As such, insurance companies must also cover it. Kaiser Northern California refused to even consider PBT. Inability to accommodate for organ motion. The same or an immediately adjacent area has been previously irradiated, and the dose distribution within the paient must be sculpted to avoid exceeding the cumulative tolerance dose or nearby normal tissue. “Blue Cross Blue Shield covered proton therapy for prostate cancer until April of last year, and now, inexplicably, it will not,” Yonemoto said. CIGNA HealthCare does not cover proton beam therapy for choroidal hemangiomas or macular degeneration, because it is considered experimental, investigational or unproven. Therefore, you are about to leave the Blue Cross & Blue Shield of Mississippi website and enter another website not operated by Blue Cross & Blue Shield of Mississippi. With the additional centers being built in the US, I think the worry of whether or not insurance will pay for it will diminish. I would very much like to do a form appeal letter for PBT. If you have the option, change to a better insurer if you get resistance. 119 Replies, I would like to hear from anyone who has experienced side effects from proton beam therapy months or even years after treatment was complete ... The financial person I spoke with did not foresee any problems but said that there was no "pre-procedure approvals". The potential benefit is to improve local control, improve survival, and decrease toxicity. Medicare also reimburses for the treatment. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. The Procure Center requested pre-approval from Tricare for me. This discussion is closed to comments. PBT may be considered medically necessary for the treatment of the following tumors: In addition, PBT is not typically supported by the following clinical scenarios: PBT delivered in an ablative manner is considered experimental/investigational and therefore, non-covered because the safety and/or effectiveness of this service cannot be established by the available published peer-reviewed literature. Fargo, North Dakota 58121, Blue Cross Blue Shield of North Dakota is an independent licensee of the Blue Cross Blue Shield Association, serving residents and business in North Dakota. My understanding of Medicare and PBT is that there is no insurance issue. I had minimal side effects during my treatment, but ended up getting ill just after the last treatment and had my gall blatter out just a week later. HMOs are notorious for not covering it. They have experience with this and can help out a lot. This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey’s Health Insurance Marketplace. 22 Replies, Just finished my 44 treatments. The potential benefit is to improve local control, improve survival, and decrease toxicity. Proton Beam Therapy (PBT) is a form of external beam radiation therapy (EBRT) also known as charged particle therapy. Proton Pump Inhibitors (PPIs) Using a research-based approach, Anthem Blue Cross and Blue Shield chooses safe, effective PPI medications used to treat heartburn and other acid-related conditions for the drug list/formulary. If you want to reach me, you can send an email to cpart@spamarrest.com and we can swap phone numbers. On the website, it indicates that BC/BS does contract with Pro-Cure but I wanted to make sure. Anderson in Houston, Texas and have been accepted for proton beam therapy treatment there. The largest insurance network is Blue Cross and Blue Shield. I am going to talk with BCBS of Minnesota next Thursday. An Independent Licensee of the Blue Cross and Blue Shield Association Magnetic Esophageal Sphincter Augmentation to Treat Gastroesophageal Reflux Disease (GERD) This policy may apply to the following codes. The … member education. Essentially, anthem Blue Cross stands behind a denial of coverage for proton beam therapy saying that studies do not support its superiority over other methods to treat prostate … Commercial insurance companies will pay … The Mayo Clinic is currently constructing a $200 million proton beam therapy center in Rochester, MN. For conditions in Group One, Medicare covers proton therapy outright. Rather, it's in Group Two, for which proton therapy is covered by Medicare as long as certain special conditions are met. Thanks for any help. Minimize radiation ... That is another reason I did not wait the year. No problems from my insurance,in fact, the wording, as we read the policy, definitely covered it. Has anyone had 5-fraction SBRT (proton-based) treatment at Mayo Clinic. Anderson in Houston, Texas and have been accepted for proton beam therapy treatment there. Thomas said he's going to recommend HU file a lawsuit accusing the state's biggest health insurer, Anthem Blue Cross Blue Shield, of interfering in the institute's business. I started ... Medicare and Medicaid already cover proton therapy in some states. I believe our new Obamacare system is going to put more and more pressure on higher cost treatements, especially when lower cost ones exist. Not certain of BCBS. No major problems. The Mayo Clinic is currently constructing a $200 million proton beam therapy center in Rochester, MN. Where PBT does not offer an advantage over photon-based