When I had my recent doctor appointment, I mentioned how I would be meeting with a genetic counselor to discuss being higher risk for breast cancer. I am not high risk like many women are because I don’t have the genetic mutation that is commonly known for being high-risk, but I still have a higher risk because my mom had cancer. That’s the reason why I started getting mammograms so early.
But the problem has been getting breast MRIs. I was able to get one because of a note from my mom’s doctor. Her doctor said I needed to have a baseline MRI to be safe and to have in my medical record for the future. Since the type of breast cancer that my mom had is only caught on MRI, they wanted something in my medical record that had an image that was clean and did not have any cancer in it. Honestly, it’s more of a cover their butt MRI to prove they checked me out, but I’m ok with that. I’d rather know that I’m ok than wonder if I should be worried.
But after that original MRI, my insurance didn’t want to cover any more breast MRIs for me in the future. I don’t need them that often, but my mom’s doctor recommended every 5 years or so. But if my insurance wouldn’t cover it, it could be $10,000-15,000. It’s bad enough that it’s $500 when they do cover it, but I cannot afford a 5 figure MRI and that is ridiculous. So the only way to get it covered it so prove that it is a necessary preventative procedure. If my mom’s doctor didn’t think it was necessary, I wouldn’t worry about it. But since they advised me to do it, I wanted to get it covered.
So I had a phone appointment with a genetic counselor this week. I wasn’t sure what to think since I knew this appointment was more about trying to prove I needed something and not about worrying about my health or risk factors. Fortunately, either there were notes about that in my record or this doctor was familiar with doing this. She got straight to the point and we worked through my family history. I was prepared and my mom helped me with making a list of everyone we knew who had cancer in my family going several generations back.
The genetic counselor did have some questions about my mom and the testing she had done, but I was able to get my mom on the phone which was helpful. And the counselor was able to tell my mom about a few new options that she might be able to look into at her hospital about different genetic tests. We don’t know if they are covered for her at her hospital, but since we have been told that there is a chance her cancer has a genetic component we want to try to be on top of any tests we can do.
After going over my family history, the genetic counselor started working through different equations that figure out your risk rate. In order to be considered high risk, you have to have greater than a 20% chance of getting cancer. It’s a bit weird to think about how this is all figured out, but I guess this is how things have to be done sometimes. There are dozens of ways to work through these equations and for some of them, my risk rate is extremely low. But we found one where my risk rate is 22.2%.
Now, I know this is just a random equation and it was only one of many options and most of the options showed my rate much lower than that. But this was something I needed to do to get the insurance coverage I’ve been trying to get. I don’t want to get into a debate about insurance, but it’s annoying that I had to figure out the one way that I have a high enough risk so that I could get the preventative care that I was told I needed. But I am grateful that I am going to get it and I don’t have to worry about it now.
The coverage I get is for 1 MRI a year, but I won’t be getting them that often. I think every 5 years is probably what I will do. Maybe even less often than that. But at least the option is there for me if I need it and knowing it’s there is a good feeling. I don’t have to worry if I have something wrong and I can’t afford to find out.
After I had this appointment, I talked to my mom and told her the results. I was saying how weird it was that I was almost celebrating being high risk for cancer, but that’s what I was kind of doing. But if that’s what it takes to get the care that I have been told I should get, then I guess it is something to celebrate.
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