I had a Lumpectomy and removal of 11/3 nodes. Now I have swelling in my hand and arm which the Oncologist confirms is Lymphedema. He says it has to get worse before it can be addressed. I would have to travel a bit to see a PT, as there is no one locally that does this. Also, as we had to cancel our vacation which involved air travel when we learned of my cancer, I'm hoping we can still do this when health permits. I know a sleeve would be important on such a trip. Does Insurance also cover Lymphedema treatment even though I had a Lumpectomy with node removal, rather than a Mastectomy?
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Q: I had a Lumpectomy and some swelling in my hand and arm.
Answers (1)
11/17/09 6:23am
Your doctor is wrong in saying your lymphedema needs to get worse before it can be treated - it should be treated right away, before it DOES get worse. Please ask him/her where the nearest lymphedema specialist is, so you can get an appointment. Insurance coverage varies company by company; many consider it physical therapy, and it would fall under your physical therapy coverage. And many consider a sleeve a "medical device," so coverage for the sleeve would be treated that way.
Your best bet is 1) Get an appointment with a lymphedema specialist, who's often part of a hospital's PT department; 2) Get it treated with decongestive massage; and 3) At the same time, ask the therapist for advice about how to handle insurance coverage. Often the way the PT classifies the charge makes a difference in whether your particular insurance company will cover it. Good luck - PJH
11/18/09 4:36am
Hi - Insurance is so difficult to figure out.... I'm sorry you have that to worry about, too. If the radiaiton oncologist is part of a hospital (not on his own), then speak to social services at the hospital. It's part of their job to unravel insurance issues. They can at least give you advice about where to start. Good luck - PJH
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By JC— Last Modified: 12/25/10, First Published: 11/17/09
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Thank you so much for your help. I feel that the Dr isn't taking me seriously, and feel that Lymphedema therapy isn't addressed very much in this county. From what I've read, it IS an important part of recovery and is something I need to be aware of and get treated as needed for the rest of my life.
Another problem is that my insurance will not be covering this part of the State after Jan 2. We have to find another health insurance between my Chemo and Radiation!! I really would like to be treated at a large breast cancer specialty center (about one and a half hr drive from home). I've talked to people who have done this. Treatments like Radiation Therapy would be directed by the center, but done locally. I have a Radiation Oncologist in mind who is local, and is also part of the teaching staff of the Medical School at the center. I'm just not sure how to make this all come about without an interruption of my treatment!!! My current insurance is not accepted by this new Radiation Oncologist. Any suggestions??