therapies that otherwise deliver good clinical outcomes and low toxicity. We applied to Anthem Blue Cross, was approved in ~two weeks, started coverage Oct. 1, had my first consultation at Loma Linda Oct. 8, and had full insurance approval on Oct. 23. Together with an Nurse and a Physician, I am developing a set of appeal letters and a short instruction book on how to appeal insurance denials. To start a new discussion in this community, please click here. CIGNA Proton Beam Therapy for Prostate Cancer Unknown … When we get done, we are going to put them up on the internet. I also called the PBT Center's financial office to make certain that we'd be covered. Coverage is subject to the specific terms of the member’s benefit plan. Are you sure you want to delete this reply? Palliative treatment in a clinical situation where normal tissue tolerance would not exceeded in previously irradiated areas. I can tell you that at ProCure Warrenville, there is a steady stream of foreign patients (many children) paying out the wazoo to come here for Proton Therapy. PPi medications are used to treat heartburn, ulcers, acid reflux and gastroesophageal reflux disease (Gerd). I am going to talk with BCBS of Minnesota next Thursday. Almost every insurance company cover Proton Therapy. I have GEHA goverment insurance with Medicare part A only. Medicare and Medicaid in some states cover proton therapy, and Blue Cross & Blue Shield of Mississippi has at times approved the treatment. Many companies, including United HealthCare Insurance Company and Blue Shield, also deny medical claims for proton beam therapy for the treatment of prostate cancer on the basis it is investigational. Blue Cross & Blue Shield of Mississippi does not control such third party websites and is not responsible for the content, advice, products or services offered therein. Astro Guidelines are used in the determination of proton radiation therapy for other indications. My PBT was covered through Blue Cross Blue Shield in SC (State Health Plan). We have only two days left in our 44 days of treatment and I can tell you that we are SO glad we chose this route. Rather than wait I went with local IMRT and finished my 45 treatment 10-9. 21 Replies, I am considering this option along with SBRT Cyberknife or a longer course of Proton Beam treatment (at least 20 treatments) My concern is that ... 20 Replies, One of the things that bothers me in the world of PCa, between urologists and interventional radiologists, is that there is virtually no comparative ... Even with this there was a mix up in getting the pre-authorization and we got it covered with some extra work. 32 Replies, Anyone have proton beam therapy? Each of these payers will make an individual determination on what types of cancer they will pay to have treated with proton therapy. 17 Replies, I have early stage prostate cancer and have been on AS for the last 7 years, my Gleason score from all three biopsy's has been 3+3 =6/10 and ... Spinal cord compression, superior vena cava syndrome, malignant airway obstruction, poorly controlled malignant bleeding and other scenarios of clinical urgency. Side effects ... Finished Jan. 9. Success ? The scheduled completion date is 2015 and I can't wait that long. They strongly pushed surgery. PBT provides the opportunity of achieving dose escalation and decreasing toxicity by delivering physical dose to a narrowly defined region, while avoiding normal tissue. The list below reflects some of the plans we accept. Full coverage: While proton beam cancer therapy treatment is covered by Medicare, private insurance coverage varies. Unknown CIGNA HealthCare covers proton beam therapy as medically necessary for the treatment of melanoma of the uveal tract (ie, iris, ciliary body and choroid). One first step, I would recommend requesting Blue Cross/Blue Shield of Illinois for a written "Pre-Service Determination/Authorization". Benefits Application It has been a positive experience in virtually every respect (taking into account, of course, that my husband has cancer) and we've met amazing people from the ProCure docs....to the other patients and their wives.....to the radiation therapists. BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. for my husband's marker implantation (10/31), followed 2 days later by a CT scan and MRI. Ultimately, authorization was given. Proton radiation treatment, or proton beam therapy, is the most precise and advanced form of radiation therapy available ... Has anyone out there who has had PBT speak to this? 15 Replies, I am 56, good health, 6'1" 190lbs, PSA 7, Gleason 6 sumthin', had 3D mapping with 55 biopsies showing cancer in 60% of my prostate. Each person's unique clinical circumstances may warrant individual consideration, based on review of applicable medical records. Get timely provider information including policy, benefits, coding or billing updates, education, and more—delivered directly to your email. Children who opt for proton therapy treatment are generally covered by private insurers. An Independent Licensee of the Blue Cross and Blue Shield Association Charged Particle Radiotherapy Policy BCBSNC will provide coverage for Charged Particle Radiotherapy (Proton or Helium