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  • sperm banking

    Has anyone had this issue..?

    I have Blue Cross Blue Shield-NJ and when my doctor called them they said they would cover sperm banking prior to my RPLND. Now it's over 4 months later and I just got a letter in the mail from them saying that they won't reimburse me. Does anyone know how to get this rectified? Last time I was on the phone with them they gave me the run around.

    Thanks,
    Tyler
    09/01/2008 - Lump found on self-examination, RT
    09/04/2008 - Ultrasound confirms TC
    09/16/2008 - Right I/O, 95% NSGCT-EC, 5% teratoma
    10/14/2008 - Nerve Sparing RPLND @ MSKCC, 2/56 + nodes
    ** Monthly Surveillance, never any high blood markers **
    03/02/2009 - 2 Nodules found in lungs on CT scan, <1cm
    03/31/2009 - Follow-up CT
    04/09/2009 - Lung biopsy, pos for EC & necrosis
    04/13/2009 - Start 4x EP

  • #2
    At the time of diagnosis my son was covered by my wifes BCBS of NJ and we had no problem.
    Last edited by dadmo; 01-30-09, 09:58 PM.
    Son Jason diagnosed 4/30/04, stage III. Right I/O 4/30/04. Graduated College 5/13/04. 4XEP 6/7/04 - 8/13/04. Full open RPLND 10/13/04. All Clear since.

    Treated by Dr. Rakowski of Midland Park, NJ. Visited Sloan Kettering for protocol advice. RPLND done at Sloan Kettering.

    Comment


    • #3
      thanks, I have to figure out how to get them to admit that they do cover it. It seems that no one that I speak with at BCBS-NJ want's to give me a straight answer
      09/01/2008 - Lump found on self-examination, RT
      09/04/2008 - Ultrasound confirms TC
      09/16/2008 - Right I/O, 95% NSGCT-EC, 5% teratoma
      10/14/2008 - Nerve Sparing RPLND @ MSKCC, 2/56 + nodes
      ** Monthly Surveillance, never any high blood markers **
      03/02/2009 - 2 Nodules found in lungs on CT scan, <1cm
      03/31/2009 - Follow-up CT
      04/09/2009 - Lung biopsy, pos for EC & necrosis
      04/13/2009 - Start 4x EP

      Comment


      • #4
        Originally posted by jiberish0 View Post
        thanks, I have to figure out how to get them to admit that they do cover it. It seems that no one that I speak with at BCBS-NJ want's to give me a straight answer
        You should have received a booklet from BSBC when you enrolled which explains what is, and isn't, covered by them. Find that book, (or get another copy of it from their customer service) and fax them the page that says sperm banking is covered
        Let's Go Mets! sigh...

        Comment


        • #5
          I guess it's worth a shot, it seems they don't have it under things covered or not covered though, I have to talk to customer service on Monday
          09/01/2008 - Lump found on self-examination, RT
          09/04/2008 - Ultrasound confirms TC
          09/16/2008 - Right I/O, 95% NSGCT-EC, 5% teratoma
          10/14/2008 - Nerve Sparing RPLND @ MSKCC, 2/56 + nodes
          ** Monthly Surveillance, never any high blood markers **
          03/02/2009 - 2 Nodules found in lungs on CT scan, <1cm
          03/31/2009 - Follow-up CT
          04/09/2009 - Lung biopsy, pos for EC & necrosis
          04/13/2009 - Start 4x EP

          Comment


          • #6
            jiberish:
            Any luck?
            Son Jason diagnosed 4/30/04, stage III. Right I/O 4/30/04. Graduated College 5/13/04. 4XEP 6/7/04 - 8/13/04. Full open RPLND 10/13/04. All Clear since.

            Treated by Dr. Rakowski of Midland Park, NJ. Visited Sloan Kettering for protocol advice. RPLND done at Sloan Kettering.

            Comment


            • #7
              Just curious how it is in other states (other than Cali), do they cover the actual sperm banking / storage fees -OR- do they just cover the costs of the extraction (now, don't laugh I'm not referring to magazines or videos here, but rather the fees associated with setting up the account, initial doctor / lab fees)?
              Maria
              *Hubby Andy diagnosed 02/13/07, Left IO 02/16/07 *Stage 1A Non-Seminoma (65% Immature Teratoma / 35% Embryonal Carcinoma) *RPLND 04/27/07 Lymph Nodes-ALL CLEAR
              *Complications from Chylous Ascites so Laparotomy 05/03/07 *No food for 10 weeks, TPN only *07/18/07 Removed drains, tubes, picc line *CT Scan 07/31/07-ALL CLEAR
              *CT Scan 02/12/08-ALL CLEAR *Hydrocele surgery 06/19/08 *CT Scan 9/30/08 and 03/06/09 shows <cm left lung nodule - under surveillance

              Comment


              • #8
                Every company is different and sets their own policy, however the general trend is for them to cover nothing. Rare is the company who even covers sperm analysis these days. So if they cover anything beyond that, consider yourself lucky and take advantage of it before it disappears.
                Let's Go Mets! sigh...

                Comment


                • #9
                  Uhhmmm I'm a California resident and I recently sperm banked at Palo Alto. They said that I'd have little to no chance of getting assistance from my Blue Shield. Does anyone know if it is just really difficult to get in California or something?
                  Diagnosed 1/07/09
                  R Orchiectomy: 1/14/09
                  Stage IB: Nonseminomous (Embryonal Carcinoma, Teritoma)
                  Treatment: 3XBEP at Stanford Comprehensive Cancer Center
                  Started 2/18/09

                  Comment


                  • #10
                    I live in CA also and have Blue Shield HMO. I had to pay out of pocket.
                    First symptoms - 02/04/09; Saw GP - 02/09/09; Ultrasound - 02/16/09
                    Diagnosed - 02/19/09; Left I/O - 03/03/09; Stage 1B Seminoma, LVI suspected
                    Radiation treatment 05/04/09 - 05/29/09
                    Follow-Up CT 12/08/09, ALL CLEAR 12/18/09, ALL CLEAR 11/08/10

                    Comment

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