C-11 choline PET

[Don1157]

Has anyone had difficulties with or been turned down by insurance company for the C-11choline PET scan?

[vandy69]

I have not had C-11 Choline, but did have C-11 Acetate and had to pay out of pocket as Medicare did not approve.

Recently had Axumin PET/CT which is the latest, greatest, and Medicare paid!

For all of these to be most accurate, your PSA should be above a certain minimum threshold.

Best wishes. Never Give In.

[Rexwaterbury in reply to vandy69]

Yes, my POS insurance failed to approve my c-11 at Mayo, stating it was unnecessary and investigational. Had to go through peer-to-peer, internal appeal process, and finally external appeal process before insurance paid for it entirely. Just keep appealing. The insurance company is betting that you’ll get fed up and pay out of pocket.

[Don1157 in reply to vandy69]

No give for sure. I recently reached 1.99 after I started a vacation from Lupron, so I am ready to go! Except waiting on approval from BC&BS.

[Hidden]

I wonder if I will ever get approved for new scans. My PSA was only 2.7 at diagnosis. It is now undetectable after HIFU. If I have to wait for a high PSA reading to get scanned I could be in trouble by then.

[Don1157 in reply to Hidden]

Let’s hope not and you stay undetectable!

[Don1157]

I just found out the ins co appoved the scan. So I am off to Decatur Ill, with a stop to visit Abe on the way back!