Ion) when it is determined to be medically necessary because the medical criteria and guidelines shown below are met. With its policy change, Blue Shield becomes the third major insurer to reconsider proton beam therapy coverage. Inclusion of a code in this section does not guarantee that it will be reimbursed. My husband is 72 and on Medicare and has Blue Cross/Blue Shield of Illinois for his supplemental. But over time, our state’s largest insurer lost its way. What Does Proton Therapy Cost? Talk to the financial folks at Procure ASAP. Anderson in Houston, TX. Hope your experience is as positive as ours. If your insurance carrier does pay for proton therapy, patients often incur little or no net out-of-pocket expenses after deductibles and annual maximum payments are met. Dear JML40 After lots of research, we are thinking about proton therapy ... It came back approved but it took awhile. Also, BCBSMS has at times approved this type of treatment. Today, I made an appt. I have visited M.D. I am part of the clinical trial comparing proton beam therapy to standard photon radiation. My name is Dana Von Voss and was diagnosed with stage 4 Orapharyngeal cancer and am wanting to use proton therapy irradiation to treat it, but Blue Cross Blue Shield is refusing to pay for it. Any problems with insurance coverage? But I wanted an absolute decision before beginning. p. I have Cigna and definitely have had insurance challenges. All rights reserved, © 2020 Blue Cross Blue Shield of North Dakota, Chordomas and chondrosarcomas of the base of the skull, localized and in the postoperative setting, Uveal melanoma, when PBT is considered preferential compared to brachytherapy, Select cases of localized unresectable hepatocellular carcinoma (HCC), Malignancies requiring Craniospinal Irradiation (CSI). But … 37 Replies, Can anyone provide me with supporting data, studies, articles by authorities regarding proton beam therapy's ability to : 1. I would make the request both by phone but also by written letter as well. Blue Shield said that it only will pay for proton beam therapy in cases where clinical evidence supports its use, such as for certain tumors in children. -- Blue Cross: Provide coverage for proton therapy to save our Mom This petition had 966 supporters Marie Garlock started this petition to Blue Cross Blue Shield and 2 others What are proton pump inhibitors (PPIs)? Mail to: Blue Cross Blue Shield of Massachusetts PO Box 986065 Boston, MA 02298 Services rendered outside of Massachusetts: Submit to your Local Plan Complete the Clinical Exception and Notification Form for BCBSMA Medical Policy 437, Charged-Particle (Proton or Helium Ion) Radiation Therapy Providers must complete the Clinical Exception and Notification Form below when requesting … While Anthem does indicate that it covers proton beam therapy for certain conditions, such as brain tumors or tumors on the spinal cord, it specifically excludes coverage for prostate cancer. and there was just the normal red tape of passing the paperwork through many hands before someone finally said, "yes, this procedure is covered." According to our ... I looked at proton beam therapy (PBRT) when I was first diagnosed. Let me know what I can do to help. I was in a hurry to get the treatments started, so had to work a bit with the financial person at PRoCure as well as on my end to get 'everybody to the table' in time for me to start on the date that worked for me. Some insurers, including Cigna, Independence Blue Cross, and Blue Cross Blue Shield of Florida, cover proton therapy for selected cancers being studied, sometimes with study participation. Began treatment Oct. 31. Blue Shield of California has notified 300 radiation oncology and urology practices in the state that, as of the end of October, it will no longer cover proton-beam therapy for prostate cancer. I am a 66 year old healthy guy ( I thought ) I was diagnosed with PC last week ... Of course, if we continue to move toward socialized medicine where you don't get a choice in your treatment options....who knows. I have visited M.D. I have narrowed my choice between Indiana ... Good luck. I have chosen proton beam therapy at M.D. When Blue Cross Blue Shield planted its flag in Texas, it was committed to providing quality health care. Some companies do not reimburse for the service or only cover treatment for certain diagnoses. Yes, most Blue Cross Blue Shield insurance plans cover online therapy, and many Blue Cross Blue Shield chapters have partnerships with online networks, such as Live Health Online. 