can anyone tell me the name/s of health insurance companies that
would cover lyme treatment expenses after a diagnosis...
or is this a stupid question ?
or is a western blot test showing some positive bands but considered a negative for lyme not considered a precondition ?
with no insurance at the moment but with the prospects of upcoming expensive treatment I wonder if it is possible to get coverage ?
if anyone has experience with this situation or advice...
I would appreciate the help...
thanks a bunch ! Posted by fighter (Member # 20170) on :
karensky~
welcome!
i asked the same question when i first joined as i was just getting a new job/changing insurance, but i didn't get much of a response.
some said that people do not like to give specific names of insurance plans on this public site
others have said that there are many plans within each company and that makes for lots of variation in coverage.
this very same question bugged me and i still wonder if there's no real answer to it,
but, from what i got out of the people here, seems like there's no cut-n-dry answer.
if anyone else can chime in on this - i,too, am waiting to hear it.
~fighter
Posted by bettyg (Member # 6147) on :
there are so many variables here ...
some, VERY FEW REALLY, accept any insurance!!
i have bcbs in iowa; they will NOT pay anything towards my previous lyme appts., treatments, many various labs done, etc. for a total of $5,000 ouf of pocket i paid 3-4 yrs. ago now.
again, i pay $700/month bcbs ... they don't pay on lyme but pay otherwise their fair share.
lyme treatments are considered "experimental treatments" and EXCLUDED.
you might post in seeking dr. .. show the state you'd like to go to and ask them if any llmds accept insurance & which ones?
then ask folks to PM you this info please!! ***********************************************
go to bottom left corner and mark box to receive all replies.
that's my best advise.
are you on medicare or medicaid?
Posted by sutherngrl (Member # 16270) on :
I have insurance through my husbands work. Its a big company, so the insurance is decent. So far my insurance has paid 60% of the cost to see my LLMD. Since he is out of state and out of network it only pays 60%. I only go every 2 months so that helps. It has paid for practically all of my labwork.
I have had insurance from 2 different major insurance companies(BCBS and United Health)because where my husband works changed companies. They have both paid about the same.
I have been lucky. I know a good many people pay out of pocket for a huge part of their care.
I think in general if you have an individual plan, not through a large corporation, you won't have as good a coverage even though you will pay more for the insurance.
Posted by Karensky (Member # 21350) on :
I expected to hear sthg like what you all are saying...
I am self-employed (but not working @ the moment due to these nasty spirochettes!) ...my husband is retired,on medicare ...I don't qualify, agewise for that yet...hhmmmmm ...I will post on Doc's then and see ...
no one has yet responded to one of my thoughts in my original post...which was...
.since the CDC guidelines consider my blood results as negative for lyme...then...I do not have a pre-existing condition...correct ?! Anyone have any experiences with that scenario I wonder ?!
thanks a bunch again for all your help...you guys/gals have really been so very much a BIG help to me as I am on this lyme learning curve ! Posted by just don (Member # 1129) on :
That IS an interesting concept and sounds as if you should have merit to that idea.
Unfortunately me thinks insurance companies have double standards as to what they want to see and hear.
Its just like the concept of we SHOULD be all cured after 6 weeks or so of abx,,,so then we dont have it. Just TRY to apply for insurance and you MUST disclose all previous boo-boos and get ONE to accept you,,,they all run like crazy.
I always thought it was because lyme is a four letter word!!!
That isnt exactly what you were asking,,but in the same line!!
Apply to several and SEE what happens. I THINK you should be able to make a case for your way of thinking!! Depends on how much info is available to them online. Not sure about that!!
Good luck and hope things improve,coverage wise. MIGHT you apply to your states pool of uninsureables?? Here I think they call that chips,,,hard to say what they call it there!!
Let us KNOW how it all shakes out for you,,,inquiring minds NEED some of this info to see where we are headed also.
Posted by bettyg (Member # 6147) on :
karen,
copy this and start a post in MEDICAL to address this ok!
subject: do i have a pre-existing condition if i don't meet CDC guidelines for blood testing?
since the CDC guidelines consider my blood results as negative for lyme...then...I do not have a pre-existing condition...correct ?!
go to lower left hand corner and mark box to receive all replies.
my NON-MEDICAL OPINION IS YES...IT'S NOT PRE-EXISTING since it does NOT meet cdc standards!
Posted by luvs2ride (Member # 8090) on :
Karen
I assume you have no insurance at present and that you will have to buy an individual policy. Right?
Each state has its own rules because, believe it or not, the government already controls insurance heavily and insurance companies cannot change anything, not even price, without submitting a request to the state insurance commissioners office.
As for pre-existing condition, I can't think you would be pre-existing since in the eyes of the CDC, you do not have lyme disease.
All my treatment is covered, but I had insurance when I got sick and my doctor and I do not have to talk about lyme (for which I am not CDC positive) because I have continual positive tests for babesia, mycoplasma, chlamydia p, etc.
My insurance company covers everything conventional except the co-pay which is $10 on meds ($30 on the expensive stuff) and $15 on the doctor visits.
You might call your insurance commissioners office and ask if they have any information about what is considered pre-existing condition and do they have any group plans you might qualify for.
The republicans are trying to include a clause in the healthcare bill that would allow indivduals, especially small businesses, to group together with others like themselves all across the country to be able to take advantage of group insurance rates. This would be an excellent thing for all of us small business owners who aren't big enough to qualify as for group insurance on our own.
Posted by TF (Member # 14183) on :
Karen, I just want to let you know that it is virtually impossible to find a lyme doctor who will take Medicare.
I have been trying to find such a doc for a friend. We have quite a few lyme doctors in my area, but none will take her due to her Medicare coverage.
Based on not being able to find one for her, I have decided that when I am old enough for Medicare, I will NOT take Medicare Part B (which covers doctors). If I did and if I got lyme disease again, I would not have any doctor to treat me.
Just wanted to forewarn you about what happens if you take Medicare Part B and have lyme disease.
Posted by bettyg (Member # 6147) on :
tf,
i'll start a post on this in seeking drs.
LLMDS ACCEPTING MEDICARE ARE LOCATED IN THESE STATES!!
iowa new york maryland .... 2 or 3 michigan penn
sorry, but my PM is down; i can't get into or SEND PMS!!
but post in seeking dr. forum showing you'd like a medicare and show the name of the STATE llmd ok ************************************************
Posted by MADDOG (Member # 18) on :
Exactly,if lyme is cureable with 6 weeks abx then if you have had 6 weeks abx they can't turn you down.
That is just my opinion .
Sarcasim this is!!!
MADDOG
Posted by LymeLearned (Member # 20565) on :
FUNNY how NO test counts if your're already insured, and ALL tests count if they want to exclude you.
Contacting Ins. Commissioner seems a wise idea.
WE SO NEED HeathCare REform!
Posted by Karensky (Member # 21350) on :
maybe it would be cheaper just to pay...even if I can find insurance they will most likely raise the rates once the claims pour in or add a waiver...my experience with past insurance and why I don't have any now ! though...from all the nightmare stories I have heard this can get really expensive right ?!
THANKS ALL...I will follow up on your suggestions...you are all so helpful...
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