Will you please pray for me? My insurance changed with this new year and I've been struggling to get my IVIG and IV antibiotics authorized through the new company.
It's been very difficult trying to arrange things through my Walgreens Home Infusion co, get what's needed from both of my doctor's offices, and deal with the different departments in the insurance company.
I was supposed to have my IVIG dose on Jan 3, every day that I miss a dose I get sicker. This is my immune system. This is what protects me and helps keep me out of the hospital.
I've missed a whole week of IVIG and I feel like I'm really crashing now.
Please pray that the insurance company will please review the information that my doctor submitted and approve me ASAP. I have a primary immune deficiency, the only treatment available is IVIG for life!
If I miss a whole 2 weeks of treatment that will drop my trough levels and it will take me a very long time to pick back up. Most of all, I feel terrible. How am I supposed to fight off my Lyme and coinfections with such a compromised deficient immune system? I can't do it!
So if you will, please pray for me. I've been calling the insurance company and Walgreens every day, at least once a day.
I'm scared and don't want to end up in the hospital again because I feel my body getting so much weaker.
Thank you friends
[ 05-04-2013, 04:00 PM: Message edited by: sammy ]
Posted by lax mom (Member # 38743) on :
Praying sammy!
Posted by faithful777 (Member # 22872) on :
Sending prayers your way!
Posted by lyme in Putnam (Member # 11561) on :
Good thoughts and prayers Sammy.
Posted by susank (Member # 22150) on :
Oh Geez Sammy. Any news? I was worried when you wrote about changing insurance companies.
I think in the past you wrote you could not do SubQ due to neuropathy?
I have just starting researching SubQ and realize it is cheaper - for the insurance companies?
Perhaps if they won't approve IV they might approve SubQ?
Better SubQ than not at all?
I don't know if you saw my post about SubQ daily. Would that make a difference for you - maybe help?
As always you are in my prayers daily.
Posted by unsure445 (Member # 15962) on :
prayers sent.
Posted by Lymetoo (Member # 743) on :
Prayers!!
Posted by sammy (Member # 13952) on :
Thank you for praying friends. They still have not approved my IVIG or my IV antibiotics. I called them every day last week and spent several hours on the phone with them trying to find out what was going on, what needed to be done, what the hold up was, how can I get the process expedited....
Friday I was told that my case was complete and now it was ready for review. They were going to send it to the managers to review it as "Urgent". I hope that this is true.
If is is stuck in the regular pool of prior auths then it will take 2wks-30days for a decision!
So I'm still stressed about this. And feeling sicker every day. I get my IVIG every other wk because my body uses it up so fast. My last dose was Dec 20th. I was due for my IVIG on thurs the 3rd.
I'm 10 days late for my treatment and I'm miserable. Every part of my body hurts so bad, I'm so tired I keep falling asleep even though I desperately want to stay awake, I just feel very fluey very terrible.
So if you will, please pray for me that I won't get any sicker and that my ins will approve my IVIG and IV antibiotics early this week.
Posted by Dekrator48 (Member # 18239) on :
Praying for you sammy!!!
Trusting that it will all work out.
Posted by sammy (Member # 13952) on :
Update
I missed my 2nd scheduled IVIG treatment today. Now I'm 4wks behind in my treatments. I can really feel it. I'm totally drained, weak, lifeless...
I've started running more fevers again. My cough is deep, harsh, and in my chest now. It hurts. I've had more headaches and feel fluey all the time too.
Heard from the Ins company today that they still have not approved my request for IVIG or IV antibiotics. They said that they needed more info for the IVIG and the requested it from my LLMD!?
My LLMD does not treat me for my CVID, my immunologist treats me for my immune deficiency!
Clearly the ins co does not want to pay for the treatments that are necessary and they are trying to drag it out a long as possible.
They don't realize how much it hurts me.
Posted by poppy (Member # 5355) on :
And you told them they contacted the wrong doc? If they can tie it to lyme, they will try to deny. It is the justification that comes from immunologist that needs to be used. Surely this was already done before you ever started it for the first time.
Posted by susank (Member # 22150) on :
Sammy - so sorry this is happening to you.
You have probably poo-poo'ed trying Colostrum.
But I tell you - were I without IVIG I would surely try it.
Please read the following links which made even me re-think Colostrum:
This first one I do not think English is their first language and I do not find the tables to which they refer:
I don't understand anything but the last sentence.
Meant to add: Perhaps try colostrum until your IVIG is approved?
[ 01-18-2013, 04:07 PM: Message edited by: susank ]
Posted by Sammi (Member # 110) on :
sammy, I am so sorry you are dealing with this. I was late on my infusion also because the infusion company stopped doing infusions right before my appointment. I know it is not good to be off schedule. It is terrible you are a month behind.
Can the IDF insurance gurus help at all?
I am praying you are approved ASAP.
Posted by sammy (Member # 13952) on :
Thank you for continuing to pray for me Poppy, Susan, and Sammi.
I feel so sick right now that I'm having a hard time seeing hope. I'm feeling very defeated and depressed.
I can hardly stay awake for more than a few minutes at a time now. My body just shuts down. I can't even stay awake during conversations with family, while watching my favorite TV shows, or while reading my favorite things.
I don't understand why my new insurance won't authorize my IVIG treatments. I got a letter in the mail yesterday saying that they do not have enough proof of medical necessity.
They are requesting more medical proof and have until 3/7/13 to make a final decision on my case! When I read that it broke what little hope I had left and I couldn't stop crying all night. (Walgreens, my immunologist, and LLMD, have sent copies of this information in at their request.)
My diagnosis of CVID is textbook, very low IgG, almost absent IgA, & no response to vaccine challenge. I also have very low NK cells. My body cannot fight infections on it's own. I need IVIG!
I've had the work-up done twice and my diagnosis has been confirmed by one of the most respected immunologists in the country.
I have a follow up with my LLMD on Wed and I'm embarrassed at my current condition. Since I've missed a whole month of IVIG, I've had no chance to see how my new antibiotic combo would work. It's barely keeping me here.
Poppy, I don't know why they want more records from my LLMD to approve my IVIG. I've spoken with the ins co and made it clear the my immunologist prescribes it, not my ID LLMD. They did not seem to care, they still wanted to see more records from him specifically.
Susan, I have taken colostrum and was on it when I was diagnosed. It does not work to support my immune system I am on some other immune supplements that my LLMD recommended for NK cells (Immunotix 3-6).
Sammi, thank you for reminding me of the IDF. I will try to call them on Monday. Hopefully they will be able to help me. They've had plenty of time to review my medical records and they need to go ahead and approve my treatment. It is wrong to keep withholding a necessary lifesaving treatment like IVIG.
It's almost like they want to see how far they can push to make me end up in the hospital or worse.
Posted by Pocono Lyme (Member # 5939) on :
I'm so sorry Sammy. I will pray for you. I would give you my IVIG if it were possible and it's tomorrow.
Maybe try your state's health insurance commission/er? This is a link to a national site. I don't know if it's health or not. http://naic.org/state_web_map.htm
Maybe call an attorney? Not sure if a malpractice attorney would be helpful? Just brain storming here.
Posted by susank (Member # 22150) on :
Sammy - do you have any idea what your levels would be now - having missed two infusions?
Below the reference range? Assuming they are - would it be helpful to test to be able to give proof that your levels fall below normal when off IVIG?
I assume at this point they might be that low. Also assuming whatever you are managing to take in the interim are not "artificially" "maintaning" the lab's normal levels.
BTW - is your lab Quest? I just realized that when the IGG and subclasses are run - at least for me - they are tested at a different Quest lab vs when just the GAM panel is run -and tested at local Quest lab. The results of the total IGG have been different. One time the California lab IGG results were 80 units lower. Just watch for this if you use Quest. ie make sure your blood goes to the same lab and is tested the same way.
Posted by lax mom (Member # 38743) on :
sammy: can you keep going up the ranks in the insurance company until you get someone who will approve you?
There is someone in that building with the authority to approve you. I would threaten a lawsuit, etc, etc.
If it's Medicare, tell them you are going to contact the Center's for Medicare and Medicaid Services, etc.
I'm so sorry you are dealing with this mess.
Posted by Lymetoo (Member # 743) on :
still praying
Posted by beaches (Member # 38251) on :
Like you said, CVID is "textbook."
And that dx has nothing whatsoever to do with LD from an insurance POV.
That CVID dx alone ought to be enough to justify continual tx with IVIG.
As Susan suggests, it would be a good idea to have bloodwork drawn if for anything else, documentation.
And laxmom is correct in that someone in the building has the authority to "approve" you.
IMO phone calls are ineffective. Put everything in writing from now on, as difficult as that is considering your current state.
Do you have someone to help you re: putting things in writing?? If not, perhaps ppl here can help you with that? Is this something you need?
Posted by lyme in Putnam (Member # 11561) on :
Prayers Sammy.
Posted by Sammi (Member # 110) on :
sammy, have you heard anything else? Still praying!
Posted by nonna05 (Member # 33557) on :
Sammy , so sorry to see that you are going through this.
You've had more than your share ( there is no Fair to this).
wILL BE PRAYING FOR YOU.. Is your back any better? Posted by susank (Member # 22150) on :
Sammy - IIRC you contacted someone - Baxter - and were denied?
Were these the programs? Gammassist? GammaGardian?
Posted by Dekrator48 (Member # 18239) on :
Praying for you, sammy!!
Posted by sammy (Member # 13952) on :
**Update Wed 1/30**
Please keep praying for me. My IVIG request was denied on 1/22, my doctors flooded my ins co with more supporting information and it was denied again on 1/28.
I feel so sick. This is the worst I've ever been. I can barely force myself to get out of bed because I want to so bad. I'm deteriorating fast being off of my IVIG. All of my infection symptoms are getting worse. My antibiotics are not holding.
