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» LymeNet Flash » Questions and Discussion » Medical Questions » insurance denying bicillin injections

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Author Topic: insurance denying bicillin injections
betty1939
LymeNet Contributor
Member # 18240

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Does anyone know how I can get bicillin injections at a discounted price?

After only 3 months on bicillin injections, my insurance has decided to deny coverage over it.

It has definitely been helping me to get rid of some of these neuro symptoms and has given me a lot of energy that I have been able to even clean my house.

So disappointed!

--------------------
Lyme IGG/IGM positive 12/08
Babesia Microti IGM positive 12/08
Hemobartonella positive 1/11
mycoplasma 6/11

Posts: 162 | From Ohio | Registered: Nov 2008  |  IP: Logged | Report this post to a Moderator
Lymedin2010
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Member # 34322

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Take Penecillin VK with probenecid to keep it in your system for longer.


I found it to be almost as effective as just the shots.

Posts: 2087 | From NY | Registered: Oct 2011  |  IP: Logged | Report this post to a Moderator
Rumigirl
Frequent Contributor (1K+ posts)
Member # 15091

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Appeal the insurance denial. Get your doctor to write a letter, include some research on it, if possible.

Ask to have a doctor in this field (whtever is appropriate) review the appeal---or ask for your doctor to do a Peer to Peer Review on th ephone with their doctor.

Usually, you are allowed 2-3 appeals, if necessary. Don't give up!

Posts: 3753 | From around | Registered: Mar 2008  |  IP: Logged | Report this post to a Moderator
betty1939
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Member # 18240

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update: I called in a refill to CVS for bicillin LA injections even though I got the letter saying it was denied, but oddly enough I only had to pay a $40.00 co-pay.

My husband and I think that what was actually denied was my doctor's office (nurses) administering the injection and billing insurance for it, but rx still covered.

Atleast for this month, I am good. I have enough shots for 1 full month and then it will be a total of 4 mos. My husband will have to give them to me again even though it makes him nervous.

Maybe after 4 mos. of bicillin injections it is better to move on to something else anyway.

Anthem Blue Cross (insurance) reasoning behind the denial is that (quote from denial letter) "research shows that bicillin injections are experimental in the treatment of lyme and that there are better treatments available for lyme such as oral antibiotics or IV antibiotics"

--------------------
Lyme IGG/IGM positive 12/08
Babesia Microti IGM positive 12/08
Hemobartonella positive 1/11
mycoplasma 6/11

Posts: 162 | From Ohio | Registered: Nov 2008  |  IP: Logged | Report this post to a Moderator
   

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