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Kaiser insurance and referral to Dr. Einhorn?

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  • Kaiser insurance and referral to Dr. Einhorn?

    Has anyone worked with Kaiser Permanente (our healthcare insurer in Colorado) to get a referral to Dr. Einhorn? We are here in Indiana to get a second opinion. But can we ask to be treated here? What are our rights? We have been told the Kaiser team has only seen one other case of a second tc with metastasis in the lymph nodes that had previously been treated with radiation. We do not have confidence in the kaiser team so far and I am scared to death my husband will not get the best care inside the Kaiser network. Any advice will be greatly appreciated! Gina

  • #2
    I'm not totally up on Kaiser these days, but from what I understand it is not like other insurance, so I'd be surprised if they covered you if you go out of network for treatment.

    Is it just a particular Doc or the entire facility you don't trust? Can you go to another Kaiser facility? Maybe you can convince your doc to work closely with Dr E?

    What treatment is being proposed at this point?

    Jan, 1975: Right I/O, followed by RPLND
    Dec, 2009: Left I/O, followed by 3xBEP


    • #3
      Hi Tripletmom,

      I actually have heard of another person going out of the Kaiser group for treatment. It was not TC related, but they had doctors write letters and proved that the current doc is incompetant to help. It may be difficult, but possibly doable. I would ask Dr. E if he could write letters or call Kaiser.

      Mary Ann
      CaregiverSon Josh 23yr Dx 3/5/08 IIIC NonSeminoma affected lung, kidney liver back & tumor/clots in vena cava & celiac artery 3/7/08 L I/O 3/30/08 PostOp surgery 4XEP (VP16 & Cisplatin) 3/12-5/25 LDH > 5000 & AFP 145 (3/5 pre-op) LDH 563 & AFP 4 (5/26 after 4Xchemo) off blood thinners 3/18/09 Surveillance per Dr E 8/4/08 *1/2012 ALL CLEAR!

      Self 1/29/09 dx thyroid cancer metastasized to right lung 2/10 thyroid removd 4/17 rx RA131 5/11/10 &7/16/10. 1/12survellience


      • #4
        Okay, Kaiser has a wide variety of plans, so I'd need to know which specific plan you're enrolled in, and go from there. If you'd rather send me a PM, feel free!

        A good point was brought up already---if your current Kaiser physician is not a narcissist, and is willing to consult with Einhorn about proper care, that may be the easiest and cheapest way to go about this. If your doctor thinks that he knows everything in the world about modern medicine, then that obviously would not be an option.
        DX 5/15/09
        Left orchiectomy 5/22/09
        60% embryonal, 40% seminoma, w/ VI, LI, T2 (CS-IB)
        CTs clear, X-rays clear, blood markers normal
        L-RPLND 7/14/09, San Antonio
        3 nodes positive, 100% embryonal, N1 (PS-IIA)
        2 rounds BEP August 24, 2009, Austin
        Enlarged lymph nodes Oct 09, Dec 09, Jan 10, Apr 10
        All clear 10/01/10