I just don't understand how they could deny me. They must not have looked at my records.
The next step is for my doctor to request a peer to peer review. Please pray that my IVIG gets approved at this level. It is my last chance.
I tried contacting my state insurance board, they told me that they no longer work with the public with problems like mine. They said that there is some new law that prevents them from helping in situations like this.
I didn't know what else to do so I tried calling my dad's HR to see if they could help. They are assigning an advocate to guide me through the appeal process. So far I haven't heard anything from my advocate... But maybe still she will be helpful in the end.
I feel like I'm losing the battle, no matter how hard I try.
I am so sick and it scares me.
Posted by Pocono Lyme (Member # 5939) on :
Sammy,
I'll continue to keep you in my prayers.
Just a thought but maybe contact the media. I've seen where people get quick results when the public is made aware of such things.
This is criminal!!! Try to not be scared.
``Fear not!'' is the most repeated command in the Bible. In fact, it's been said that there are 365 ``Fear nots'' in the Bible -- one ``Fear not'' for every day of the year! In fact, Lloyd Ogilvie in Facing the Future without Fear said there are 366 ``Fear nots'' in the Bible, one for every day of the year, including Leap Year! God doesn't want us to go a single day without hearing his word of comfort, ``Fear not!''
Actually, there are more than 365 ``Fear nots'' in the Bible! Thank God because we need to be reminded to ``Fear not'' and trust God everyday.
When I am afraid,
I will trust in you.
In God, whose word I praise,
In God I trust; I will not be afraid.
What can mortal man do to me?
(Psalm 56:3-4, repeated in similar words in verses 10-11.)
Posted by Lymetoo (Member # 743) on :
More of this to come:
"I tried contacting my state insurance board, they told me that they no longer work with the public with problems like mine. They said that there is some new law that prevents them from helping in situations like this."
I would also call the media.. I know you don't have the energy for it, but perhaps your family could be interviewed?
and prayers
Posted by Dekrator48 (Member # 18239) on :
Dear sammy,
I agree that you may have to be the "squeaky wheel" in order to get what you need...you know the saying.
I am praying fervently for you, dear.
May you feel God's unending love and grace.
Big hugs to you!!
Posted by Sammi (Member # 110) on :
sammy, I am so sorry you are still dealing with this. Have you contacted IDF?
I recommend doing a Google search to get the name and contact information of your insurance company's CEO. Try emailing this person or sending a certified letter describing your need and stating that IVIG is medically necessary. End the correspondence with "Can you help?"
Prayers continue.
Posted by susank (Member # 22150) on :
Sammy - so sorry.
Is there the remotest chance you could get back on the insurance plan you were on before?
Posted by momindeep (Member # 7618) on :
I'll pray for you Sammy...and will continue till I hear differently.
Posted by sammy (Member # 13952) on :
**Update 1/31**
My doctor's office was able to get a peer to peer review appt with the medical director for this afternoon.
So if you will, please continue to pray for me, for my doctor, that this situation would work out for the best.
Thank you
Posted by Sammi (Member # 110) on :
Big prayers continue for you sammy.
I cannot see how they could possibly deny this. I am praying for approval and that you will be able to get your IVIG asap!
Posted by Dekrator48 (Member # 18239) on :
Praying sammy!!!!!!
Posted by momindeep (Member # 7618) on :
Continuing prayer for you.
Posted by Lymetoo (Member # 743) on :
YEA!!!
Posted by Lymetoo (Member # 743) on :
What happened today?
Posted by gagamooppop (Member # 34314) on :
Praying
Posted by Sammi (Member # 110) on :
sammy, one more thing you may try is to contact the manufacturer of the IVIG you need to see if they have an assistance program. Many do. This may allow you to get your infusion while the insurance company is reviewing your case (which they should not need to do because you need it!).
Posted by poppy (Member # 5355) on :
If this peer to peer thing does not work out, and you run out of other options, maybe consider the suggestions in other posts here about contacting the media.
The story that might attract a journalist is that the state has stopped helping people with insurance problems. That is a bigger story, and you are the personal face they could use.
I am a bit worried that the cost of the IVIG to the insurance company might affect what they are charging for the group coverage. This is why having health insurance tied to employment is not a good idea. Maybe the insurance exchanges will make some improvement in that situation eventually.
Don't understand the state insurance people not helping. They have not changed their website info on this subject:
[ 02-02-2013, 02:51 PM: Message edited by: poppy ]
Posted by sammy (Member # 13952) on :
Thank you for all your continued thoughts and prayers.
I know I need to but I haven't been able to bring myself to type the words of this update until now. I haven't been able to stop crying when I think about it then my thoughts and words get all jumbled up.
Sadly, my appeal with the "peer to peer review" was denied. They are saying that I don't have enough medical evidence to prove my diagnosis.
They are not accepting my initial testing done by my immunologist. They wanted him to have repeated the all of the tests one month and then two months later to verify that I truly have the immune deficiency.
My doctor says that this is not the standard way to diagnose because testing once is adequate. He says that a person will not get better, that they will only get worse with further testing. So the insurance company is holding me to extremely high standards.
They told my doctor that we can wait until March and retest everything, if we want to resubmit the appeal.
When I heard that, I lost all composure and broke down. I can't wait until March! I've been off IVIG since Dec 20, I've already missed 3 doses! I'm just feeling to sick...
After much crying (I couldn't stop at that point) and discussing this with my doctor on the phone, he decided that there is no reason to wait until March. All the IVIG should be out of my system by 4 wks so it would be safe to retest by 8wks. So he will let me retest after the second week of Feb.
He did not like the idea of taking my situation to the media and said that he would not support me in it.
So even though I feel so incredibly sick and am struggling, I have to try and hang in there for a few more weeks.
I have talked with my infusion company and my dad's HR and there may be some other options if this doesn't work out. But we have to wait and see what happens with this appeal first and if I could be approved then.
Posted by sammy (Member # 13952) on :
Poppy, I did call that phone number. Maybe the person that I talked with didn't listen to me? I don't know...
Sammi, I also tried calling Baxter to see if there were any programs to help me. They had no advise and no programs for people like me, loyal long-term customers, that are stuck in a temporary bad situation due to ins changes.
I also called IDF. They told me that I was doing all that I could be doing and wanted to know the outcome. Guess I should call them back...
I've been wishing I could go back on my old ins but my family was paying out of pocket (way too much $$$) for it each month. As soon as I was eligible, my dad signed me on to his ins this year. We thought that this was such a blessing but really it has been a nightmare. It has not covered anything for me!
To everyone who has been praying for me and encouraging me during this time, you have been a lifesaver. Thank you so much!
Posted by Sammi (Member # 110) on :
sammy, this makes me sick to my stomach. I am so sorry. You need your infusions!
It is a shame the IDF cannot help.
I recommend contacting the CEO of the insurance company. I did this once when my insurance company was going to stop coverage of my IV antibiotics. Clearly state your case in writing and be sure to include that the IVIG is deemed medically necessary. You may also want to mention that not getting the infusions may cause you to get much sicker. End the letter with "Can you help?" It is worth a shot.
I am so sorry you are dealing with this. It is unfair, unfair, unfair! I have been praying constantly for you, and I will continue.
Posted by lax mom (Member # 38743) on :
sammy: what about calling a patient advocate agency so they can do the fighting for you?
will continue prayer for you.
Posted by Dekrator48 (Member # 18239) on :
sammy,
I'm so sorry that you are going through this.
You said, "My doctor says that this is not the standard way to diagnose because testing once is adequate."
Can you ask your immunologist to point you to that standard in writing?...you know...like the IDSA guidelines are "the standard".
If you can show the insurance company that the accepted standard is the same standard that your immunologist followed, then I think you would have acceptable proof of your medical diagnosis....right?
I am continuing to pray for you, dear sammy.
Posted by susank (Member # 22150) on :
Oh Sammy!! So sorry. Do you know all the criteria - exactly - what you need to prove to them that you have CVID and require IVIG?
Before I was approved I had to show subnormal IGG levels ie was tested three times - one time per month.
Also was tested to see if I had sufficient protection against things like Strep - which I did not.
I think some require something like a vaccine challenge?
What all will yours require?
They want you to do a GAM and subclass panel - then wait and do another one?
What lab have you tested through? Quest? Labcorp?
Your levels might be really low now - low enough. Again - I would test now - off the record - where only you know the results - with Privatemdlabs where the GAM test is $60. That is a discounted rate to that online service.
If your levels are as low as I expect they would be by now - if the test through PMDlabs/(they use Labcorp) - then test officially immediately upon getting those results.
That might put you ahead by two weeks.
I don't know the turn-around time for the basic GAM panel - but I do know you could order the test tonight and go to the lab tomorrow. The results are sent to you - accessed by your computer.
------- Your insurance company will be paying for the official testing they require?
And if you get sick enough to be in the hospital -they pay for that also? Don't they realize that is what can easily happen when a CVID person is off IVIG?
Have you had any tests run since your last infusion? A CBC? Abnormal results?
Still praying for you.
Posted by daynise (Member # 39609) on :
Just adding my prayers. I am so sorry for what you are going through.
Posted by susank (Member # 22150) on :
Sammy I know we would all donate to help buy some Gammagard for you. But that would go against you - your levels would not be true. Wishing so badly I could help further. Will keep praying.
Posted by momindeep (Member # 7618) on :
Still praying.
Posted by momindeep (Member # 7618) on :
I'm still praying for you.v
Posted by momindeep (Member # 7618) on :
Today I am praying for you. I will ask the Lord to help you feel not alone and to give you strength to endure.
Posted by Dekrator48 (Member # 18239) on :
Praying for you, sammy!!!
I am in agreement with momindeep...praying for you to have strength, hope, peace, comforted and not feel alone.
