Getting the FoundationOne Test In Germany: Fifteen Tips

As you probably know, if you're a cancer patient, neither genetic nor genomic testing is likely to be covered by your German insurance company, unless (1) you have two or three relatives with the same kind of cancer or (2) your insurance company is really nice. Nevertheless, Germany being devoted to bureaucracy, you may find yourself in a situation like mine. So here are some tips:

(1) Tell your gynecologist or your oncologist that you would like FoundationOne genomic testing. 

(2) Watch your oncologist sweat. "I'm not allowed to order the test," said my oncologist, "Because of #$%^&*UIO and WERTYHJ@#$%TY," (In other words, I couldn't follow her explanation.)

(3) Go to your gynecologist or your general practitioner (Hausartz) and say you'd like her to order the test.  Watch her sweat. In my case, I went to my gynecologist first, because I'd written to the  FoundationOne company, who advised me that either my oncologist or my gynecologist could write the test order.

(4) Listen to lengthy explanation from worried, guilty gynecologist that the test is "off-label," therefore very expensive, and maybe the insurance company will not approve, and maybe I'll have to pay for the test myself.

(5) Start a GoFundMe (or the crowdfunding company of your choice, but GoFundMe was great) to raise money for the test.

(6) Write to your insurance company and cc the mail to your gynecologist and your oncologist. Send every diagnosis you ever got to the insurance company, while feeling as though you were promising to hand over your firstborn child.

(7) Call your oncologist to let her know your insurance company might be paying, but meanwhile you'd really like this test. Listen to her get irritated about how she's answered lots of emails from you.

(8) Explain to time-pressed, overworked gynecologist that she really has to read this email your insurance company just wrote.

(9) Get (if you're lucky) a definite approval from your insurance company and dance merrily to your gynecologist in hopes of getting her to write the order for the test. Watch her writhe in her chair and explain that sometimes insurance companies tell doctors "You prescribed too many off-label tests! Pay up!" In other words, she's afraid of being stuck with the 5000 euros, or the 3000-something euros. Five years after the fact. Which is also five years after the time you're floating in heaven or frying in hell.

(10) Offer to pay. Your GoFundMe cash just came through.

(11) Listen to her say "No," you don't pay . . . 

(12) Talk to the oncologist again. She still can't write the order for the test.

(13) Go see the oncologist, who's willing to send in the tissue sample. 

(14) Listen to her when she mentions that you could just try your general practitioner: "All you need is that Stempel." (the official bureaucratic stamp).

(15) Go to Hausartz about another, unrelated form you need filled out. After that form is taken care of, slide the FoundationOne form across the table. Have her sign it while she's so busy she doesn't know what she's signing.

P.S. The tissue sample is now in the mail! I'll keep you posted.