I am newly diagnosed 6 months with lyme. Already my ppo insurance is refusing to fill some of my lyme doctors prescriptions and refusing to reimburse me at all for lab work. I know this is a problem for lyme patients. Any tips are greatly appreciated. I have lost my job and dependent on COBRA benefits at the present time.
Posted by Lymetoo (Member # 743) on :
I just kept after them. Get your doctor to do whatever he can when it comes to appeals.
It took 9 months of hounding my insurance before they would pay for my Igenex test.... but they paid!
Posted by Keebler (Member # 12673) on :
- Much depends on your insurance company. You might check with all those in your area lyme support groups who may have the same insurance company as you to see how they might have fared and if there are any coding or other specifics that might help when you submit the bills.
Kaiser is likely the worst regarding any kinds of lyme treatment or coverage.
Also as the billing person at your doctors' office if there is anything to do differently that might help move this along. -
Posted by Keebler (Member # 12673) on :
Topic: Why (Most) (real) Lyme Doctors Don't Take Insurance -
Posted by Rumigirl (Member # 15091) on :
You have to be really, really persistent. Also, it helps to research exactly what is needed, on the web, on your insurance company's policies, state policies, info from other patients, etc. There is information here on Lymenet, probably in a "sticky" on top of Medical.
But you can also do a search.
Also, on the meds issue, find research articles about the med and the infection being treated (or other issue), look onine for the Clinical Policy Bulletins of your insurance company under the med/diagnosis/issue at hand. You can figure out ways to fight this.
I've also often made complaints to the state Attorney General's office---and had to be persistent with that.
Keep good notes on who you speak to on what date, what they said, etc. with insurance & state AG's.