Topic: Insurance + Clinical Trial with Theraspheres Y-90 (not SIRS)

Hello all,

My boyfriend John has the option to begin a clinical trial therapy of Theraspheres for CC (only available in 5 centers across the country) or go with the more standard SIR Spheres.

We are concerned about insurance issues. We have been told to expect problems getting SIR Spheres approved, and even more issues getting Theraspheres approved since it is still not FDA approved for CC.

These treatments are incredibly expensive, so we really do have to have coverage first. I am wondering if any of you have had experience with getting Theraspheres approved or insurance and clinical trials, and/or any advice. Thanks so much for your help!

Sincerely,
Sarah

Re: Insurance + Clinical Trial with Theraspheres Y-90 (not SIRS)

Sarah,

I have been told that Medicare covers it, but I am not sure on Medicaid. Many on here have been through the exercise of appealing with insurance companies. You could search "insurance appeal" and may find something useful.

Re: Insurance + Clinical Trial with Theraspheres Y-90 (not SIRS)

There are plans out there paying for Therasphere.

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