Prostate Cancer – PET scan denied

I will try to make a very long story short.

Father (50 years old) has recently been diagnosed with a very aggressive prostate cancer after a digital rectal exam and then biopsies.

His doctor wants to do a PET scan to determine a treatment plan. Unfortunately, insurance (Blue Cross Blue Shield) denied it and will only cover a CT scan even though his cancer is difficult to spot on CT scan. Peer to peer hasn’t worked and BCBS won’t answer our questions.

How would it work if we pay for the PET scan out of pocket? This cancer spreads rapidly so spending time on appeals would be difficult.

If we pay out of pocket, would they refuse to cover treatment for things found in the scan? Would paying out of pocket ruin our chance at getting it approved in the future? Would it change what they cover once we proceed with a treatment plan?

Thank you!

Editing to add based on rules: 24/50, 28105, $100,000

submitted by /u/havesomegodamfaith
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