posted
Hi All: We are trying to fight my insurance company. Does anyone know if this is a hard test to refute. I did three samples of urine and the third one was positive thus the test was said to be positive. They are trying to say that my treatment is experimental. Aren't there states that it is law to treat chronic lyme with long-term abx. It is astounding to me that I have fought this for almost four solid years and I have a current infection. I knew it but I didn't want to know. Can anyone help with this. It would be greatly appreciated-- Thank you.... Posts: 859 | From Southeast | Registered: Mar 2011
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posted
Hi Tutu: They are denying any and all treatment and appointments. To the cost of about 2000 plus a month right now out of pocket. With supplements etc it is 3000. Thanks for any and all help.
I guess what I am wanting to be clear on is that it is a current infection which I am not sure how they can deny. Like my friend said, okay, are you going to pay for treatment until I get another Igenex test. What are your thoughts... thanks any and all...
Posts: 859 | From Southeast | Registered: Mar 2011
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WPinVA
Frequent Contributor (1K+ posts)
Member # 33581
posted
Not sure what state you are in but here is a link for the report of the Virginia Governor's Task Force on Lyme:
Perhaps your state has something similiar? It's not law but it's a set of recommendations from an authoritative source acknowledging the insurance and diagnostic problems with Lyme.
Posts: 1737 | From Virginia | Registered: Aug 2011
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AuntyLynn
Frequent Contributor (1K+ posts)
Member # 35938
posted
You can thank the IDSA for this insurance refusal! Unless you get a POSITIVE ELISA followed by a POSITIVE Western Blot, all else is "unproven" and "experimental" in the eyes of the Insurance Companies.
In fact the IDSA crowd is currently doing a media blitz on "bogus test results" right now. Coupled with the argument that people are "abusing antibiotics" and exposing the population to resistant bugs.
If they are so damned worried about antibiotic resistence, why in HECK don't they go after our FACTORY MEAT FARMS?!
(See PaulieinCt's post of today about a "new" diagnostic tests - the link he includes a prime example of IDSA PROPAGANDA!)
This is why, IMHO, we need to go after these IDSA B*st*rds, with a Class Action Suit, for WILLFUL PROFESSIONAL NEGLIGENCE.
They REFUSE to consider any other medical opinions but their own, and they are the REASON why so many Lyme patients SUFFER for years, without a definitive diagnosis, or effective treatment!
By the time patients actually figure out what is wrong with them, their disease has progressed so far that it is much harder to treat!
Posts: 1432 | From New Jersey | Registered: Jan 2012
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AuntyLynn
Frequent Contributor (1K+ posts)
Member # 35938
posted
Mass and Rhode Island have both passed laws that make it illegal to prosecute doctors who treat aggressively for Lyme - but as far as I know, no State has yet gone after insurers for refusing to pay for treatments!
Posts: 1432 | From New Jersey | Registered: Jan 2012
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posted
Wow all... this is super helpful information. I am going to give the report to my lawyer. Thank you WP and Aunty Lynn... also great information.
Lymetoo... you are always there... Thank you...
If there is anyone that has had success fighting the insurance co -- would they please message me or direct me to someone that has. This is a nightmare though I know all of you understand.
Thank you again...
Posts: 859 | From Southeast | Registered: Mar 2011
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posted
Have you appealed your insurer's denial at all levels of appeal?
Have you tried complaining to your State's Insurance Commissioner?
-------------------- Sick since at least age 6, now 67. Decades of misdiagnosis. Numerous arthritic, neuro, psych, vision, cardiac symptoms. Been treating for 7 years, incl 8 mos on IV. Bart was missed so now treating that. Posts: 765 | From nw ct | Registered: Sep 2008
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Hi Paulie: I am waiting to hear from a lawyer that is taking my case on contingency- to my knowledege we have. I did complain to the insurance commission but with this recent result I don't know how they can deny me. Thank you all!
Posts: 859 | From Southeast | Registered: Mar 2011
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