My cancer policy is denying my claim for my husband's recent surgery to correct a Tracheostomy defect noted on his last PET scan. His stoma was so small that even a child's size lary tube could not be inserted. Under the surgery benefit the definition of a covered surgery reads "for the purpose of treating a diagnosed cancer." It also has a Prosthesis coverage. Could I claim his stoma as a prosthetic device since it replaces a normal body function?

I think since his stoma was created due to cancer treatment that the correction of the defect is still cancer treatment. It's not from anything else!

Anybody had this fight with an insurance company?

Sheryl


Wife/caregiver to Charles
ENT diagosed SCC Rt Tonsil Stage IV, MET 6 lymph nodes in neck 1/2001
Tonsillectomy, RND and six weeks RADS 2/2001
ENT diagnosis from CT scan, SCC in Rt tongue 2/13
25% of tongue removed 2/13 (clear margins)
SCC BOT with mets to 2 level 2 nodes and Lt. Delphian node 8/2014
Surgical biopsy shows cancer in larynx 9/2014
Laryngectomy, resection & rebuilt tongue w/ pectoral muscle, selective neck dissection 11/2014
Recurrences '16 HPV Neg No EGFR Mutations Detected