LymeNet Flash: IV therapy stopped because ins will not pay

This is topic IV therapy stopped because ins will not pay in forum Medical Questions at LymeNet Flash.

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Posted by poodlegirl (Member # 6746) on :

I am in my 3rd month of IV therapy and my ins co had decided I have had enough treatment. They will pay for no more meds. can they do this? Has anyone else had this happen and if so what did you do????I am better but probably not well. I am having my picc line removed wed. I am on orals again

Posted by arg82 (Member # 161) on :

I had this happen to me after six months of IV meds in 2002. I was much better after the six months but still had a way to go. I didn't try to fight my insurance company or find another way to get the meds and I'm still very sick.

If you follow with orals, hopefully you'll find something to help you keep improving! And you can fight your insurance company, especially if your doctor is willing to help you fight. It's unfortunate that insurance companies feel that short-term treatment is enough. And since there aren't any blood tests to really show that you're improving but need further treatment it's really hard to fight the decision.

Hopefully other people will be able to help you more! Just wanted to offer my support.

Peace and healing,
Annie

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Posted by janet thomas (Member # 7122) on :

IM Bicillin and a macrolide?

Posted by lyme_suz on :

Hi poodlegirl,
Did you get you picc line pulled Wed.?

Listen, our insurance quit paying after 6 wks. The insurance was paying $1700 a day to our home health agency!

We found a home health agency that would sell us the rocefin ala carte. Some of these angencies refused to sell rocefin only because of liability; but with a lot of legwork I found one that would do it for us.

We were charged $70 a 2gram IV dose.
This same agency wanted $89 a day for supplies! We got our infectious disese dr. to write Rxs for the hepron and saline. Our insurance ran it through our pharmacy benefit
so it was about $10 for 20 injections. Also we found that the home health nurse had extras she gave us. A dr. at an urgent care gave us 5 salines for free. We paid the nurse that had been coming from the first agency out of pocket. We paid her $75 a week to treat both my kids. In hindsight, I think that you could go to a dr. office to get site checked and dressing changed if if the insurance will pay a portion leaving a copay of less than $75. At the beginning I was too tired to take them out. Also, the nurse probably done it for less money; but we had already begged the hepron and saline
off her.. We went into debt paying these reduced rates, but felt it was the way to go.

I hope the oral antibiotics work for you and you don't have to deal with cost of IV. If you do maybe some of these ideas ideas will help.
Best Wishes,
Suz

Posted by sweet pea (Member # 6495) on :

My insurance won't even pay for a month of IV, and I've been sick for over a year. My LLMD could not convince them otherwise. I'm going to fight it, I just received the "Insurance" issue of LymeTimes, it looks very helpful. My pharmacist told me that my employee benefits company will be a better advocate for me than my LLMD, because they are the ones who purchase the group insurance. I thought this was a good idea because I get my insurance through the state Association of Chamber Executives, so the insurance company won't want to lose their business. I just need to get motivated to do it....

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