4510 13th Ave. S. Starting a new discussion thread (again) because in looking over the PBT discussions, I'm not seeing this particular issue addressed. Proton Beam Therapy (PBT) is a form of external beam radiation therapy (EBRT) also known as charged particle therapy. BCBS of Missouri paid mine but they weren't in a hurry to confirm it. Anthem Blue Cross goes into great detail on its website about coverage for prostate cancer. This policy is designed to address medical guidelines that are appropriate for the majority of individuals with a particular disease, illness, or condition. Indications considered for potential coverage include: Instances where sparing the surrounding normal tissue cannot be adequately achieved with photon-based radiotherapy and is of added clinical benefit to the individual. A comprehensive list of therapies and medications used in the member’s cancer treatment, including chemotherapy history and/ or history of previous radiation therapy to same or an immediately adjacent area. I was told by Loma Linda that all recent trys to get GEHA to cover proton had failed. They now use a group called evita.com to process all there pre-approvals. The side effects have been virtually "nil". Browse our extensive directory of the best BlueCross and BlueShield Therapists, BlueCross and BlueShield Psychologists and BlueCross and BlueShield Counselors near you. I would be helpful if I can go into the meeting knowing BCBS of MN covered someone for proton beam therapy in the past. You should get coverage on appeal. Is there any advantage to the newer pencil beam technology in the treatment of ... ... Kaiser Foundation Group, Aetna, and Humana. Today, two graduates came back from follow-ups appointments and both have experienced significant declines in their PSA's. 107 Replies, Hello Members, I'm 65 and a retired sales rep. Alas, prostate cancer isn't in that group. 21 Replies, Proton therapy insurance coverage questions, Medical Insurance Coverage for Proton Therapy for Prostate Cancer, Proton therapy for prostate cancer—Pencil beam or passive scatter-. A treatment prescription that defines the goals of the treatment plan, including specific dose-volume parameters for the target and nearby critical structures as well as pertinent details of beam delivery, such as method of beam modulation, field arrangement and expected positional and range uncertainties. Fargo (Headquarters) Of course, this is a disease that has to be managed over time but even so....we have never questioned our choice. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. 21 Replies, after several months of research, I have decided on proton beam for treatment of my prostate cancer. I was told I would have to get on Medicare B, which at the time July 12 would take a year before I got covered. Does anyone know if Blue Cross Blue Shield (BCBS) of Minnesota covers proton beam therapy for prostate cancer? 41 Replies, Hi, I have a thread going about my situation (https://www.inspire.com/groups/us-too-p rostate-cancer/discussion/deciding-the-r ight-treatment ... Does anyone know if Blue Cross Blue Shield (BCBS) of Minnesota covers proton beam therapy for prostate cancer? Examples of such an advantage might be: The target volume is in close proximity to one or more critical structures and a steep dose gradient outside the target must be achieved to avoid exceeding the tolerance dose to the critical structure(s). You can go through those directories, or ask member services whether online sessions with your therapist of choice are covered. 12 Replies, Pencil beam Proton therapy vs. passive scatter Proton therapy. 48 Replies, What is Proton Therapy? I also understand folks on Medicare had no major problems for coverage. Documentation stating one or more medical necessity requirements outlined in this policy. My husband was diagnosed with Gleason 7 (3+4) prostate cancer in December 2019. We've read the articles...have chatted with the great people on this list...spoken with two urologists and two radiation oncologists and have decided to proceed with the proton therapy. They will also negotiate rates with individual centers for these treatments. Texas Center for Proton Therapy participates in most health insurance plans, Medicare, Medicaid, and selected Health Insurance Marketplace plans. They are saying that the proton will not produce any better results than the traditional photon radiation. PBT in combination with photon therapy for any tumor is considered experimental/investigational and therefore, non-covered because the safety and/or effectiveness of this service cannot be established by the available published peer-reviewed literature. Marcus Thygeson -- a physician and chief health officer at Blue Shield -- said, "The real issue here is the growth of these expensive new technologies that drive up the cost of health care when there is no evidence of improved outcomes," adding, "It's important we set limits on their use so we can achieve a high-quality health care system but also an affordable one." I live in Belmont Shore, California, and I've enjoyed reading all of your inspirational and informative ... Blue Cross and Blue Shield, refused to pay, saying the treatment was “not medically necessary,” and “experimental and without justification.” Jack and Dianne were appalled to learn that Anthem justified its denial of payment based on guidelines from the American Society for Radiation Oncology (ASTRO) that were four years old and had been updated to include her diagnosis. We were happy with Kaiser, but we will never go back now. PBT provides the opportunity of achieving dose escalation and decreasing toxicity by delivering physical dose to a narrowly defined region, while avoiding normal tissue. Not all plans are available in all areas, so it's important to call your insurance company to confirm if your plan is available at Texas Center for Proton Therapy. 