• Borderline (LMP) tumors, IVF, and Insurance

    Asked by SarahPants on Monday, May 21, 2012

    Borderline (LMP) tumors, IVF, and Insurance

    Hello Everyone!
    I'm curious as to whether insurance companies cover borderline tumors as cancer? In the past six months I've had two surgeries removing borderline tumors from both ovaries as well as my bladder. Luckily, my oncologist is a rock star and has been able to leave a little of each ovary behind. My oncologist has said that I will likely recur, and he has recommended that my husband and I start the process of IVF while there still might be some viable ovarian tissue. So here's the dilemma- my husband's insurance does not cover IVF, however, it possibly covers it for cancer patients. Sooooo- do borderline tumors actually count as cancer? Also, there are some groups out there, such as livestrong, that will cover IVF for cancer patients. Would I qualify? Has anyone had experience with this? Any advice?

    4 Answers from the Community

    4 answers
    • CarolLHRN's Avatar

      Wow. This is a tough question! I used to do reviews for insurance companies and I would probably have this case reviewed by our medical panel. Some insurance companies are very strict and if you don't actually have cancer would not cover it. I do know that the company I used to work for needed the oncologist to state the patient had cancer in order to be approved. It really can't hurt to put in a request for it. Most insurance companies require prior authorization for IVF. The worst thing that can say is no and you will still have the right to appeal the decision and have it reviewed by a medical director that is an oncologist.

      I'm not sure if there is other funding out there but again, there is no harm in asking around.

      Good luck on your journey.

      over 8 years ago
    • nancyjac's Avatar

      I'm not sure what you mean by borderline tumors. If they were removed then there should be a pathology report that identifies whether they were malignant or not.

      over 8 years ago
    • SarahPants' Avatar

      Thanks CarolIN! I did hear back from my Dr. and he did say that it was cancer and that he would sign off for the IVF and the insurance. It looks like the insurance will pay for cancer patients consultation and diagnostic testing, but that's it :( Boohoo. At least they recommended some funds that sponsor IVF for cancer patients. I'll try them out.
      Nancyjac- yes- "borderline" or LMP serous epithelial tumors are my pathology. They are a specific kind of rare ovarian cancer more commonly found in younger women. They're mostly chemo resistant and usually slow growing- partly malignant partly benign cells. I was confused when I first heard as well. My overall prognosis is good (knock on wood), as long as I can remove my ovaries before it spreads anymore. Hence, the rush to save my eggs as soon as possible.
      Thank you both for replying! I'll let you know what happens. Maybe my husband and I will just have to pop out a kid (really fast) on our own- haha!

      over 8 years ago
    • Dreynolds' Avatar

      Thanks for this info. I had surgery in June for the same borderline tumors... It is very confusing. They are cancer and my insurance covered it. Vaginal hysterectomy with biopsies. Staged at II b/c.

      about 8 years ago

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