We are interested in enrolling our son on ANBL0032 (antibodies) but our insurance doesn't pay for clinical trials. Has anyone been through this and have any advice? We are prepared to appeal but I was just hoping for some advice. I worry since so much of relapse treatment is done through clinical trials, not to mention the antibody trial. We're in CA.
Thanks for any help...
We are in Michigan, so I am sure there are variances, but I will tell you of our issues during our fight.
Our insurance also does not pay for anything that is considered experimental. Therefore, anything outside of current protocol is not covered. I suggest you not waste too much time appealing with your insurance company, as they cover what they are contracted to cover, and ususally there is not much they can do about that. It's not that they are being mean or unfair, or don't want to pay for expensive treatment usually, it's that the employer didn't contract with them to cover those costs. So, you need to look for other ways of getting treatment covered. In MI we have children's special health care. It's like medicaid, but for specific dx, and they pay for what the insurance does not, in most cases. When our son relapsed all treatment was considered experimental so when our insurance didn't pay, children's special health care did. There are also many programs that help with paying for treatment, and a medical social worker at your hospital is a great help in finding those programs. You may also want to look into facilities that will treat your son even if you can't pay, or can't pay the full cost, or discuss with your hospital what kinds of payment plans they may be able to set up for you, as a last resort.
~Dawn~
Mom to my Super Hero Braeden in Heaven (dx NB III & OMS 5/15/07, relapsed 8/08 and 11/08, alive eternally 4/18/09)
Honoring Braeden's bravery, Fighting neuroblastoma
Joshua 1:9