Anyone out there have experience going through Fred Hutch using Group Health. We thought it would be part of the coverage, but just recieved noticed that Fred Hutch will be considered out of network which I am guessing means greatly increased expense. It is amazing how quickly insurance notify you with a NO, but will drag on and on before getting to Yes.
Group Health & Fred Hutch
Posted 21 July 2014 - 11:06 AM
Posted 21 July 2014 - 03:15 PM
It will be more expensive. I don't know exactly how they do that. Some make you pay the difference in cost between being seen in network vs out, some make you pay a percentage higher, like if you have 10% co-pay they bump it up to 20%, etc. I suppose some could refuse to pay anything.
However, unless your wife presents in the future with some major issues, mutation, extreme side effects, etc. she probably does not need to be seen by a huge cancer center.
When I was dxed I was immediately sent to Mayo because my family doc after consulting with local oncs had never seen WBCs and platelets as high as mine were and they thought I must have acute leukemia which they don't treat at our smaller cancer center. When it was determined that I had CML and my treatment plan was arrived at, I was then seen twice a year at Mayo and the rest of the time my followup was with a hem/onc here. Mayo is only 90 minutes away and they work closely with our medical center. I'm now down to once a year at Mayo.
Run of the mill CML is pretty boring and the large institutions have patients who generally are much sicker than we are and need specialized attention more than we do. So your wife should be fine with being seen in a smaller setting knowing that if there is a problem you have Hutch in your back pocket.
"You can't change the direction of the wind but you can adjust your sails."
DX 12/08; Gleevec 400mg; liver toxicity; Sprycel 100mg.; CCyR 4/10; MMR 8/10; Pleural Effusion 2/12; Sprycel 50mg. Maintaining MMR; 2/15 PCRU; 8/16 drifting in and out of undetected like a wave meeting the shore. Retired 12/23/2016! 18 months of PCRU, most recent at Mayo on 7/25/17 was negative at their new sensitivity reporting of 0.003.<p>
Posted 21 July 2014 - 04:07 PM
Thanks and this sounds like our plan of action. We would like to use Fred Hutch as the "2nd Opinion" and peace of mind. Unless something changes then yes she is probably going to spend most of her time going through her regular Group Health Oncologist. Every day I breath a little easier knowing there is so much hope, but I won't be sleeping at night completely until I know the drug is in her system and working.
Posted 22 July 2014 - 01:19 PM
Thank you so much. Still learning. I have heard SCCA and Fred Hutch thrown around almost interchangably. Would you be kind enough to tell me the difference?
Posted 22 July 2014 - 04:24 PM
This describes the SCCA, and there is a short video:
She would likely be treated at UW, but there are other regional locations.
Here are the Hem/Oncs who treat CML and are part of the SCCA network:
I would avoid those who focus on transplants.
Edited by Trey, 22 July 2014 - 04:31 PM.
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