I found out today that Dr. J is no longer excepting Aetna at his practice. So as of today he is not participating in Aetna or Blue Cross and Blue Shield. I called the insurance co. and they told me that the dr. cancelled his contract with them as of 8-11. Now I wonder what all his patients are going to do od how they can afford an office visit now. This is a devestating blow for all his patients(about 3,000) and I am sure more of this is going to continue to happen everywhere that there is a lyme literate dr. practicing. I guess $ is the true root of all evils after all.
Any help or advice would be greatly appreciated. Posted by LYMESCIENCE (Member # 9259) on :
You can still file for out of network coverage. It should end up being not all that much more expensive
Posted by bettyg (Member # 6147) on :
Is Dr. J considered a alternative therapy/holistic MD and recommends a lot of supplements?
Reason I ask is the VP of Iowa's Des Moines HQ for BCBS told me last week, they are DENYING all my out of pocket expenses to my LLMD, RX compounded meds, $800 of supplements for 1 month, and 5-6 labs done nationwide.
So do some more checking before you get sticker shock as BC told me earlier they would be covering most of this! I'll be appealing. Bettyg Posted by AP (Member # 8430) on :
Dr. J's practice does recommend a ton of supplements. I spend about $400 a month on them out of pocket. He is not, however, a holistic MD.
Posted by lrtbc (Member # 2477) on :
Ok, how can anyone afford on office visit of now without ins., $300 plus take pay for all the supplements? us lymies need to for an advocate group like the HIV people have. The insurance companies dare not cut them off, but it's ok for them to cut us off? We all need to unite for this right. If we all contact our states health higher ups, maybe we can help get the coverage that we all need.
Posted by mtnwoman (Member # 8385) on :
Anyone know what are Dr J's half hour office visit charges?
Posted by Lymetoo (Member # 743) on :
Definitely call your company and ask if they reimburse for out of network drs. My Aetna ins reimburses 80%.
Posted by Aniek (Member # 5374) on :
Bettyg - I've never heard of an insurance company covering supplements outside of something like B-12 injections.
lrtbc - call your insurance company and find out what they reimburse for out of network visits. Often there is a percentage they will reimburse after you meet your deductible.
I'm not sure if the insurance will do this, but see if they could go over some old claims from your visits and tell you how much they would reimburse if you submitted them now that he is out of network.
But it's unlikely you will get a promise of how much they will reimburse. But any info you do get, ask for it in writing. Keep good notes on the name of who you speak with and the date of the call.
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