The New York Proton Center is committed to helping you secure approval by providing your insurance company with supporting clinical evidence about your case. We will work with you to complete all the paperwork, explain to your insurance company the reasoning behind your treatment plan and assist you with the appeal process as needed.
Please contact us so we can discuss your particular situation and provide support through every step of the process.
Proton beam therapy is covered by Medicare, Medicaid, and many private insurance companies. Coverage is determined on a case by case basis depending on your diagnosis, medical history and other factors.
It’s essential that you and your primary oncologist submit a request for coverage of your proton therapy plan prior to scheduling treatment to learn about your coverage. Many providers cover proton therapy, but not all.
If your insurance carrier determines that your case requires further review, your first request might be denied. This happens often so don’t get discouraged. In fact, it might take several appeals before your submission is approved. We can support you through this process. We can respond directly to insurer questions, write letters of medical necessity, provide supporting documentation, participate in peer-to-peer discussions involving your case and provide comparative treatment plans as requested.
