I had not read Aetna's Lyme page for a year maybe two years. I gave a copy of Aetna's 'NO coverage and wrong information', to my LLMD-Dr C. He wanted a copy and to write them because nothing was being covered-- (I was denied ANY coverage related to lyme).
Yesterday, I pull up the Aetna site and they have changed for the better. YES, there is some wrong info, but some of the changes are in our favor!!
Hopefully anyway, lets see if they really do what they say.
NOTE: Aetna even gave Lymenet.org as a place for Lyme Disease help...see below.
"Other Places To Get Help Online Resources LymeNet (Lyme Disease Network) Web Address: http://www.lymenet.org
This Web site contains general information about the diagnosis, symptoms, and treatment of Lyme disease. It has an online discussion group, photos of ticks, and links to other Internet information sources."
I am submitting my IV request again, because now they agree IV treatment necessary and they also say it is better for those that have 'CHRONIC LYME'!!
I have not read thru everything yet, so those that have Aetna check out the website again!
Good luck, I will let you know if they OK the IV treatment. Michele
PS. Did a little research and found the following... who changed the Lyme information and the date it was last changed;
Lyme Disease Credits Author Amy Fackler, MA Author Debby Golonka, MPH Author Sydney Youngerman-Cole, RN, BSN, RNC Editor Susan Van Houten, RN, BSN, MBA Associate Editor Pat Truman Primary Medical Reviewer Adam Husney, MD - Family Medicine Specialist Medical Reviewer Christine Hahn, MD - Epidemiology Last Updated September 18, 2006 ------------------------------------------end.
[ 06. March 2007, 11:09 PM: Message edited by: foggedup ]
Posted by foggedup (Member # 7415) on :
No One with Aetna??
Posted by wiserforit (Member # 9732) on :
I've got Aetna! Thank you for the information!
When I got IV Rocephin, I was on the evil Oxford plan; yet, I had 11 specialists write in to Oxford to say I needed coverage. I got 8 weeks covered. Then I took out a $10,000 loan to cover more. *OUCH*
Aetna is also covering my SPECT scan at Columbia Presbyterian. We'll see how much of the neuro-cog testing will be covered.
Thanks for the website info; I'm checking it out to see whether NY is better!
Best,
wiserforit
Posted by foggedup (Member # 7415) on :
Interesting.
I am in the process of getting my IV coverage OK'd. I hope they don't say "4-6 weeks and you will be cured, enjoy the rest of your life"!
I have 1 share left in my stocks, I have sold it all (except for that 1) for my health care. I don't want to sell the last one. Silly, but at least I have some stock. haha. so sad...
Hope to start on the IV's soon. foggedup
Posted by Lymetoo (Member # 743) on :
I have Aetna and have never had a problem.
Posted by foggedup (Member # 7415) on :
lymetoo,
I have Aetna PPO, and they will not pay for anything pertaining to Lyme. Aetna calls Dr. C, alternative and experimental--Therefore NO blood work, no office visits etc...
Dr C has had his office call Aetna, resubmit claim after claim and they deny all.
They have paid for prescriptions, but denied IV.
I will be seeing Dr. C. soon, so with these few changes, maybe they will pay.
wish me luck!! Foggedup
Posted by wiserforit (Member # 9732) on :
OMG! I just looked up Aetna's NY policy for Lyme and they quote Wormser's 2003 article throughout as rationale for denying longterm treatment!
If I ever need to go back on IV, I'll have a heck of a time, thanks to Wormser. i am seronegative on ELISAs, which Wormser has now etched in stone as being an essential aspect for diagnosis. What's worse is that 'Aetna just reviewed and approved this policy in 6/06!
I channel my disease to his bloodstream....ticks...ticks.. ticks... I summon you to find the Worm-man...go to him....
Posted by Lymetoo (Member # 743) on :
I never had IV....was afraid Aetna PPO would decide to NOT COVER all prescriptions for Lyme.
Posted by foggedup (Member # 7415) on :
This is from my Texas Aetna site. I have just completed my letter to Aetna, so I should hear something by next week. Hopefuly they will cover more than 10 days or 3 weeks. Foggedup
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