I was on Immunesupports group but realize I belong here. I have found some great info and inspiring messages here already.
I have a question for anyone who may be able to offer any help. I have been on IV Rocephin for several months, and was making steady progress.
I was then told by a doctor that I had better be sure that the insurance was paying because they have been allowing patients to rack up huge bills and not notifying them they weren't paying.
Sure enough, they had paid one month's worth. Previously, I had done several months of IV Zithro and they had paid.
This is where it should be interesting to everyone here. I had been using a different home infusion company, and they had been billing treatment under Unspecified autoimmune disease.
Insurance will pay for that.
When the new company started billing under Lyme Disease, a red flag went up and they would only pay for one month.
Lesson Learned Painfully.
I am now quickly losing the progress I had made and getting no where with appeals.
I am searching for a new insurance company in Ohio that is better for Lyme treatment or is getting disability and going on Medicaid better??? I had BC/BS.
Sorry so long. Thanks
[ 03-31-2009, 01:48 PM: Message edited by: Truesun ]
Posted by Truesun (Member # 19735) on :
Hi Everyone, I am new here. I was on Immunesupports group but realize I belong here.
I have found some great info and inspiring messages here already.
I was told by Betty to edit my writing style. Too difficult to read. Thank you.
Basically, last post was that I need help in choosing an insurance company in Ohio.
Have BC/BS and they have refused my IV treatments. I am ready to renew insurance and need help. Any suggestions on best insurance for Lymies in Ohio or is Medicaid Better?
Posted by sutherngrl (Member # 16270) on :
Many insurance companies will only pay 28 days on IV meds for LD. But maybe changing insurance companies will get you another 28 days.
I hope someone will come along with better info for you.
Posted by sammy (Member # 13952) on :
Welcome Truesun:)
Thank you for sharing your experience with us here. Unfortunately it is what I had feared.
I have been on IV Rocephin for about 5wks now and still have not heard whether my insurance will cover any of it. They did not require a prior auth, I was told that coverage would be based on medical necessity. So i'm waiting and it is making me very nervous.
I too live in Ohio and have Anthem BC/BS. Please pray that my particular plan will cover the cost!
Truesun, good luck finding better coverage. Hopefully others from the Ohio area will chime in with their experiences for you.
Posted by Truesun (Member # 19735) on :
Hi Sammy, I have Anthem also. There policy is only thirty days. You can go online and see if they are paying your bills. I would check before you go much further. I didn't need prior auth until it was billed Lyme disease. This they won't cover.
Good Luck
Posted by kylasrain (Member # 12031) on :
I have BC and they are denying pre-auth for IV treatment. (I knew to get pre-auth as I heard they usually deny the claim.)
They are stating that my doc is not credible (Why? Because he's not a BC doc?!)
I had an incorrect diagnosis! (They're not even doctors!!)
I am not sick enough. (How sick do I need to get?! Seriously!?)