Blue Cross Blue Shield won’t pay for cancer patients undergoing chemotherapy to preserve the ability to have children

Blue Cross Blue Shield of Massachusetts has informed me that sperm banking is not considered a “medical necessity” for cancer patients undergoing chemotherapy treatment according to their existing policy. Although Blue Cross recognizes that chemotherapy has a high risk of causing infertility, sperm banking is only covered for couples who are documented as already, but unsuccessfully attempting to have children naturally.

Patients that simply want to preserve the ability to bear children at a later point in life are not covered.

My sperm bank results came back. Not surprisingly, I have an extremely low sperm count. They typically would have a patient come back for multiple visits just as a precaution, but due to the cost, I’ll refrain. My first visit alone now has me responsible for a 10 year contract at roughly $4,700.

I had a conversation with staff from the Lance Armstrong foundation today. This turns out to be an all-too-common occurrence for cancer patients undergoing chemo. Most HMOs have loop holes that keep them from being financially responsbile for cancer patient fertilty.

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2 responses to this post.

  1. gotta love insurance

    Reply

  2. Posted by Anonymous on June 5, 2009 at 5:01 PM

    Hi Bill,
    I just got forwarded your blog by a former co-worker at NEI. I want to start off by saying I wish you and your family the best during this difficult time. I too was diagnosed with TC back in May of 2007. I was treated at B&W’s (Dr. Richie) and Dana Farber (Dr. Hayes) – the best places in the world for cancer treatment. With my initial surgery and removal of my testical, the Dr’s thought they got it all and no signs of vascular spreading (stage I). I proceeded to go through monthly CT scans at DF to ensure they got it all (odds were that I was 70% cured). In January of 2008, unfortunately it came back on me with a small tumor forming in my abdomen near my kidney (stage II). The confidence I had with the Dr’s and the fact that I caught it early put me at ease. In May I opted for RPLND surgery where they removed 21 lymph nodes in my abdomen. A difficult surgery to say the least, but after a year later, I can say that I have fully recovered and have finally beat this aweful disease. I do still go to DF for alternating CT’s and chest X rays every 3 months to be safe.
    TC is one of the most curable forms of cancer. It follows a very predictable path, and advancements with surgery techniques and chemo cocktails provide a 99% cure rate. I can say that while I was going through my diagnosis, there were some very difficult emotional times along with pains from surgery. I know that the experience has truly changed my life, not just with scars, but with a new perspective on life.
    I wish you the very best with your treatment. Keep your spirits up and a smile on your face. While I did not have to go through the chemo process, if you ever need someone to chat with, please don’t hesitate to call me. It helped me a bunch to talk with other TC patients when I was going through it.
    I will be sure to keep up with your blog.

    Gregg H
    617-759-3400

    Reply

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