posted
Hi, What treatment options has anyone tried when there insurance co. won't pay for IV antibiotics and unfortunately I have chronic lyme. So I have many nero issues and I don't know if regular antibiotic pills will correct any of my problems. Thanks for you help.
Posts: 90 | From NC USA | Registered: May 2002
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Michelle M
Frequent Contributor (1K+ posts)
Member # 7200
posted
Hello lrtbc. Do you have an LLMD? Even for chronic cases, there are lots of antibiotics that cross the blood-brain barrier and can be of great help in neuro lyme. What have you tried already?
My insurance would only cover 30 days of IV, though my LLMD wished for much longer.
Sometimes insurance will cover Bicillin or other intramuscular injection type therapy as it's less expensive than IV.
Lots of lymies have recovered using only orals.
More details??
Michelle
Posts: 3193 | From Northern California | Registered: Apr 2005
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posted
Heres a tidbit of info. Get them to write a prescription. Different insurance for IV meds when they come from the pharamcy. My guess is that if you can get them to give you a script for Rocephin, your insurance will cover the vials when you pick them up at the pharmacy.
Now comes the issue, how do you reconstitute the powder. That's tricky, so maybe someone can follow up from here.
Posts: 559 | From Cary, NC | Registered: May 2006
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posted
yes, I do have a lmd. Went to an apppointment on Friday and that is when they told me that me insurance would maybe cover a 30 day iv and that would be it. I am wandering what if any oral antibiotics would help with my nero conditions. I have had this for 15 years. Posts: 90 | From NC USA | Registered: May 2002
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posted
My daughter is on IV. She was on Rochephin for 2 months, Claforan for one, then after a 6 month break was back on IV zithro for 2 months and now is on IV doxy with 90 days approved.
Our doctor told us it is a month to month approval. Even if your insurance usually only approves 2 weeks or 30 days, if it is working they may approve a bit longer. Dr. J says he asks for 90 days initially and it often is approved. It was with the doxy.
I am just saying that while companies have policies they are not always written in stone.My daughter had an abnormal SPECT and 14 months on orals that were not working before we even tried getting IV approved. We were told that part of the approval process is getting a case built for why IV is needed.
I would try the 30 days if you can get that. If you do better, they may approve a bit more. Sometimes you can get it from the company or I understand there are organizations that can help with powdered forms that you can mix. We donated weeks worth of IV meds to someone in need when my daughter was switched to another abx. I hope someone was able to use it.
Good Luck. My daughter has been ill for 12 years and the IV Rocephin was the first thing to really make a difference. She would have stayed on it had she not had gallbladder problems.
Posts: 55 | From USA | Registered: Sep 2005
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posted
Two ideas: Can you appeal to the insurance co? They may consider an individual appeal. There is a thread or article here on how to do that, I don't know exactly where to find it.
If you have it administered at the hospital as an outpatient, will that work? It can be done that way with Medicare.
Best wishes, Hopeful4
Posts: 873 | From WA | Registered: Dec 2005
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posted
I echo that. Rocephin is a godsent. Stay on that until it quits working. The key is to stay on any med that continues to work. And if beta lactam meds work, then don't change until your symptoms dissapear. At that point then you should target those bugs that are intracellular, and don't forget to treat the co-infections.
I agree with the previous post. Get as much documentation as possible, a SPECT, or a PET. I personally recommend a PET scan, as it is a big bonus in terms of being able to quantify problems in the CNS, wheras a SPECT can only qualify problems.
Also, if you get a PET scan from an independent hospital, as I did, and the report says that your test is compatable with CNS Lyme, many times you can write yourself a ticket for at least 2 months IV therapy, my company has already paid for nearly 4 months IV therapy. Then again, I'm also responding.
Are you seeing Dr. J in Charlotte, NC?
Posts: 559 | From Cary, NC | Registered: May 2006
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