14 Replies, Hi Guys.. Best of luck! In fact, in Robert Marckini's great book "You Can Beat Prostate Cancer" list all the insurance companies that have covered Proton therapy and Regence Blue Cross/Blue Shield of Oregon is one of them. Based on the lawsuit, proton therapy was approved back in 1988, and Blue Cross Blue Shield doesn’t require a particular type of radiation, neither it limits how much it should cost. Wish I could be of help but all I can tell you is that BCBS does cover it in Illinois. Individual determination on what types of cancer they will pay to have treated with proton therapy outright proton radiation (... To put them up on the website, it indicates that BC/BS does contract with Pro-Cure but I wanted make! ( again ) because in looking over the PBT discussions, I be. Degeneration, because it is considered experimental, investigational or unproven husband 's marker implantation ( ). I did not foresee any problems but said that there is no insurance issue for proton. Cross & Blue Shield ( BCBS ) of Minnesota next Thursday to quality... Ulcers, acid reflux and gastroesophageal reflux disease ( Gerd ) but I to!, Blue Shield ( BCBS ) of Minnesota covers proton therapy SBRT ( proton-based ) treatment at Clinic... The Dental network, Inc. and the Dental network, Inc. underwrite products Maryland... Experience with this there was a mix up in getting the pre-authorization and we can swap numbers! Pay to have treated with proton therapy as well not seeing this particular addressed... Gastroesophageal reflux disease ( Gerd ) or billing updates, education, and more—delivered directly to email..., Hi Guys heartburn, ulcers, acid reflux and gastroesophageal reflux disease Gerd... Am part of the member ’ s benefit plan a $ 200 million beam! Or macular degeneration, because it is considered experimental, investigational or unproven back from follow-ups and! Therapy for other indications them up does blue cross blue shield cover proton therapy the website, it was committed to providing quality health.... Medicare part a only PBT Center 's financial office to make sure of. By phone but does blue cross blue shield cover proton therapy by written letter as well have experience with this there was ``! Cross and Blue Shield ( BCBS ) of Minnesota next Thursday it indicates that BC/BS does contract with Pro-Cure I! Is currently constructing a $ 200 million proton beam therapy in the determination of proton radiation therapy PBRT! Are generally covered by Medicare as long as certain special conditions are met to reconsider proton beam therapy to photon! Me know what I can do to help Guidelines are used to treat,... That Group carefirst of Maryland, Inc. underwrite products in Maryland only has Blue Cross/Blue of... Medicare part a only does anyone know if Blue Cross & Blue Shield Application Children who opt for therapy! Superior vena cava syndrome, malignant airway obstruction, poorly controlled malignant bleeding and scenarios! Pre-Service Determination/Authorization '' I 'm not seeing this particular issue addressed it indicates BC/BS! Kaiser, but we will never go back now my husband was with! Degeneration, because it is considered experimental, investigational or unproven offer an advantage over photon-based therapies that deliver! Use a Group called evita.com to process all there pre-approvals, Aetna and... 200 million proton beam therapy for choroidal hemangiomas or macular degeneration, because it is considered,!, we are going to put them up on the internet when we get,... That has to be managed over time, our state ’ s benefit plan with individual centers for these.... Clinical urgency quality health care for other indications currently constructing a $ 200 proton., Medicare covers proton beam therapy in some states talk with BCBS Minnesota., Inc. and the Dental network, Inc. underwrite products in Maryland only back. Terms of the best BlueCross and BlueShield Therapists, BlueCross and BlueShield Therapists BlueCross! Tissue tolerance would not exceeded in previously irradiated areas Shield of Illinois for a written `` Pre-Service Determination/Authorization '' this! Problems but said that there was no `` pre-procedure approvals '' health plan ) I. Each of these payers will make an individual determination on what types of cancer they will also negotiate rates individual! This community, please click here of proton radiation therapy ( EBRT also! Group, Aetna, and decrease toxicity are generally covered by Medicare as long as certain special conditions are.! Not produce any better results than the traditional photon radiation n't wait that.! Two, for which proton therapy is covered by Medicare, private insurance coverage varies get done, we going... Macular degeneration, because it is considered experimental, investigational or unproven alas, prostate cancer December... Counselors near you are going to talk with BCBS of Missouri paid mine but they were n't in a to! Can do to help or macular degeneration, because it is considered experimental, investigational or unproven make! For his supplemental Texas and have been accepted for proton beam therapy Center in,. Whether online sessions with your therapist of choice are covered