Posted by momindeep (Member # 7618) on :
Sammy, today I will ask the Lord to give you peace...not any old peace, but His peace. I will ask for calm for you in the midst of this storm taking place around you right now and that your mind will not be troubled but in realization that the Lord is in control and is indeed listening and acting even though it doesn't appear to be so at this time.
Posted by momindeep (Member # 7618) on :
His blessings are fresh and new each day and His thoughts of you are like the sand on the seashore. He loves you very much, Sammy and today I pray for you that you can cling to that promise that He will never forsake or leave you.
My prayers continue.
Posted by momindeep (Member # 7618) on :
Prayers for you today. The Lord is holding you in the palm of His hand.
Posted by Sammi (Member # 110) on :
sammy, how are you doing? Please let us know when you can. Prayers continue for you.
Posted by Lymetoo (Member # 743) on :
Praying for my friend, sammy.
Posted by momindeep (Member # 7618) on :
Praying for the Lord to keep you sheltered in the midst of your trials...that your faith will be renewed, and that you are able to get answers and help quickly.
Prayer for you continues.
Posted by sammy (Member # 13952) on :
Thank you friends, I do have a positive update
My Walgreens infusion pharmacist called me to tell me that they think Medicare should cover my IVIG based on my diagnosis. They are going to try to get it authorized now that I have the denial letter from Cigna.
They are hoping to get it approved in writing by the end of this week! So if you will, please continue to pray for me that God will work it out for me to resume my IVIG treatments as soon as possible!
Thanks so much!!!
(I should add that this couldn't come at a better time because I developed pneumonia over the weekend...)
Posted by poppy (Member # 5355) on :
Keeping our fingers crossed for you. Great that the Walgreen's pharm is sharp.
Posted by Sammi (Member # 110) on :
sammy, I am so happy to hear possible good news!
I am very sorry you have pneumonia. Make sure the pharmacist tells Medicare it is a result of not getting your infusions.
Praying hard for good news ASAP!
Posted by susank (Member # 22150) on :
Sammy - more prayers that all works out with Medicare and you can start treatment soon.
Is your Cigna a PPO - or whatever?
I had thought Cigna was one of the least difficult insurance companies to deal with IVIG-wise.
I have been so worried about you. I thought that something had happened - like pneumonia. Geez. I don't suppose you were told what kind of pneumonia?
Assume you are on treatment for that and it is helping?
Posted by lax mom (Member # 38743) on :
Thank goodness for Medicare!
So sorry about the pneumonia.
Posted by daynise (Member # 39609) on :
praying for you!!!
Posted by Lymetoo (Member # 743) on :
Happy dance!! Thank you, Lord!!!
Get well soon!
Posted by Dekrator48 (Member # 18239) on :
So thankful to hear that Medicare should cover the IVIG!
Continued prayers for your healing.
Hugs!!
Posted by momindeep (Member # 7618) on :
Good news...sorry about you getting sick, tho. I will pray that the Lord will use that to your advantage...if anyone can use illness to your advantage it will be Him.
Praising the Lord for His help in your troubles...and thanking Him for His continued support of your life. He is in charge, indeed, and He will not fail you.
Posted by momindeep (Member # 7618) on :
Today I pray that Sammy is comforted by Your presence and that she can sing your praises for blessings seen and unseen.
Asking the Lord for special favor for you today...that He will perfectly work out your situation for you and help you do what is necessary.
My prayers continue for you.
Posted by sammy (Member # 13952) on :
My IVIG was denied through Medicare. Just got the call. My heart is broken.
Now I have to wait until March to rerun all the labs two weeks in a row to prove that I have CVID and re-appeal to CIGNA.
I was hoping to get back on IVIG sooner because I'm scheduled for major back surgery on April 8th (posterior spinal fusion T3- L2) and i'll need my immune system functioning as best as it can.
I just feel so sick
Posted by Sammi (Member # 110) on :
Oh no sammy! I am so very sorry. Did they give you a reason?
I am completely shocked and so upset. I wish there was something I could do to help.
Can your immunologist do anything?
It may help to write a letter to the CEO of CIGNA. Explain this treatment has been deemed medically necessary by your doctor. Let them know that you got pneumonia as a result of not getting the IVIG and that these type of infections are common for people with CVID (especially untreated). Hospitalization costs for infections will add up to much more than the infusions.
Please know that we are all praying so hard for you.
Posted by momindeep (Member # 7618) on :
aoh no! I will ask the LORD to show His glory by working this out for you! I will bombard the throne for you.
Posted by lax mom (Member # 38743) on :
sammy: You have to go through the appeal process through Medicare. It doesn't take months either.
It's much easier to get approval through appeal with Medicare than regular insurance.
Most people don't ever even try to appeal. This is how I got my Valtrex covered.
Sammy -I just don't know what to say. This is nuts. Perhaps do try to appeal with Medicare?
I feel certain that in March your bloodwork will prove you need IVIG. You sure you have to wait until March? What if your levels proved your case now?
Will continue to pray for you.
Posted by Dekrator48 (Member # 18239) on :
Praying that God will intervene to strengthen you, get your IVIG approved, and restore your health.
Big hugs, dear sammy!!!
Posted by gagamooppop (Member # 34314) on :
Really sorry to hear Sammy...you are in my thoughts and hopefully something will come through...you are a very strong person and have gone through a lot.
I really hope the ivig pulls through...
Posted by momindeep (Member # 7618) on :
Prayers continue and praying that you can trust the Lord.
Posted by momindeep (Member # 7618) on :
Still praying and hoping positive news comes to you soon.
Posted by Rumigirl (Member # 15091) on :
OMG!!! I just saw this (I've been off LN for a long time until now). I've been wondering how you were and meant to email you.
This is beyond belief!!! They are denying the absolute diagnosis that you have and ramifications of not getting the IVIG.
Please, please, make a strongly worded written complaint to your state AG"s office, making sure that you stress that this if life-threatening (or whatever words you want to use---it's an emergency) and that you need their help immediately.
You can start the complaint process verbally on the phone, and follow up with written statements from yourself and your immunologist (ask his office for a copy of whatever he has already sent the insurance co).
This is your best bet right now. I did it, and it is the only reason I got my IVIG denial overturned in a matter of days. My insurance co had without warning revoked an authorization already given for IVIG and my port care!! And I was not allowed to do the port care myself---so it was life=threatening.
I got NOWHERE with the insurance co repeatedly. They'd be very happy if I kicked the bucket! But the state AG's office got on their case immediately, because it was an emergency, and my insurance co reversed the denial! And I've had no trouble ever since on this matter.
Don't delay on this, in spite of how horrible you feel.
Pneumonia??!! Good God, this is terrible! Please, just start with a call to the AG's.
PS It seems to me that this belongs in Medical Questions, except that you are asking for prayers, so . . .
[ 02-21-2013, 09:48 AM: Message edited by: Rumigirl ]
Posted by momindeep (Member # 7618) on :
Hoping to hear from you soon and wondering how you are getting along. Still keeping you in my thoughts and prayers.
Posted by Sammi (Member # 110) on :
Me too!
Posted by Dekrator48 (Member # 18239) on :
Praying for you, sammy.
Hope you are able to give us some good news soon.
Posted by sammy (Member # 13952) on :
*Update 2/21*
Hi friends,
I haven't been here much lately because I've been feeling worse. I ended up developing some cellulitis in my feet. I'm in extreme pain and can hardly walk.
It started out as severe swelling in my feet and legs and just got worse. I've also had fevers all week.
So I really need to get back on my IVIG...
Next week I will finally be able to get the specialty labs for my immunologist. I have to go through the full diagnostic testing again to prove that I have CVID to my ins co (so I will have tests next week and the first week of March).
My doctor is allowing me to do the tests back to back because he is certain of my diagnosis, otherwise I would have to wait a month for that second week's test.
After we get all the test results my doctor will try to appeal again.
In the mean time my home infusion nurse has decided to try to help by coming out every week to show that I am home bound and document how sick I am without the IVIG. She thinks that this will help.
Right now I am trying to take everything one day at a time. Trying to hang on.
This has been a very difficult month for me. I greatly appreciate all of your continued prayers, encouraging thoughts, and any advice.
Thank you.
Posted by Sammi (Member # 110) on :
sammy, thanks for the update. I am so upset this has happened to you, but I am glad the ball is starting to get rolling.
So many people are on your side! If only the insurance company was. Your infusion nurse sounds very nice.
Taking things one day at a time is the best. We are all still praying for you. I hope your next IVIG is really soon.
Hang in there okay?
Posted by lpkayak (Member # 5230) on :
sammy-i think of you a lot even tho i havent been writing much. i hate what is going on and cant think of anything to suggest or do for you. it sounds like some things are moving forward and you have a few importatnt people fighting for you. i hope it gets resolved as quick as it can so you can get your meds.
Posted by Lymetoo (Member # 743) on :
I think that WILL help with your home health nurse! That was good of her to suggest it!
Does the testing make you feel ill?? I HOPE NOT!!
Posted by Dekrator48 (Member # 18239) on :
Good to hear from you, sammy.
I think that will also be helpful for the home health nurse to document your home bound status and increasing illness.
I was a home health nurse for 10 years. Proving home bound status is one of the most important things between the nursing agency and the insurance company. Documenting a steady decline in your health will be helpful too. She should be as detailed as possible...she probably already knows that.
I'm glad you can get your labs done soon.
I will continue to pray that this all works out for you very soon and your health improves greatly.
Hugs!!
Posted by AuntyLynn (Member # 35938) on :
Praying for your miracle Sammy.
Posted by Rumigirl (Member # 15091) on :
Sammy, this is terrible!
I know that it is an extreme burden for you to do this, but I can't emphasize enough how important it is that you make an emergency complaint with your state AG's office in their Health Bureau.
Don't depend just on the tests alone. This insurance company (and Medicare!) has not shown that they are on the right side of the fence.
