19 May 2017 at 3:00pm
This all makes me so f'ing angry. What is the bloody point of having insurance if they don't deal with something like this. Yes let's wait until the chances of a cure have severely diminished before we try to fix it at much greater cost and lower chance of success. It's mind blowingly absurd.

My rant over, I am pretty sure when I spoke to Bupa they covered RFA for LGD depending on clinical advice.
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jcombs99
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Quote jcombs99 Replybullet Posted: 19 May 2017 at 3:18pm
Bob
    Clam down u could be me when I had 8cm HGD I had 7 ins. company in 3 years my Doc was amazed I think he was THINKING I was a DUMB Carpenter .Then the ins. I brought FROM the US Gov for $20,000 for ONE YEAR the local store clerk got for $1200 as in WHY WORK live off Gov..

CHEERs Mate

Edited by jcombs99 - 19 May 2017 at 3:19pm
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jcombs99
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Quote jcombs99 Replybullet Posted: 19 May 2017 at 3:20pm
Nice weather in Paris Wine is even better.
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steelee
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Quote steelee Replybullet Posted: 20 May 2017 at 7:36am
Originally posted by jcombs99

Nice weather in Paris Wine is even better. [IMG]smileys/smiley20.gif" align="middle" />


Enjoy!
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jcombs99
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Quote jcombs99 Replybullet Posted: 20 May 2017 at 1:35pm
S
    Almost Dead DUMB Carpenter was going to step off curb BUT didn't BUS @ 20 mph missed by 1in or 1/4 of sec ..No big deal happens ALL the time on Job Site.Tough Luck Yankee pay attention don't be LOOKING be THINKING ..

CHEERs

Edited by jcombs99 - 20 May 2017 at 1:36pm
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