I'm looking at having a PICC put in within a couple weeks.
My insurance plan allows 28 days of IV therapy.
After the 28 days, I need to have seen a board certified neurologist or ID doctor that agrees that I need to continue in order to try to get the ins. to pay past 28 days.
My question is have many of you had luck doing this, or do most just end up having to self pay?
I don't know of any LL neuros or ID doctors in the area..not to say there aren't any, but my LLMD didn't have any good suggestions.
Any input would be appreciated.. the IV stuff is new to me and I'm scared and overwhelmed as it is..
Thanks.
Posted by Lymetoo (Member # 743) on :
Get it lined up WAY ahead of time, because ONE MONTH will do virtually nothing for you.
I hope someone has some names for you. I'll check my list later... off for a nap!
Posted by poppy (Member # 5355) on :
Contact support groups in your state and ask them.
Posted by Dogsandcats (Member # 28544) on :
I found out that the health care place that sent out the meds and the nurse had a special way of coding the meds that got it thru....
You might ask different places if they know a way around it. They wouldn't tell me how, just did it.
Posted by sammy (Member # 13952) on :
Contact Infuserve America. They offer the best out of pocket prices and they will help you come up with a treatment plan that will be affordable.
Like orals, some IV antibiotics are far cheaper and some are more expensive than others. The pharmacists and staff at Infuserve truly care about you as an individual and are willing to work with you to help you get what you need.
You do have to pay up front with Infuserve but they have an insurance/billing specialist that will submit all your forms for reimbursement for you. Sometimes your insurance will pay for part of your infusion supplies and even your medicine when billed separately this way on your medical policy. Because Infuserve's prices are lower you can get a good amount of money back if your insurance is willing to reimburse.
Unfortunately, you will not know if your insurance will pay unless you submit the forms and try. They will not tell you upfront. Sometimes they reimburse me, most of the time they don't.
I'm grateful that Infuserve does the work for me because I'm not well enough to take on the extra burden to have to submit the paperwork myself. The reimbursements help when I do get them.
One more thought, when I switched from the home health infusion company to Infuserve I learned that my out of pocket cost through Infuserve was LOWER than my copay through the home health infusion company. Crazy right, it's true. That's how much they jack up the prices.
Another option you may have is to make arrangements with a local home health infusion company. See if they will give you a low out of pocket price if you continue to use their company after your insurance stops paying. Other's here on LN have had luck with this. I have not. You can do a search and see what they recommend.
Posted by Rumigirl (Member # 15091) on :
Since you are in CT, you should definitely try to find such a neuro of ID dr well ahead of time. Definitely speak to people in your local Lyme support group. Look on Lymenet, there is a place to check out your local online support groups by state.
Also, post under Seeking a Doctor for a CT neuro or ID dr who will do this.
PM me, I do have the name of a sort of LL neuro, but I would have to give you heads up @ this dr. He's not a slam dunk.
Posted by skies (Member # 28064) on :
Thanks for the input.
I will def. go with Infuserve after the 28 days is up. In the meantime, I'll have to try and find a LL neuro or ID doctor that will actually help me. I'm too tired to deal with the run around and the extra expense of seeing someone that's not LL and/or will not do anything to help me with this. I already see an excellent LLMD, so all I really need is the 2nd opinion to extend the IV coverage.
I did email a lady from a CT support group, maybe she has some ideas.
Any additional input from others is appreciated. Thanks again.
Posted by dmc (Member # 5102) on :
there are 2 IDs on the CT list. will send my list to you
Posted by skies (Member # 28064) on :
Thanks to everyone for the input.
Anyone else care to chime in? Did you have luck getting coverage past the 28 days or did you self pay?
Posted by outerspace1226 (Member # 34274) on :
Yes, there's people on here who's insurance covers years of IV. But if you know they are already taking that stance of 28 days, you'll be hard pressed to change their mind.