So let the State AG's office be your lawyer to make them do what they should!
When my insurance co dumped me from IVIG, and even withdrew their existing authorization---all without notice---they also dumped EVERY patient on IVIG,
according to my dr. MS patients, etc., etc. He said that hardly anyone got back on, except me. The ONLY reason that I got it back was that I was willing to "take it to the mat" with the State AG"s office. And now they've given me no trouble ever since. Pretty much no one else was willing to fight it the way I did.
So the squeaky wheel gets the grease! But you have to do the thing that stands the best chance of forcing them to do what they should---and this is it from my hard won experience.
Posted by AuntyLynn (Member # 35938) on :
Sammy -
I know this is a fight over IVIG, but for what it's worth ... lymedisease dot org's advice on fighting (IDSA based) Insurance denials.
Sammy, prayers continue for you.
Posted by Sammi (Member # 110) on :
Sammy, prayers continue for you.
Posted by momindeep (Member # 7618) on :
Asking the Lord for a resolution for you Sammy and that the plan will be exactly what you need and in the meantime that He will be close to you, reassuring you that it will be okay.
Praying for you daily.
Posted by sammy (Member # 13952) on :
Thank you for your continued prayers friends. Today is a very important day, I'm getting my specialty labs drawn at noon to be used for my IVIG appeal.
I am so nervous. I really need them to reflect how I feel, not good at all, so I can finally be approved.
So if you will, please pray for me today and pray specifically for my labs that they will be what we need.
Thank you!
Posted by Sammi (Member # 110) on :
sammy, I am glad you are getting your labs today. I pray that they will reflect how you are feeling and that you will be approved ASAP.
Do you know when you will get the results?
Posted by Dekrator48 (Member # 18239) on :
Praying, sammy!!
Posted by Rumigirl (Member # 15091) on :
Keep us posted!
Posted by susank (Member # 22150) on :
Sammy - still praying for you. Any news?
I think the GAM panel takes just a few day to get results back. The subclasses longer I think. (Because they are sometimes sent to different/ out of state labs and/or just take longer?)
Did your doctor sign for "partial" results to be released? So maybe you could get the GAM results back pretty soon - then wait a few more days for the subclass results?
Posted by momindeep (Member # 7618) on :
Each day I pray for you and bring your case to the Lord...He is faithful.
Posted by Lymetoo (Member # 743) on :
Praying!
Posted by sammy (Member # 13952) on :
Hi friends,
My home infusion nurse called me, we finally got some results back.
All of my immunoglobulin results were low.
My IgA was 9 (normal (81- 463) My IgG was 471 (normal 694- 1618) My IgM was 32 (normal 48- 271)
The IgG level was was I've been most concerned about. I knew that the the others would be low. There is nothing that can be done to treat them.
Now I need to try to relax a little and maybe sleep better now that I know that my results were consistent with what they had been in the past. It's hard to relax when I'm still waiting for important results and have to retest next week.
Then it will all be reviewed by the insurance company again...
Thank you all so much for continuing to pray for me through this long ordeal.
Posted by Sammi (Member # 110) on :
sammy, it sounds like you have a wonderful infusion nurse.
Your results say it all. What other tests is the insurance company wanting you to have done? Do you have to also repeat the ones above?
You are closer to getting your much-needed IVIG. Prayers continue for you!
Posted by Lymetoo (Member # 743) on :
That is "good news"... at least they can't deny that, right??
Posted by Dekrator48 (Member # 18239) on :
Sounds like you are getting closer to resuming your IVIG based on those results.
I will continue to pray for you.
Posted by AuntyLynn (Member # 35938) on :
Praying that you will get everything you need, very soon.
Posted by momindeep (Member # 7618) on :
Sammy...just checking in and letting you know that I am continuing praying for you. Hoping to hear from you soon. Trusting the Lord for a positive outcome for you.
Posted by Sammi (Member # 110) on :
Me too! Hoping for good news soon!
Posted by Rumigirl (Member # 15091) on :
We want good news for you ASAP! Hurry up insurance co!
Posted by sammy (Member # 13952) on :
**Update 3/6/13***
No news yet, we can't appeal to the insurance co until all of my test results are back.
I'm due to have more blood drawn today at noon.
If you will please pray for me, I'm feeling very nauseous and having a hard time drinking anything. I'm looking and feeling dehydrated.
Being dehydrated will negatively impact my labs. I've only got a couple hours to really push some fluids and get my hydration back up close to normal. So please pray that I can get the fluids in and keep them down! (Currently trying Gatorade, may switch things around a bit as I feel the need...)
Thank you all for continuing to encourage me, pray for me and just be here for me during this difficult time. I want to give you a big thanks from the heart.
Posted by Sammi (Member # 110) on :
sammy, keep trying to hydrate. Is there anything you can drink that may also help the nausea? Or can you take something for the nausea so you are able to hydrate more?
Is this the last round of tests you need to have done? I hope so.
Prayers continue. I hope you feel better soon.
Posted by poppy (Member # 5355) on :
If you have an IV line, could you do fluids that way? Lactated ringers or something?
Posted by AuntyLynn (Member # 35938) on :
Green Coconut Water!
Praying for you!
Posted by lax mom (Member # 38743) on :
sammy: why can't you appeal the Medicare denial? That's much easier to get overturned than private insurance.
Posted by susank (Member # 22150) on :
Sammy - praying for you here.
Please keep us posted.
I went five weeks w/o IVIG - and towards the end - boy - I felt it. I can only imagine how you are feeling.
I had my first SubQ GG infusion this afternoon.
It went well. So praying things for you also go well.
Posted by lax mom (Member # 38743) on :
Posted by Dekrator48 (Member # 18239) on :
Praying for you, sammy.
Posted by Rumigirl (Member # 15091) on :
quote:Originally posted by lax mom: sammy: why can't you appeal the Medicare denial? That's much easier to get overturned than private insurance.
Yes, yes, yes! Through your state attorney general's office health bureau. Also, there is your state insurance co. But the AG's office is usually the best.
I can't believe that you still had to do yet more tests?!
I keep praying for good news.
Posted by sammy (Member # 13952) on :
Unfortunately, I was not able to get blood drawn yesterday.
I got sicker and threw up all that I drank that morning. Then I couldn't keep anything down. I also spiked a fever 102. My whole body hurts, my muscles burn, all my joints hurt even where I didn't know I had joints! I have a cough and sore throat too so I'm pretty sure I have the flu.
My nurse said that she is on call on Sat so she will come draw my blood then. I thought that was very nice. Hopefully I will be better then.
Please please pray for me that I will feel better, and that my stomach will start working so that I can tolerate fluids and foods again.
Thanks so much!
Posted by momindeep (Member # 7618) on :
So sorry Sammy. The Lord has your back. Will continue to petion the Lord on your behalf.
Posted by AuntyLynn (Member # 35938) on :
MY BF had Swine Flu 3 years ago. He couldn't even keep down water. I gave him coconut water.
Not coconut milk - coconut WATER found in the juice aisle or in "natural sports drinks"/juices.
He took small sips every so often through the night, and by morning, had consumed nearly a pint of the coconut water (with its natural electrolytes) ... he started asking for toast and tea.
Praying you will get the help you need, and soon!
Posted by Sammi (Member # 110) on :
sammy, I am praying that you feel better soon.
Your nurse sounds very nice and caring. I am glad she is on your side!
Posted by Lymetoo (Member # 743) on :
I am so sorry you are sick!!! GRRR!! Hope it will be short-lived.
Posted by MADDOG (Member # 18) on :
Hang in there Sammy!!!!
MADDOG
Posted by Silverwolf (Member # 9196) on :
<<<<< sammy >>>>>,
We will continue to pray, you've been in our tho'ts.
Hoping you get to feeling better soon,and are able to get all the test results in,to get the help you need.
<<<<< sammy >>>>> extra hugs...it shouldn't have to be this difficult.
love and prayers from Silverwolfi and TxCoord
Posted by Haley (Member # 22008) on :
Praying Sammy.
Posted by momindeep (Member # 7618) on :
Up for sammy. praying daily for you with concern and hopefulness.
Posted by Dekrator48 (Member # 18239) on :
Still praying, sammy!
May God sustain you as only He can. Love and hugs!!
Posted by momindeep (Member # 7618) on :
I was praying for a quick fix for your situation Sammy, but I see that that isn't forthcoming.
Doesn't mean that the Lord isn't faithful or not working for your behalf...He is right there with you through this trial...to help you endure.
So, today I am asking the Lord to hold you up and give you the strength you need to run this race to it's conclusion. His grace is sufficient and I ask Him to handle you gently and to remind you of His promises.
Posted by sammy (Member # 13952) on :
All of these are even a little lower than last week.
I called my doctor's office earlier today to ask about the appeal since I had the second set of labs drawn on Sat. The nurse wasn't very encouraging on the phone. I actually cried as I hung up.
My doctor tried talking them into letting him have another peer to peer review but they are making him do a full paper/letter appeal. The office is trying to make it urgent since I am so sick and need it ASAP but they don't know if it will be expedited.
Please pray that the appeal will be expedited and that they will approve my IVIG this time around.
I need to start on the IVIG soon so that I can have my surgery scheduled in April. This is very important.
Thank you!!!
Posted by lax mom (Member # 38743) on :
sammy: fax the labs to the insurance co appeals office yourself if you have to, with a note explaining the severity of the situation.
While you are at it, fax the same thing to Medicare.
I'm telling you from experience...it is soooo much easier to get an appeal approved from Medicare.
Praying for you sammy.
Posted by daynise (Member # 39609) on :
Praying. So want this to be over for you and for you to feel better...
Posted by Lymetoo (Member # 743) on :
So sorry to hear! Continuing to pray!
