I just switched to Blue Shield of CA (Blue Cross Blue Shield) and have been on bicillin 2x/week for several months. Prior to BCBS, no issues with insurance(Aetna and even United HC).
My LLMD in NJ directs my treatment, but my local IM in Virginia administers the shots.
BCBS won't let me continue to buy the drug through the pharmacy, then take it to my local IM doctor.
If the doctor gives me the shot, she has to order the medicine and bill it all with the injection fees.
If I don't agree to this, I have to administer the shot myself.
Has anyone else dealt with this and found any way around it? I feel like it is forcing me into self-injection, and I am not comfortable with that.
Posted by savebabe (Member # 9847) on :
Maybe you can find someone to give the shot for you? My husband was trained by my llmd and currently gives me two shots a week. It really isn't that bad once you do it. Good luck.
Posted by sixgoofykids (Member # 11141) on :
I'm starting injections Sunday. A friend who is a nurse is going to teach my husband and 19 year old daughter to do it.
Posted by NoVAChick (Member # 9814) on :
Thank you for your kind suggestions. Unfortunately, I live alone and have no family nearby. None of my friends would be good candidates for giving a shot.
Posted by David95928 (Member # 3521) on :
Is the issue that they won't let youi get it through the pharmacy plan (MedCo)? This may only partially helpful. In 2003, I tried to get Bicillin through my pharmacy plan through BCBS/CA with no luck. After numerous insistent phone calls, I learned that I could buy it and submit for reimbursement through major medical. It was a total hassle as, each time I submitted, it was as if it was the first time. They would question it, "lose" it, reroute it to another pharmacy plan in which I was not enrolled so it would be turned down, and in general delay it in any way they could. But I did get re-imbursed. It was purchased at CostCo. If you are in southern California, I would be very tempted to just go to San Diego a couple of times a year and buy it for cash in Tijuana. David
Posted by NoVAChick (Member # 9814) on :
David, Thank you! That makes sense. I think they are just making things more difficult than they have to be.
But it seems like they like to keep pharmacy billing separate from medical billing and that is what the issue is.
It seems like I may be able to buy it through the pharmacy and my local IM can do the injections, billed as low level office visits. Waiting for confirmation.
Unfortunately, I live in VA, or I would go to Tijuana. My employer is in San Fran, which is why I have this lovely insurance.
Thank you so much!
Posted by WildCondor (Member # 434) on :
I always got my Bicillin at CVS, and self injected at home. As long as you know what to do, it's your prescription! Make sure you are trained in how to administer the injections.
You could always get the Bicillin injections at your local doctors office.
Posted by NoVAChick (Member # 9814) on :
Wild Condor and Cave 76,
Thanks for your responses! Prior to BCBS, I had no issues and simply picked up the shots at the grocery store.
Then I took one needle at a time to my doctor, who injected it. This is my first script with BCBS.
After several frustrating calls to BCBS this week, the result is that I can again pick up the shots at the grocery store.
Then, I have to either have a home health RN teach me to self-inject, or inject me each time.
I plan to be taught to self-inject. I can't begin to describe how stressful they made this.
today I was on the phone with them for about 1.5 hours straight.
Thanks to all who responded for the support.
NoVAChick
PS: Wild Condor, I enjoyed the Mystery ER show about your lyme story. How inspiring.
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