Archive for the ‘Blue Cross Blue Shield’ Category

Big thank you to WBZ-TV

On Monday, when I found out that Blue Cross Blue Shield wasn’t going to help me or any other chemotherapy patient to preserve fertility, I was pretty upset.  Enough so, that I contacted my local news media outlets for help.

Joe Shortsleeve, of WBZ-TV, the CBS affiliate in Boston, read my story and called to hear me out.  After agreeing to send a news crew for a televised interview at Dana-Farber tomorrow, Joe placed a call into Blue Cross Blue Shield to get an official comment.

The response was “Tell us who the patient is, and if we cover his expenses, ask him if he will drop the story”.

My response (in the 2nd call with Joe) “You can tell them who I am, but I’d rather run the story- this effects every chemo patient, and I’ve already accepted that I have to pay for my sperm banking”.

Within 30 minutes, I received a phone call from Blue Cross Blue Shield.  The representative stated “Good news, we just had a meeting.  As of October 1, 2009, all Blue Cross Blue Shield of Massachusetts members who undergo a treatment that could cause infertility, will be covered for fertility treatments.  Men will be allowed to bank sperm and women will be allowed to bank eggs for two years for a future pregnancy.  We are also going to pay for your sperm banking costs that you have already incurred.”

On that note, it is time for bed- I need to wake up at 4 AM tomorrow for my first chemo treatment.

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Blue Cross Blue Shield reviewing fertility policy

My grievance, although initially denied, has been escalated to some sort of medical director at Blue Cross Blue Shield.  I’ve accepted the fact that they won’t reimburse me according to their current policy.  That being said, I intend on raising some public awareness about this issue, as it is relevant to every young person going through chemotherapy.

On a positive note, Dana-Farber provides free snacks and lunch to chemo patients.  I’m nervous, and strangely excited to get my treatment started.  I’ll have internet access in the infusion room, thus my plan is to continue to work for my company, but as a remote employee.

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.

Let the awkward appointments begin

Tomorrow, I start my day with a trip to the local sperm bank, however it’s called an “endocrine lab” at Brigham & Women’s. I’m pretty sure they use this name to keep people from laughing at what is actually going on in there. I’ve got to freeze my “goods” because chemo treatment could potentially make me infertile.

On a ridiculously stupid note, my HMO (Blue Cross) covers almost all of my cancer-related treatment which is great, but according to their existing policy, I can only freeze sperm if “currently undergoing a treatment that causes infertility”.

In a nut shell, I have to start the chemo first, then freeze my sperm to qualify. I beg to differ… the moment my right testicle was removed was the start of treatment that could cause infertility. Of course my oncologist agrees, informing me that the moment I start chemo- I could become permanently infertile. Thus, I’m going to the sperm bank without Blue Cross agreeing to pay for it, which would be a $1,100 bill, plus $400 annually for the freezer space. To Blue Cross’ credit, my situation is now under review with their grievance department, and I’m hoping for a positive outcome. I think common sense is on my side, as I’m sure a story about an HMO refusing to help a young man who wants to have children won’t help their PR efforts.

After the sperm clinic, I’m headed over to Dana-Farber for my 2nd CT scan of the month. I get to try the drinkable dye this time, which I’m ecstatic about. My first CT scan involved an IV injected dye, which burned like hell, and I’m a big wimp when it comes to needles. If I could drink Milwaukee’s Best in college, I sure as hell can drink some chalk-tasting liquid tomorrow.

I’ll follow that up with a PFT (pulmonary function test). I opted for BEP chemo treatment, which poses some sort of risk of lung damage. This test is supposed to determine the current health of my lungs. I’ve heard that this involves breathing into a tube, but it doesn’t hurt.