Posted by Sammi (Member # 110) on :
I agree with the others about faxing your results. I also suggest contacting the CEO of the insurance company. This worked for me when they were going to discontinue IV therapy.
Is there any way you can go back on the insurance you were on before?
I am praying that you are approved very, very soon!
Posted by susank (Member # 22150) on :
Sammy this is nuts. So sorry.
You very clearly and obviously 1. Have CVID 2. Respond to treatment - ie Gammagard 3. Seriously decline when deprived of it
What possible reason could exist for you to be denied coverage by the insurance company?
Why, in the interum, did you not qualify for the Baxter program to help those in situations like yours?
The peer to peer means your doctor presenting your case to other doctors? How many? Chosen by whom? Paid for by whom?
How could any doctor well versed in immune defiency diseases could go on record supporting your denial?
If this does not get resolved quickly then you need to be contacting some real higher-ups - like your Congressmen. CNN etc.
Remember that IVIG treatment is not unknown to President Obama - in that he enacted measures to cover supplies for Medicare patients so they could afford their IVIG.
Praying for you still.
Posted by Dekrator48 (Member # 18239) on :
Praying fervently for you, sammy!
Posted by MADDOG (Member # 18) on :
Sammy do you have Anthem blue cross? They turn down anything that isn't on the Walmart 4 buck list or free a Meijer.
I will switch back to regular Medicare next year. Then i will also have medicaid to fill in the co pays per Obama care.It begins in 2014 and the Ohio governor excepted the federal plan.Imagin that!!!
So next year I will be in surgery for both shoulders.Getting my hip re-evaulated and mabey a hip replacement finally.
And i will try to get to doc R. in ohio a actual lyme literate doctor,that is 60 miles not 450 miles away.
MADDOG
Posted by momindeep (Member # 7618) on :
Still on deck and praying for you.
Posted by payne (Member # 26248) on :
sammy, for give me in my ignorce of your fight.. As, you struggle with ins. and health, We pray, and Ask The Lord to bend an ear to Your Voice speak to HIM, He is Our Shepherd.. we His Flock... "O God, be merciful to me! For my soul trusts in You; And in the shadow of Your wings I will make my refuge, Until these calamities have pass." Psalm 57:1 Soon, we ask you Oh, Mighty send angels to arrange sammy's needs.. AMen
Posted by Dekrator48 (Member # 18239) on :
Praying, dear sammy!!
Posted by lax mom (Member # 38743) on :
sammy:
Posted by Sammi (Member # 110) on :
Prayers continue!
Posted by susank (Member # 22150) on :
Sammy - are you OK? Worried about you. Can you please check in - even if a brief note?
Praying for you!!!
Posted by nonna05 (Member # 33557) on :
Praying for you,,,,,,,,,,
Posted by momindeep (Member # 7618) on :
I am asking the Lord to end this exhausting ordeal for you today. That it is finished and you can move forward.
Posted by Sammi (Member # 110) on :
sammy, how are you doing? Please let us know when you can.
Prayers continue for you.
Posted by Dekrator48 (Member # 18239) on :
Lord Jesus,
Please hear our cries for help for our dear sammy.
Please rescue her from all the trials that are weighing her down. Provide her with new life... restored health that glorifies your Great Name.
We know that all things are possible through You, Lord.
We put our trust in You.
I pray this in the name of the Father and of the Son and of the Holy Spirit. Amen
Posted by Lymetoo (Member # 743) on :
Amen, amen, amen!
Posted by momindeep (Member # 7618) on :
I am at the throne sammy...and will continue to be so on your behalf. Thank you Lord for the opportunity to pray for sammy. May You reveal Your glory through her trial.
Posted by girl (Member # 18022) on :
Praying. xoxo
Posted by daynise (Member # 39609) on :
Still praying for you Sammy.
Posted by sammy (Member # 13952) on :
Dear friends, thank you, thank you, thank you for continuing to lift me up in prayer.
Your kind words of encouragement and prayers are what's helping me get through these rough days.
I've hesitated to post until now because I felt like I didn't have the words and information to share.
On friday my infusiom co told me that my IVIG was denied. I tried calling the doctor's office but it was too late in the day, no one was able to help me.
Monday I spent 2 hrs on the phone with Cigna. I found out that my most recent appeal had not been denied yet ... BUT ... they were unable to find the letter and the information that my doctor submitted.
I called my doctor's office to tell them what I learned but the nurse was not concerned. She had the attitude that they sent the appeal so their job was done, now all we have to do is wait. But I can't just wait.
Today I tried calling the office manager and ended up leaving a voicemail.
I was feeling upset that here I am suffering, so sick and no one is really helping fight to get me the treatment that I so desperately need.
I tried contacting the Attourney General's office for help, they told me that they do not get involved in personal health insurance problems. They told me to call the Ohio dept of Ins and gave me their phone number.
ODI had me fill out a complaint form explaining what was going on and what I needed their help with. The person I spoke with on the phone was very nice. She said that someone will be assigned to my case, they will look into it and call me tomorrow.
Later in the afternoon I got a call from the doctor's office. The office manager spent over an hour on the phone with Cigna today. She got them to locate the appeal letter and records.
They were supposed to expediite my appeal so (since they lost it for awhile) they will review it within 24-48hrs.
So if you will, please keep praying for me and for those reviewing my appeal. That they will make the best decision for my health. That they will approve my IVIG treatments again.
Thanks so much, sammy
Posted by Dekrator48 (Member # 18239) on :
Dear sammy,
It was good to hear from you.
I am continuing to pray for you and the people reviewing your appeal.
Jesus, I trust in You!
Jeremiah 29:1(NIV)
11 For I know the plans I have for you,'' declares the Lord, ``plans to prosper you and not to harm you, plans to give you hope and a future.
Romans 15:13(NIV)
13 May the God of hope fill you with all joy and peace as you trust in him, so that you may overflow with hope by the power of the Holy Spirit.
Posted by Sammi (Member # 110) on :
sammy, thank you for the update.
It is a crime what you are going through to get your infusions. I am glad you contacted your doctor's office manager since the nurse would not help. Also, if you would not have called a lot more time would have passed with nothing being done!
It is good that the office manager and the person from ODI are working on this. You are in the home-stretch finally!
I continue to pray that this will be approved ASAP.
Posted by lax mom (Member # 38743) on :
Praying sammy!
Posted by momindeep (Member # 7618) on :
Good to hear from you! It will work out for sure. The Lord is on this for you and I will be too.
Posted by sammy (Member # 13952) on :
Please keep praying, no news yet!!!
Posted by momindeep (Member # 7618) on :
Praying for you!
Posted by Lymetoo (Member # 743) on :
Praying that God will save you! I just know He will!!
Posted by Dekrator48 (Member # 18239) on :
Still praying for you, sammy!!
Posted by Sammi (Member # 110) on :
I am still praying also!
Posted by momindeep (Member # 7618) on :
Aww sammy I AM STILL PRAYING FOR YOU. I remain hopeful that the Lord is doing His work for you behind the scenes.
Posted by poppy (Member # 5355) on :
Insurance companies routinely "lose" paperwork to avoid paying for a treatment. Certified or registered mail probably best in this situation.
Posted by momindeep (Member # 7618) on :
Another new day with the Lord's provision and providence for you sammy. Assurance that He is faithful to you and loves you beyond our comprehension. Praying for you and asking Him to hold on to you. He will not forsake you.
Posted by Dekrator48 (Member # 18239) on :
Amen to everything momindeep said!
Praying for you, sammy!!!
Posted by sammy (Member # 13952) on :
Dear friends,
Thank you for sticking with me and praying for me every day. Your encouragement helped so much.
I have sad news to share. I just found out that my insurance co denied my 3rd appeal for the IVIG. My doctor's office had to call to get the decision because neither of us have received a letter yet.
They are half hoping that they letter will say that my IVIG treatments are approved.
They told me I have one more chance, an external review. The office doesn't know how to go through and request this process so the manager is looking into it now.
As you can imagine, I am extremely saddened by all this.
I've gotten so weak and sick being off of the treatment. It is scary to have to face many more weeks to months for another appeal. I'm honestly scared that my body won't make it.
I was supposed to have surgery (spine fusion) in April to fix the problems caused by all the compression fractures in my back. (Now I cannot)
I just learned that my DEXA scan was worse this year than it was last year. It is so severe that I cannot have the surgery. My top doctor has never seen anything like this... (T score -5.1 in the spine!).
I keep trying but honestly I feel like I'm losing the battle.
Posted by sammy (Member # 13952) on :
Also, the Attorney General's office and the Ohio Dept of Ins told me that they cannot help. Can't remember if I told you about them.
My heart is broken right now.
Posted by lax mom (Member # 38743) on :
sammy: please, please appeal with Medicare.
Posted by Sammi (Member # 110) on :
sammy, I am so sorry. I am shocked when your test results show that the infusions are warranted.
Please follow lax mom's suggestion. Also contact the CEO of the insurance company telling him/her that IVIG is deemed medically necessary by your doctor, and end the letter with "Can you help?"
I know it is exhausting dealing with all of this. Is there any way you can go back on the insurance you were on?
I am very sorry about your back surgery being cancelled also. You have been through more than anyone should have to endure.
Big prayers continue for you.
Posted by poppy (Member # 5355) on :
Has anyone done this? If so, please post your experience to help Sammy.
Posted by momindeep (Member # 7618) on :
This is very difficult for you. I won't ask why of the Lord...His answers are not understood often...if He were to even say. But I do know, that while you are being dragged through the mud of this world, He is there with you.
And while you are taking it one minute at a time, I will continue to lay your needs at His feet.o
Posted by daynise (Member # 39609) on :
oh Sammy, I'm so sorry.
Posted by Dekrator48 (Member # 18239) on :
sammy,
I am so sorry to hear this news.
I will never stop praying for you.
