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» LymeNet Flash » Questions and Discussion » Medical Questions » Neighborhood health plan RI...IV ABX

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Author Topic: Neighborhood health plan RI...IV ABX
lucky8711
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Does anyone on hear Have Neighborhood Health Plan in RI and are you on IV ABX?

My NP plans to put me on IV Rocephin in the next couple of months and I am already stressing out about the $$$.

Looking for others experiences if any.

Posts: 80 | From RI | Registered: Jun 2010  |  IP: Logged | Report this post to a Moderator
mom2kids
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I think in RI your insurance is not allowed to deny any Lyme treatment. I'll double check that, because my memory is so awesome, but I think that's the law.

--------------------
Down on her knees, she wept on the floor.
This hopeless life, she wanted no more.
Dead in the mind and cold to the bone,
She opened her eyes and saw she was alone. ~Seether

Posts: 427 | From Rhode Island | Registered: May 2011  |  IP: Logged | Report this post to a Moderator
lucky8711
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Oh yes that would be great! Thanks...I wouldn't even know how to begin going about finding that info.
Posts: 80 | From RI | Registered: Jun 2010  |  IP: Logged | Report this post to a Moderator
mom2kids
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I probably won't get to this until tomorrow, unless I have trouble sleeping tonight. If I forget, please just PM me to remind me. I tell people I have the memory of an 80 year old coma patient...

--------------------
Down on her knees, she wept on the floor.
This hopeless life, she wanted no more.
Dead in the mind and cold to the bone,
She opened her eyes and saw she was alone. ~Seether

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mom2kids
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Here are some sections of Rhode Island State Law regarding Lyme Disease treatment and insurance coverage:

http://www.rilin.state.ri.us/Statutes/TITLE27/27-18/27-18-62.HTM

http://www.rilin.state.ri.us/Statutes/TITLE5/5-37.5/5-37.5-5.HTM

I'll get more details, but this is a start.

--------------------
Down on her knees, she wept on the floor.
This hopeless life, she wanted no more.
Dead in the mind and cold to the bone,
She opened her eyes and saw she was alone. ~Seether

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Nancy2
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Mom2kids is absolutely right.
RI Lyme Law states that your insurance
MUST cover any treatment prescribed by a Lyme Literate practioner. It is a mandate that was put through the RI General Assembly to protect patients who at the time were denied IV by most insurance companies due to cost.

Nancy

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lucky8711
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Thank you both so much for the info!

I am scared of course to breathe a sigh of relief until the time comes however.

I wonder if the Insurance Co did per chance try and deny it if I state my awarenes of this mandate that would change things....

Here I go projecting already. LOL

Thanks again!

Posts: 80 | From RI | Registered: Jun 2010  |  IP: Logged | Report this post to a Moderator
mom2kids
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Lucky, save that energy to get well instead of worrying about the unknown. Especially in a state that has legislation to protect you as a patient. If you need any more help you can just PM me....

--------------------
Down on her knees, she wept on the floor.
This hopeless life, she wanted no more.
Dead in the mind and cold to the bone,
She opened her eyes and saw she was alone. ~Seether

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gmb
Unregistered


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Lucky,

One thing you should check with you insurance co is if the dr who prescibes the IV may need to be in network. Your LLMD is most likely out of network so maybe you'll need to have her coordinate the IV treatment thru your PCP.

Just a thought...This was not the case for me, BCBS covered all of my LLMD's IV stuff even though she was out of network. I'm just not familiar with Neighborhood Healthplan.

Maybe your LLMD can make the phone call or has other patients covered under your plan.

good luck.

gmb

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