Breast Cancer India

Herceptin is covered under medical insurance?

As I mentioned earlier in my post,My wife is diagnosed with Breast cancer and out of 06,three chemotherapy have completed. She is under medical family floater policy (The new India Assurance company). 5th and 6th Chemotherapy with Herceptin will start by 27th Feb 17 and another in march 17..

1)Would like to know any one claim is accepted by the new India Assurance company as far as Herceptin is considered?

2) Any kind of supporting letter is required from Oncologist to get it through.

Please advice.

regards

sp

6 Replies
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I do not give chemotherapy, so am not the right person to guide you fully. To answer your questions:

1. All insurance companies pass claims on Herceptin

2. Letter may be needed only if things do not pass through.

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Hello sppande ..

I had few problems in Getting Herceptin bills approved by Health Insurance company. But a letter from the Doctor was needed and many supporting Documents requested.

Best is talk to your Insurance company representative before hand (in my case my company had a corporate insurance so the HR directed me to a insurance representative who came to my place and took lots of supporting documents)

Also please note my first/second bill was rejected. But after 3 months I got all my claims.

Let me know if you have any quetsions

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If herceptin is taken along with chemo medicine it is covered under insurance. This is what the insurance company says. However we need to talk to the insurance company. In my case my organisation helped a lot in the negotiation and I could claim the amount after 3-4 months. I took herceptin along with chemo for 6 months and alone for another 9 months. Totally 17 cycles

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Hi Gjoe,

I have similar case, my mom is taking taking herceptin injection from last may 2017.when she was taking with chemotherapy ,the insurance was approving cashless transaction. But now when all chemo completed , the insurance is not approving the trastzumab injection alone saying alone this injection does not come under insurance policy. The insurance is corporate insurance , my doctor wrote a reconsideration letter to insurance for Trastuzumab, targeted therapy, but still they are not approving. Can you help me in this, how in your case you get it done.

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Hi sir,

my mom is taking taking herceptin injection from last may 2017.when she was taking with chemotherapy ,the insurance was approving cashless transaction. But now when all chemo completed , the insurance is not approving the trastzumab injection alone saying alone this injection does not come under insurance policy. The insurance is corporate insurance , my doctor wrote a reconsideration letter to insurance for Trastuzumab, targeted therapy, but still they are not approving saying its monoclonal antibody, part of immunotherapy which is not cover able under insurance . The insurance people are saying we have our own sets of doctor and they don't approve this injection alone. I am not able to understand the concept when it can be approved with chemotherapy , why it is not when given alone. This injection cost is very high which is not possible for normal middle class to afford every 21 days from own. We have to go by insurance , I tried all possible way to convince them, produced doctors note what exactly Trastuzumab but didn't workout. Can you help me in this, how I can make it done.

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