Have you been provided with any information that tells you what criteria you must meet for your treatment to be approved?
...And upon what grounds they have based the denial on? (Perhaps this is in the letter, but I doubt it. It may just say that the treatment was denied)
It makes no sense.
I would want to know very specifically what labs, etc did not meet the criteria and caused the decision to deny you treatment.
We know that insurance companies base their decisions on money, and do not have your best interest in mind.
Praying, praying, praying!!!
Posted by lax mom (Member # 38743) on :
With Medicare, was it a Prescription plan denial (Part D) or a Medical denial (Parts A or B)?
Posted by lax mom (Member # 38743) on :
Do you have Original Medicare? or a Medicare Advantage plan?
I have appealed myself and been approved. It's not hard, but if you are sick it's easy to give up and not bother.
We are here for you sammy! You are going to get approved.
Posted by susank (Member # 22150) on :
Sammy - I felt certain you would be approved this week.
IIRC you and I have the same insurance company.
The only difference I see is that I was insured with them when diagnosed.
I don't know where the approvals are made/denied. Locally? Nationally?
My card says send claim forms to Chat. Tenn.
Surely criteria is not different according to regions of the country.
Nor should it be based on the type of plan you have with the company like HMO, PPO etc - should it?
Your GAM levels off IVIG are much like mine - except your IGA levels are lower than mine.
How could the same company approve IVIG for me but deny you?
It would be interesting to have an open look at their "files". There should be no "pick and choose" as to whom to cover and not.
This is the same insurance company that is covering your other medical conditions/meds/surgeries? I assume so.
"Just" not the IVIG.
I also do not understand why Baxter is not helping you in the meantime. What - one has to be pennyless to be accepted in their Gardian program?
If anyone needs IVIG you do.
Do you have a Congressman to contact? One that might not have previously known much about IVIG - but might now know of its importance due the bill that Obama recently signed - Re: IVIG and Medicare.
Still praying for you. Susan
Posted by poppy (Member # 5355) on :
I just remembered that you are probably in a situation with the insurance co as primary and medicare as secondary. That means appealing to medicare is not going to work, I guess.
Could someone check and see if Ohio Congressmen voted "aye" on the bill? If yes, get names and contact numbers? I am having computer problems otherwise I would do the research.
Posted by lax mom (Member # 38743) on :
susank: there are 16 Congressmen in OH.
Posted by susank (Member # 22150) on :
P.Tiberi - R - District 12 M. Fudge - D - District 11
Posted by Rumigirl (Member # 15091) on :
Please, please, sammy, do see about appealing Medicare. You can't give up, no matter how horrible and discouraging this is.
Before you do the external appeal, which you/your dr should DEFINITELY do, write to your insurance company and ask for ALL of the information that was used to come to a denial, including all internal communications. I will look up the wording to use and email it to you. I originally got it from CALDA. I used it and they sent a lot of very revealing information.
That way, you'll have a better idea of how to target the external appeal. The beauty of the external appeal is that it is done by a neutral medical professional outside of your insurance company.
One other thing you should look into is having a lawyer write a letter for you, threatening a law suit from your precipitous decline, due to their repeated denials. Believe me, this can scare the pants off the insurance co, which is what you need! It could be a legal aid lawyer, if need be. Or if you have a friend or relative who is a lawyer.
I know that you are in no shape to do all this, but someone has to do it. Can you get help from your sister? Or a friend? Even a little? Or an agency of some sort, such as a county agency or a state agency that helps people with problems such as this.
Posted by nonna05 (Member # 33557) on :
Sammy, I'm so sorry you have to be pulled down like this.
Has any eating issues gotten better during this time?
Isn't there supposed to be a patient advocate for these problems?
I know a woman who used to be a nurse and just retired from such a position,
She would get in the middle of it all and boy could she put the pressure on.
She had medical and litigation/insurance back ground.. She would fight for patients rights, treatment,etc.
If you went to the ER wouldn't they have to get you sarted ,just to keep you going,,,
Praying for you....Think of you often,
Lord ..Bless Sammy with your favor, break down the walls that are in the way of her geting what she needs to get better,,,,and she'll shout it from the roof tops.
Posted by Dekrator48 (Member # 18239) on :
Still praying, sammy!
Love and hugs to you!!
Posted by sammy (Member # 13952) on :
I've been so sick, I've read your responses but haven't been able to sit up here long enough to reply.
First of all I want to thank you all so much with my whole heart. I'm so grateful for your prayers, encouragement, caring thoughts, and advice.
I do have Medicare parts A, B, D. So far, Medicare has denied our requests for IVIG because they follow suite with the decisions of the primary ins provider. And my primary Cigna continues to deny my appeals with no reason given....
Sad thing is I also have Medicaid right now (as 3rd provider). All this insurance and none of it helps!
Walgreens is trying again to get Medicare and Medicaid to try to cover my treatments together since it looks like Cigna is not going to provide the care that I need. I should hear from them sometime today.
I've also checked into the Baxter/Gammagard program again to see if they could help. They told me that I do not qualify simply because I do have insurance. They will only provide help in the case of a lapse in ins. Mine is a denial but I still have ins coverage.
I've also contacted the IDF (Immune deficiency foundation) advocate to get some help. She gave me some questions to ask the ins co yesterday and wants me to send her info to look over so that she can try to help.
Unfortunately, I could not get what she asked for. I could not get copies of denial letters. I also found out that there were no reasons stated as to why my appeals were denied.
They also cannot find my March appeal. The last appeal that they can find is from Feb.!
I spent about 3hrs on the phone with them yesterday. It's so frustrating trying to get good information from them. I wonder if I called today if I would get different info, if they could find the March appeal? They are that bad.
Please pray because my dad is asking his employer to step in and go above Cigna's decision to have them to approve my IVIG treatment. I hesitate to do this because I fear for my dad's job, I didn't want to bring attention to our medical costs.
But since things have gotten so out of control my dad is insisting that we give them all the information about how Cigna has handled (mishandled) our case.
You are right, we have discussed that we may eventually need a lawyer for the external review. But we have to find out for sure what doctor needs to do the appeal now?!
Thank you so much for your prayers. They are greatly needed and appreciated. I've never felt so bad. I need God to carry me through each day to keep me here.
Posted by lax mom (Member # 38743) on :
I am soooo sorry sammy that you have to go through this insurance mess.
Heck, I would still appeal and appeal and appeal Medicare and Medicaid, in writing because they are bound to reconsider. It never hurts to try.
At one point when I kept getting different answers from the pharmacy and the insurance co (the were both passing the buck), I actually put both of them on a conference call with me...and their stories changed.
I have a feeling that once a lawyer or your dad employer gets involved, things will move quicker.
Don't worry about your dad's employer knowing about this cost. You cannot be the only person on this employer's plan who is sick.
We are all pulling for you sammy and if we could, I'm sure we would try to do the fighting for you
Posted by momindeep (Member # 7618) on :
Sammy, I take you to the Best Place every day. I had to get a lawyer to help me fight our insurance for our daughter a few years back. All the appeals and whatnot did not put a ding in the situation UNTIL I got a lawyer and then bam! Made me angry that it took a lawyer, but it was necessary.
Posted by momindeep (Member # 7618) on :
BTW tell your dad I will be praying for him. I know how it is to have a beloved daughter who is very ill and have every effort for her well being trampled.
Posted by Sammi (Member # 110) on :
sammy have you seen this:
Cigna Medical Coverage Policy, Subject Immune Globulin Intravenous (Human) (IVIG)
I am not an insurance guru, but frrom what I see here it looks like you qualify.
Posted by susank (Member # 22150) on :
Sammy - also - could you contact one of the Reps. mentioned above that could possibly intervene on your behalf with Cigna? They can do these kinds of things I think.
Posted by momindeep (Member # 7618) on :
Praying that you can rest your mind for awhile on the cross today. That you are able to call to mind His redeeming work just for you and that you can rest assured you are the apple of His eye.
Posted by Dekrator48 (Member # 18239) on :
sammy, I am praying for you and your Dad.
Anything is possible with God. Never give up hope.
BTW tell your dad I will be praying for him. I know how it is to have a beloved daughter who is very ill and have every effort for her well being trampled.
- I think about your parents often, sammy. I know they must hurt terribly.
I heard a minister today say that sometimes when we pray we receive His grace, His hope, and His strength and He says, "I love you, my child."
Posted by momindeep (Member # 7618) on :
Praying that through this time of waiting that you are able to lean on the Lord. That you can trust the Potter and know He is using this trial for His glory. That He will sustain you supernaturally.
Asking others to pray with me in corporate prayer so we all can pray together for you.
Posted by Sammi (Member # 110) on :
Still praying sammy.
Posted by Dekrator48 (Member # 18239) on :
Praying for you, sammy and trusting God to take care of you in every way.
Posted by momindeep (Member # 7618) on :
Still praying daily for you ąnd your family.
Posted by susank (Member # 22150) on :
Also still praying. How are you?
Posted by Dekrator48 (Member # 18239) on :
Praying, sammy!!
Posted by momindeep (Member # 7618) on :
Today asking the Father for His providence to interceed on your behalf. Prayerfully asking that it will be well with your soul. My petitions and concerns continue for you aand your family.
Praying that your worry comes to an end and fearfulness is gone from your heart and mind...that you can have the peace that passes understanding infuse your being.
That the Lord will lay His loving touch upon you and that your countenance can be renewed and strong.
He loves you so much sammy...
Posted by Sammi (Member # 110) on :
I am still praying for good news sammy.
Posted by Lymetoo (Member # 743) on :
Lord, we ask you to cover sammy with your Love and your Mercy. Give her strength to go on, to continue her fight. Give her peace and courage.
Posted by Dogsandcats (Member # 28544) on :
Oh Sammy, my heart aches for you. I will be praying for you. I am so proud of you to make all these phone calls and to keep trying. God hears your cries....
