Strattice and insurance

Hi Teri,

My sister had Strattice used during her recon last year. Insurance was no issue at all, I don't think the Strattice was even detailled by her consultant?

Are you in Ireland? Insurance problems are usually more of a US issue? If you are in North American, I can recommend www.facingourrisk.org/messageboard for advice on anything to do with reconstruction.

Good luck,
Flo.

Hi Flo, Thanks for your reply. I am in dublin , my surgeon wrote to my insurance co to get clearance to use Strattice as it was her first time to use it. They say the cost should be absorbed by the hospital as they will only pay the regular cost of this procedure. I'm going to have to fight my corner. I was just wondering if any other surgeon in Ireland is using it and who is paying.
Teri

Hi Teri,

Thats disgraceful! Are we turning into the US with their Insurance companies ruling everyone's life and health?

Mr. Maurice Stokes in the Mater uses Strattice. I think Ms Salman there uses it also. And I'm sure Kevin Cronin must be using it also. My sister was with Quinn Healthcare and has had no issues with the Strattice being used - are you VHI by any chance? She has heard a couple of docs comment recently that it is very expensive - but surely its more expensive if you don't use it and the recon fails and has to be redone???

Here's a link to some info on Strattice from the manufacturer. It may contain some points and benefits that will be relevant to your fight to get it cleared. http://www.lifecell.com/strattice-recon ... ue-matrix/ (Although I still can't believe you are having to fight for it at all!!! - Grrr)

Good luck!
Flo.

THANKS FLO
THATS GREAT TO KNOW. I AM WITH AVIVA. THIS IS THE FIRST TROUBLE I HAVE HAD WITH THEM. I WILL LET YOU KNOW HOW IT WORKS OUT. GOOD LUCK IN YOUR OWN JOURNEY!
REGARDS TERI

Have been through a similar experince in England. I know for a fact that Aviva reimburse Strattice based reconstructions in the UK.
I know it is a different health system but it is the same company providing the same service, so I don't see why they can't fund your case. The irony is you only need a single procedure when using strattice. Surely that is cheaper than doing 2 ops. Sounds like a case of the insurance company making decisions with out knowing the full story. Strattice based reconstruction is now a standard of care for women facing this procedure in the uk. I am sure that will be the case in Ireland.
I would keep the presure on your insurance provider and recommend that they look into the uk experience.
Best of luck with it all

Thanks Newb
They have at last agreed( after requesting a final response letter which is necessary to go to financial ombudsman) to cover the cost to the level of e2300. I hope that will cover it. Honestly do we need this kind of treatment from ins companies?
Tnx for your interest
Teri

Hi Teri,

It is appalling that after all you have had to go through that the Insurance company is adding further stress by being difficult in not paying out!

There is a possibility of me having to have a mastectomy (won't know for sure for 2 weeks) and at 46 I would want a recon. I'm researching all the different ones now and surprisingly hadn't heard of the Strattice till I read your post. I was just wondering (a) why did you opt for that particular option and (b) are there only a few surgeons doing it?

I hope you manage to get it sorted.

Micheline.

hi Wexlass,
Sorry to hear you may have a mastectomy. In my own case, I had had a lumpectomy in 2003, all well til 2010 when a mammo showed calcifacations in the same side which were not benign. So a mastectomy followed. I didn't want another op site( back or stomach) so I opted for the least invasive answer which was to insert a tissue expander under the chest muscle during the mastectomy, then in a second op replacing that with a permanent prosthesis. Unfortunately my muscle was too tight to the chest wall to put expander under . The surgeon had to leave it just under the skin. This is why I have to have the strattice to give interior support to the recon.
My experience is very unusual. The expander couldn't be put in the right place possibly because I had had radiotherapy on that side. My surgeon has never had this experience or used strattice before, but I do have confidence in her.
This is not much help to you I'm sure. I know of others who's experience has been great and straightforward. Strattice is newish here but has been used in the Mater.
I'm due to have my second op in September, I am looking forward to having it sorted. Otherwise I am well, it was caught at an earlier stage than the first which was less than 2cm with clear nodes. so the constant checking is obviously worth it. We are lucky at this stage in treatment that the teams work well for us. It's not easy of course but we have every chance to go on to live a full life afterwards. It's a mountain to clime on our life's journey.
The very best of luck to you in yours.
Teri