LymeNet Flash: IV antibiotics and Insurance

This is topic IV antibiotics and Insurance in forum Medical Questions at LymeNet Flash.

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Posted by lisalymetexas (Member # 49263) on :

Hello again,

I have some new questions. I need to find out who here has had a good experience with an insurance co. and IV antibiotics? Could you please send me a message and let me know who that was? Also, has anybody had a patient advocate help get them what they needed and what insurance was that.

Please let me know which ones to avoid. I am on Medicare and trying to figure out if I should switch to Medicare Advantage.

Thanks,

Lisa

Posted by madisongrrl (Member # 48682) on :

Every insurance has their own narrow criteria that they require for proof that you need IV antibiotics.

My LLMD works with BCBS, which luckily is my current insurance. I had a positive iSpot test and did oral antibiotics for about a year. I retook the iSpot test and it was still positive. This was proof to the insurance company that I failed oral treatment and got me at least 4 weeks of insurance coverage for IV. They might cover more, I just waiting on my pending insurance claim right now.

Posted by Lymetoo (Member # 743) on :

Four weeks is the standard. Anything beyond that will be very difficult.

Also remember that most LLMD's do not take insurance, though the meds should be covered.

Good luck! [Smile]