Hugs
Posted by Tracy9 (Member # 7521) on :
Sammy, This is horrible. I am so very sorry for what you are going through. Is there any way you can drop the Cigna insurance so that Medicare/Medicaid would pay? This is absolutely outrageous. I know when you are really sick it is so hard to do anything to fight these things; I hope your Dad is helping you.
Praying hard.
Posted by Holly Beth (Member # 39193) on :
prayers sent your way Sammi!
Posted by Rumigirl (Member # 15091) on :
I am sending love and prayers to you, sammy. Justice MUST prevail here.
One word for you now: LAWYER!!!
Posted by momindeep (Member # 7618) on :
I will be praying for you through out the day.
Posted by sammy (Member # 13952) on :
Thank you for thinking of me and continuing to pray for me. You all are true friends!
I'm sorry it's taken me so long to get back here to respond. I was so terribly sick all last week. I could hardly sit up, wasn't able to keep food down, could barely keep gatorade down sometimes...It was not a good situation. And I had the overwhelming need to sleep all the time.
I'm doing a little better now. I've been able to keep down things like white toast and plain noodles with butter, very easily digestible.
Last week we learned that the doctor's office appeal was denied. We resubmitted the appeal on Fri and should hear a decision by the end of this week.
Please pray that this new appeal/request for IVIG gets approved. We've done all they've asked us to do. They keep denying but don't give a reason for denial (I've been told that they should always give a reason so that you can fix/fulfill what is missing that they are requiring.)
Friends, I truly need a miracle. So please pray for a miracle for my IVIG to be covered. All the glory will be to God for providing this for me. Because right now this feels like an impossible task but I know in my heart that nothing is impossible for Him.
Thanks so much, more than words can express...
[ 04-08-2013, 06:21 PM: Message edited by: sammy ]
Posted by lax mom (Member # 38743) on :
Oh sammy. I am so sorry that you are still being denied.
It appears that a lawyer may need to be involved. I know that's easier said than done.
I am praying a strong prayer for God to make a way.
Posted by Sammi (Member # 110) on :
sammy, I have been so worried about you. This is senseless. Your labs justify the IVIG. Don't they have to give you a reason for denying?
My prayers for you continue for strength and IVIG approval.
Posted by Rumigirl (Member # 15091) on :
At this point, I see no reason why the state AG's office would continue to refuse to help you. That is their job! And the same for the state insurance board. But usually the AG's office is more aggressive in these matters.
I think it's true that they are REQUIRED to give you a reason for a denial, so that can be addressed.
What about the external appeal? You should also do that pronto.
Plus, as I said, it looks like you need to hire a lawyer. But first try the AG's office again, and file that external appeal.
This is just insanity.
Love, prayers, and strength to you.
Posted by Dekrator48 (Member # 18239) on :
Praying fervently for the new appeal to be approved.
Praying for a miracle intervention.
Praying for your complete healing.
Praying for you to feel complete trust and peace that God will work this out for the good.
Praying for God to be glorified in this situation.
Praying for the denials to crumble under the powerful and mighty hand of God who wants what is right for you.
Posted by momindeep (Member # 7618) on :
Wow...will put the pedal to the metal in prayer for you. Hang on.
Posted by girl (Member # 18022) on :
Praying you will get it! xo
Posted by momindeep (Member # 7618) on :
Continuing prayers for you sammy...and asking forthe Lord's protection while you wait.
Posted by Lymetoo (Member # 743) on :
This is SO CRIMINAL!!
P R A Y I N G!!!!
Posted by Jane2904 (Member # 15917) on :
Praying that the IVIG gets approved.
Posted by lax mom (Member # 38743) on :
sammy: I don't know where you are finding your strength but I admire you during this battle. You haven't given up and are still making the calls necessary.
I am still praying for you. Restoration is on its way.
I pray that you will get to the point where you won't even need Cigna's approval!
I have seen miracles in my own family...you are no different.
I know God sees your struggle, how you have handled yourself with dignity despite how dirty the insurance co is playing.
He is holding you in the palm of his hand, protecting you and working behind the scenes on your behalf.
Posted by momindeep (Member # 7618) on :
Bringing you to the Lord. Asking Him to stroke your brow and hold your hand. Asking Him to keep you safe and shield you from incompetence. Asking for the best outcome. For Jesus's sake and His glory.
Posted by sammy (Member # 13952) on :
Dear friends, I have GOOD news to share, my appeal for IVIG was finally approved!!!
This was a verbal approval and we were given an authorization # but we cannot start the treatment until the infusion co gets an actual letter from the ins co.
Unfortunately, they did get a letter but it said that my IVIG was denied by the plan... very confusing. So my infusion co is trying to get them to correct the letter since we've been given the verbal approval and auth# for it.
So things are looking up. God has truly provided us a miracle
But things are still messy and I/we could still really use your prayers that this would get worked out in our favor.
Please also pray that the approval will be good at least until Dec 31, 2013. So we won't have to go through this again in just a couple months.
Thank you so much.
Thank you with my whole heart!
You all are true friends
Your encouragement and prayers have helped carry me through these most difficult 3.5 months.
Posted by sammy (Member # 13952) on :
Would you pray for one more thing? I heard that my doctor was going to change my dose from 80g every 4wks to 30g every 4wks.
This is the dose that I started at when I was first diagnosed and it was not adequate. The 80g dose barely kept my IgG trough level in the low normal range. My body needs it and uses it up so fast.
So the 30g dose will not be enough, i will still feel stick and still be at risk of infection.
Please pray that my doctor will be open to going back to my old dose that was working for me. And that my ins will cover it too...
Thank you!!!
Posted by Sammi (Member # 110) on :
sammy, this is GREAT news! Your prayers, and ours, have been answered!
Why does the doctor want to lower your dose? That is a huge decrease. Maybe you can speak to the office manager about this, she seemed helpful before.
I am praying that you will get the dose you need and the infusion ASAP!!
Posted by Lymetoo (Member # 743) on :
PRAISE THE LORD!!!
Did your Dr lower it in order to get approval??
Posted by momindeep (Member # 7618) on :
sammy...will pray this to the final, perfect outcome...this is so encouraging and good...praises for our Father in heaven for keeping you during this adversity.
Posted by Dekrator48 (Member # 18239) on :
God is good!!!
He works out all things for our good!
So happy you got good news!
Posted by lax mom (Member # 38743) on :
Yay sammy!!!!! So happy for your blessing and I will continue praying!!!!
This news and the news of payne getting better made my night!!!
Posted by Rumigirl (Member # 15091) on :
Oh, finally, finally!!! But the confusion with the letter denying it??!! And then your dr wants to drastically lower your dosage?? What the blazes? This MUST get corrected---both the letter and the dosage.
My understanding from another friend who has CVID is that every 3 weeks is the most usual protocol for CVID. Given your tough situation, I wonder why he wants it every 4 weeks.
But at least if he can give you the previous dosage, that would be good. Personally, I think more often would be much better, even if the dosage is lower per time. But I am hardly the dr here! (Wish I could rx it for you; I'd give you the higher dosage and more frequently---ha!).
Prayers for you to get this quickly corrected.
Posted by momindeep (Member # 7618) on :
Asking the Lord to fine tune the details for you sammy. He is working this out for you. Thanking the Lord for His loving care and faithfulness.
Posted by momindeep (Member # 7618) on :
Thinking about you. Praying for you ąnd asking for a superb outcome.
Posted by payne (Member # 26248) on :
prayers joined... Posted by Dekrator48 (Member # 18239) on :
Praying for you, sammy!!
Posted by momindeep (Member # 7618) on :
In prayer for you.
Posted by Dekrator48 (Member # 18239) on :
Praying for God to send all that you need to you, sammy.
Posted by momindeep (Member # 7618) on :
Another day sammy. Iam thankful to the Lord that we can pray to Him without ceasing and He welcomes each and every prayer. I am thankful that He understands our need for prayer and that He encourages us to do so.
So with that in mind I ask the Father to be your present help in this trouble you are experiencing.
Posted by momindeep (Member # 7618) on :
Still thinking on you and praying for things to turn around for you. Hopeful to hear positive news from you soon. Don't give up...will continue praying each day for you.
Posted by Lymetoo (Member # 743) on :
The Lord will bring you through this, sammy!!
Posted by Sammi (Member # 110) on :
Still praying sammy.
Posted by sammy (Member # 13952) on :
Thank you so much for your continued prayers.
I had my first dose of IVIG last week. Unfortunately, I ended up getting the flu a day later. I had fevers for 3 days, was pretty much bed bound. I'm slowly getting better now.
I have an appt with my Immunologist this week. I'm planning on asking him to change my dose at least back to where I was before. I'm currently getting less than half my normal dose every 4 wks.
I am concerned that the dose change maybe was not what my doctor wanted but what the ins co dictated. If this is the case, we need to find out how to appeal/ change the dose because this low dose will not be adequate for me to get better and stay well.
So thank you, thank you for continuing to pray for me. I know God is listening.
Posted by Sammi (Member # 110) on :
sammy, thanks for the update. I am so sorry you have had the flu Getting the flu is even more proof that you need IVIG and that you need the right dose.
I don't know how the insurance company can think that getting half the dose you need is adequate. I pray that you can get the proper dose ASAP and get back on track.
Hang in there okay?
Posted by Rumigirl (Member # 15091) on :
quote:Originally posted by Sammi: sammy, thanks for the update. I am so sorry you have had the flu Getting the flu is even more proof that you need IVIG and that you need the right dose.
I don't know how the insurance company can think that getting half the dose you need is adequate. I pray that you can get the proper dose ASAP and get back on track.
Hang in there okay?
Amen!! Thank God you are getting it again. But 1/2 dose??!! This is just criminal what they are putting you through. Let those insurance scrouges live in your body for a few days, then see what they would say! I wish we could do this. sigh.
