My survival might depend on this…
I (f49) was diagnosed with cancer in July, and while I am ok right now, my prognostic outcome is not particularly good. While I have no complaints about the general oncologist I was referred to, I have found that a renowned expert treating ONLY my type of cancer in my city. The problem? My Providence plan does not cover him (he does take Providence but only specifically negotiated plans from large corporations like Nike, Intel, etc.) We are self-employed and buy on the open market for a small fortune 😉
I have a 'second opinion' (cash pay) consultation scheduled with him next week. If he agrees to take me on as a patient, I will need to convince Providence to cover him as he is my best option for mid/long-term survival, clinical trials, etc. My understanding is that this request would need to come from my PCP.
Has anyone successfully navigated an exception with their insurance provider (via PCP) and what did that process look like? I want to get it right the first time and don't know what I don't know. TIA!
submitted by /u/Mint_503
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