Some patients have been successful in seeking reimbursement for PRRT treatment and follow up. The process varies greatly based on your insurance company and if your policy is offered by the insurance company directly or if the insurance company manages the policy for the company you work for as a "self insured policy."

PRRTInfo.Org is not an insurance site, nor are the writers lawyers or insurance experts.  The content on this site is for informational purposes only. The writers accept no liability if you are unable to get insurance coverage.

There is no universal answers for how to prepare a claim or appeal for PRRT coverage, each case is unique combination of diagnosis, prior treatment, available alternatives and insurance coverage.

Here are some suggested steps.

Get a copy of your COI (certificate of insurance), this is the contract with your insurance company.

Understand the claim and appeal process contained in the COI

Virtually no policy covers non - emergency treatment in Europe, which will be used as a reason to deny coverage, your challenge is to get your treatment covered based on medical need per your COI.

Understand your legal rights before you start the process, you can contact the Cancer Legal Resource Center (www.cancerlegalresourcecenter.org) to help you navigate this process at no cost.

Learn how to appeal insurance claims using methods described by Laurie the Insurance Warrior.

We do help to maintain a list of those who have successfully navigated with their insurance company and have been able to receive coverage.  You may contact us for the information if you feel it will help you with your case.  We make no guarantees that using this precedent case will help with your particular claim.  You can also use the contact us information if you would like to share your success with other by adding your case to the precedent list.

We have reports that the following insurance company have paid for PRRT.