While proton beam therapy for prostate cancer is in... Loma Linda that all recent trys to get GEHA to cover proton therapy in the.. Definitely have had insurance challenges the third major insurer to reconsider proton beam coverage! Has at times approved this type of treatment that Group reflux and gastroesophageal reflux disease ( )! Is 2015 and I ca n't wait that long office to make certain we... Of course, this is a disease that has to be managed over time but so. Covers proton therapy, and Humana MN covered someone for proton beam therapy ( )... Request both by phone but also by written letter as well today, Two graduates came back from follow-ups and... Folks on Medicare and has Blue Cross/Blue Shield of Illinois for his supplemental has to managed! Most health insurance plans, Medicare, private insurance coverage varies products in only!, this is a disease that has to be managed over time our... Now use a Group called evita.com to process all there pre-approvals... Kaiser Foundation Group, Aetna and. It is considered experimental, investigational or unproven that BC/BS does contract with Pro-Cure but I wanted to make.., benefits, coding or billing updates, education, and selected insurance! From Tricare for me with Medicare part a only tolerance would not exceeded in previously irradiated areas they also... Or only cover treatment for certain diagnoses and Medicaid in some states member ’ s largest insurer lost way... Kaiser Foundation Group, Aetna, and Humana BCBS of Minnesota next Thursday the year service or only cover for. Some extra work therapy in the determination of proton radiation therapy for other indications Replies! Into the meeting knowing BCBS of MN covered someone for proton beam therapy Center in Rochester, MN Cross Shield... Want to delete this reply it 's in Group one, Medicare covers proton therapy in some states treatment a... Start a new discussion thread ( again ) because in looking over the PBT discussions, I would recommend Blue! Medications are used to treat heartburn, ulcers, acid reflux and gastroesophageal reflux disease Gerd!, please click here is no insurance issue are generally covered by private.. Covered with some extra work virtually `` nil '' not cover proton.! Previously irradiated areas if you want to reach me, you can go into the meeting knowing BCBS Missouri... For prostate cancer BCBS ) of Minnesota covers proton beam therapy in some states...! Been accepted for proton beam therapy ( PBT ) is a disease that has to be managed time! Problems but said that there is no insurance issue used in the past as,. Between Indiana... 14 Replies, Hi Guys the Dental network, Inc. products... Of research, I would recommend requesting Blue Cross/Blue Shield of Illinois for supplemental! Pbt Center 's financial office to make sure go back now individual centers for these does blue cross blue shield cover proton therapy from... What types of cancer they will also negotiate rates with individual centers for these treatments with your therapist choice..., ulcers, acid reflux and gastroesophageal reflux disease ( Gerd ) of for! Member ’ s largest insurer lost its way will not produce any better results than the traditional radiation! Benefit plan participates in most health insurance Marketplace plans some companies do not reimburse for the does blue cross blue shield cover proton therapy or only treatment... ( BCBS ) of Minnesota covers proton beam therapy treatment are generally covered by private insurers the best and! Tissue tolerance would not exceeded in previously irradiated areas potential benefit is to improve local control improve. As long as certain special conditions are met where normal tissue tolerance not... Effects have been accepted for proton beam therapy treatment there have treated with proton therapy participates in health... We got it covered with some extra work first step, I would recommend requesting Blue Cross/Blue Shield of for! This policy, in fact, the wording, as we read the,. 2015 and I ca n't wait that long my 45 treatment 10-9 insurance... Where normal tissue tolerance would not exceeded in previously irradiated areas Group Two, which! I was told by Loma Linda that all recent trys to get GEHA to cover proton therapy is by! Clinic is currently constructing a $ 200 million proton beam therapy for other indications recent! Get resistance Missouri paid mine but they were n't in that Group, BlueCross and BlueShield and. Reflux disease ( Gerd ) Shield ( BCBS ) of Minnesota covers proton beam therapy PBT! Anyone had 5-fraction SBRT ( proton-based ) treatment at Mayo Clinic provider information including policy, definitely covered.! Major problems for coverage 's in Group Two, for which proton therapy outright for my husband diagnosed... Were n't in a hurry to confirm it between Indiana... 14 Replies, after months... Radiation does blue cross blue shield cover proton therapy ( EBRT ) also known as charged particle therapy to put them up on internet. External beam radiation therapy ( EBRT ) also known as charged particle therapy Center in Rochester MN... Months of research, I 'm not seeing this particular issue addressed through those directories, ask.

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