Posted by momindeep (Member # 7618) on :
The Lord knows your situation sammy...He is working this out for you. Still praying for you.
Posted by momindeep (Member # 7618) on :
How are you doing sammy? Still praying for you and asking the Lord to give you protection and a great help while you wait for answers.
Posted by Lymetoo (Member # 743) on :
I know you're very ill and weak, but make sure you document how you are feeling each day. Write it down if you get the flu, a cold, etc.
God Bless You!
Posted by momindeep (Member # 7618) on :
Sammy...I pray for you each day. Don't loose hope! The Lord of the universe knows ALL things.
Posted by payne (Member # 26248) on :
sammy I had some extra Prayer Power I wanted to share with you.. look at this as you need to be here on this earth to continue your goodness and thoughts with those in need.. you go girl.. FIGHT, wayne Mighty is OUR LORD
Posted by sammy (Member # 13952) on :
**Update 5/4/13**
Thank you all so much for continuing to stand by me in prayerful support. I am extremely grateful, more than words can say. And I hope you don't get tired of hearing that but it's true. I don't think I could get through this without your encouragement and prayers supporting me.
I am finally getting better from the flu (It might have been a herx?!). That really knocked me down and I couldn't hardly function for quite awhile. So Thank God for pulling me through that.
I also saw my Immunologist last week. Unfortunately, that appt did not go well. Long story short, he does not want to be my doctor any longer. He is also not willing to re-prescribe my normal dose of IVIG, back to where I was (low normal trough range) in Dec before we switched ins co.
He said some very hurtful things during the appointment. Like "you're never going to get well even with IV antibiotics and high dose IVIG". I went into the appt asking for my IVIG dose to be raised back up to normal because I need my immune system supported to get off the IV antibiotics.
So my current dose of IVIG is less than half of what it used to be. I also used to get it every other week and now I get it every 4wks. I know that this dose will not be enough to help prevent or treat all infections. It will help some though so I am grateful to have it.
I have tried to think about what I want and need to do next. I really don't know for sure.
I went ahead and made an appt with another clinical immunologist at Children's Hospital because i've seen her before as a second opinion last year. I did not stay before because she was so busy, I would wait 5+hrs to see her in the clinic, I was just one of many and she didn't remember me from appt to appt.... I guess this is what you get when you see super specialist.
My appt with her is on May 15 so please pray that my new doc will go ahead and resume my previous normal IVIG treatment or come up with a better treatment plan.
Please also pray for me while all of this goes on and I continue to wait. I've really not been doing well. I've been so very sick, I need the higher dose IVIG. My body uses the small amount too quickly.
I do want to add, we have an answer to prayer My dad's company is reviewing how my case was handled (by ins co) and they are allowing any dose of IVIG that the doctor thinks is best. My new doctor just has to prescribe it!
This review may impact the way that our ins co handles future pre-certifications/ prior authorizations too.
So, now that I've overwhelmed you...Sorry! If You'd like, read it bit by bit and pray that way
Thanks so much, you all are true friends!!!
Posted by poppy (Member # 5355) on :
Your former doctor is tired of having to jump thru hoops for you. Doctors do get tired of insurance company demands and it sounds like this one just wants easier patients to deal with. Not your fault.
But this is no excuse to say mean things to sick people. It always surprises me when a medical person just won't tell the truth about the situation and takes the low road instead.
Hope you find someone who will prescribe, now that it may be easier to get this approved.
Posted by Dekrator48 (Member # 18239) on :
Thanks for that update, sammy.
I am also grateful for the good news and praying that your new Dr will have a new plan to prescribe larger doses more frequently.
Please do not dwell on what your old Dr said to you. He obviously does not know what God can do.
Someday when you ARE well, you can look forward to showing him what faith, hope and perseverance looks like.
I am praying for you, dear sammy, and will continue to do so until you are well.
"Our God is greater, Our God is stronger, God you are higher than any other.
Our God is healer, awesome in power, Our God, Our God..."
Just made my day to read your update. Sometimes when I wake up in the wee hours of the morning I feel the Lord prodding me to pray for you.
During my work day the Lord brings you to my mind and helps me pray for you.
I am grateful that you remain stedfast in your faith and hope...it is a priceless gift from your Father in heaven.
So, I, like dekarator, will continue on this path of prayer for you till you are better.
Let us thank Him in advance for the His provision to come...He is so in love with you sammy.
Posted by Lymetoo (Member # 743) on :
quote:Originally posted by sammy:
I do want to add, we have an answer to prayer My dad's company is reviewing how my case was handled (by ins co) and they are allowing any dose of IVIG that the doctor thinks is best. My new doctor just has to prescribe it!
- Well, THAT part is good news!! Do you know of another Dr you could make an appointment with in case this one doesn't go well? Make two appointments!
I will continue to pray for you! We'll get this done!! God is on your side!
Posted by Sammi (Member # 110) on :
sammy, thanks for the update. It is great that your dad's employer is looking into how the insurance company handled your case. I bet this review will help others who are dealing with similar issues.
I am very sorry that your immunologist is so thoughtless and made such inexcusable comments. He should not be a doctor. I think it is likely a blessing in disguise, so you can get treated by a better doctor.
I am praying for you to get the right dose approved at your upcoming appointment and for strength to get through this difficult time. You have dealt with more challenges than anyone should have to and you have endured them with such grace.
Posted by lax mom (Member # 38743) on :
Posted by nonna05 (Member # 33557) on :
Hi there !! Still praying for you.......
I really don't understand how your doctor just basically fired you as his patient..Lord at least give some referrals.
Or>> give you what you're asking for for the 45 days he's supposed to cover your med .needs, until you get to help..
I can say that is one good thing from my Kaiser Ins.episode...
They did miss the boat, but as I was leaving my 3 main doctors gave me scripts for outside their system to last six months..
This was so I had at least the minimum to get by.
I pray you find what and whom you need. Did your LLMD help or try to at all?????
How is your back doing.....
My four walls are still purple..meaning I'm seeing them to much...
Actually got out a couple times ,then pow with pneumonia. Took all of April, but I think I kept the ground I gained from LD treatment.
All that to say or ask how that part is going? Your protocol etc.
You sure have a lot of prayer going for you.
Wouldn't it be great if , like the king in the Bible just finally gave the woman what she wanted ,because she asked Sooooooooo often,
Take care, Nonna Posted by momindeep (Member # 7618) on :
praying for you! Hopeful that you can find goodness in your day today.
Posted by momindeep (Member # 7618) on :
Hi Sammy! Don't know where you live, but hoping springtime is helpful to your mind, soul, and body. Prayerfully talking to the Lord about you. Asking Him to keep you strong, especially deep down in your very heart.
We are standing on the promises of our Father.
Posted by momindeep (Member # 7618) on :
How are you doing, Sammy?
Posted by Dekrator48 (Member # 18239) on :
Praying for you sammy!
Waiting patiently to hear from you again.
Posted by Jane2904 (Member # 15917) on :
Praying for you Sammy!
Posted by sammy (Member # 13952) on :
*Update 5/16/13*
Thank you all for your prayers. God is listening!!!
Yesterday I traveled to see my new immunologist. I'm not well so just getting ready is an exhausting physical challenge for me. Then the car ride... so by the time I got to the hospital I was more than spent.
When I went to check in at the clinic and they couldn't find my appt. I was pretty devastated but sadly not surprised. Part of me was waiting for something to go wrong.
Long story short, eventually the receptionist found out that the scheduler remembered giving me that appt. So I was able to be admitted to see the doctor and I only had to wait a few hours yesterday.
I saw both a fellow and my clinical immunologist. After telling them about all the constant infections that I've suffered through this past winter and spring my doc decided that I needed to get back on a higher dose of IVIG.
Instead of having the treatments every 4 weeks I'll get them every other week. She kept my dose the same. So this should really help because my current dose was not keeping my trough levels within the normal range.
I really need this higher dose to help me fight off opportunistic infections and my chronic infections.
If you will, please continue to pray for me that my new dose will be covered by my ins co without hassle. I need to start ASAP!
Thank you so much!
Posted by Sammi (Member # 110) on :
sammy, I am SO happy your appointment went well! Your immunologist sounds like she is knowledgeable and caring.
I am thrilled that you will have more infusions!
Prayers continue that this will be covered and that you can resume ASAP.
Posted by lax mom (Member # 38743) on :
YAY!!!!! All things are working together for your good!!!! YAHOO!
Still praying for you sammy.
Posted by momindeep (Member # 7618) on :
Yahooooo! Will continue to PRAY! In His time...in His time...His plan for you is perfect.
Posted by momindeep (Member # 7618) on :
Just to let you know that I am still praying for you. Hope things are moving forward positively for you.
Posted by Dekrator48 (Member # 18239) on :
That's great news, sammy!
Continuing to pray for you!
Posted by momindeep (Member # 7618) on :
Each day I pray for you Sammy. I am hoping that you are okay...and wondering how you are. Talking to the Lord about you.
Posted by nonna05 (Member # 33557) on :
PM......am praying
Posted by momindeep (Member # 7618) on :
Still in my prayers every day.
Posted by susank (Member # 22150) on :
Also still praying. How are you? Any updates?
Posted by momindeep (Member # 7618) on :
How's it going for you Sammy?
Posted by momindeep (Member # 7618) on :
I am still praying for you...but wondering how you are? Asking the Lord to help you in all ways...so sorry things are taking so long.
Posted by Rumigirl (Member # 15091) on :
I'm really concerned with no update from sammy, and her situation being so difficult. I emailed her.
Posted by Sammi (Member # 110) on :
Prayers continue for you sammy.
Posted by momindeep (Member # 7618) on :
Rumigirl...can you let us know if you hear from her? Thanks.
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