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• Avastin and health insurance
• Posted: 2007-08-26 16:21:05 By Ellen K
• I'm 61 and was diagnosed with wet AMD in one eye 2 years ago. I received my first Avastin injection 14 months ago and have received a total of 6. My sight is much improved since the first injection. My biggest battle now is my insurance provider. They approved Avastin (over the phone) and covered the first 2 injections. They then started to send strange explanations of benefits. They now say they've reconsidered and won't cover it AND want me and the doctor to reimburse them for what they've paid thus far. They want medical research to prove Avastin is both effective and safe for treating wet AMD. My doctor thought he was doing a good thing to use Avastin rather than the incredibly expensive Lucentis. I've found some research, but they're very small studies because Genentech isn't even trying for FDA approval of Avastin. They're of course pushing their new, more expensive Lucentis. Has anyone had a similar experience? What did you do?

• Re: Avastin and health insurance
• Posted: 2007-08-27 14:01:51 By Vince M
• Medicare initially would not pay for Avastin but they have now reversed and are paying for it. I would think that alone should prove it is effective. There is a paragraph in this web site that may help.
  http://www.eyes.uab.edu/armdinfo/textonly.html#1
  Good Luck and keep fighting

• Re: Re: Avastin and health insurance
• Posted: 2007-08-31 15:03:38 By Ellen K
• Vince,
  
  Thanks for your response.
  
  I understand that Medicare pays in some states but not others. I'm not yet on Medicare, but Medicare in my state of Georgia won't pay.

• Re: Avastin and health insurance
• Posted: 2007-08-30 11:19:31 By Ann C
• Glad to hear from Vince M that Medicare is now covering Avastin, but what about those of us who do not yet qualify for Medicare. I am 58 and have wet AMD in my right eye. I have had 3 injections with my 4th scheduled for 9/20. I am beside myself with worry about how to pay for this. Even considering stopping the shots so I don't put my family into financial ruin. My insurance co covers the visit and the testing but not the injection and the avastin which my Dr puts at $600 a shot. He has not billed me yet but I know it is coming.

• Re: Avastin and health insurance
• Posted: 2007-09-26 14:31:23 By Barbara L
• Hi ellen! I am going through the same thing I am 46 and have gotten 3 injections and really improved my vision too; did they stabilize yours? How does this work; I am sorry about your insurance coverage problem so far they are paying our bills but not sure how that is going to go; this is all new to me too. Barb. psalms5556@yahoo.com Avastin is wonderful!