posted
I am with Golden Rule from UHC. It sucks. Since I am having so many health problems I worry about the future and certain medical complications which may come up.
I am wondering what the best health care to apply for is. I know they all suck when it comes to Lyme, but I am just going to apply and see if I get accepted anywhere. I cannot put down I have lyme because I havent tested positive for it but I did test positive for Babesia. However, I get mepron for free so I would never need to get medicine for babesia so I am not sure if I should put that down.
I was considering BCBS Blue Preferred. It is 334.00 a month but is really good (100 deductible, 10% copay on everything). It has a section where you can type in your previous providers information and they can see all your medical history. Not sure if I should do that or not.
Do you guys think it's a good or bad idea to try to switch? My insurance pays for all my blood work. I have only 10 copay for my meds so far. I am just trying to think about IV in the future. I am not sure if GoldenRule would even cover a month of IV. If I somehow do get accepted, I don't want to regret it later down the road since GoldenRule has been paying for monthly blood work and meds.
There is stuff I would like to get examined but with the insurance I have it would cost a lot. I am very worried about my heart pain and I am not sure how to go about that.
(Sorry if this sounds confusing)
Posts: 251 | From Baltimore | Registered: Oct 2012
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
- Ask the support groups in YOUR state. Each state has their own insurance commission and the "rules" can differ for the same company from state to state.
It is very rare to find any insurance that will cover IV past 28 days for lyme. Even then, you would have to PROVE lyme with a 3 step sytsem, postive Elisa, postive western blot and maybe also a postive spinal tap (never a good test).
And it would have to be from a very recent bite and be a current acute case. They would want to see the bulls eye rash, too, on your body, not from a past photo (although we all know that few really see any rash or that chronic lyme does exist, they deny all that).
The IDSA does insist on that triple play, so to speak to prove the need for treatment but that treatment would not last longer than a month. We know that is all wrong but you will be hard pressed to find any doctor covered by any insurance who won't follow the IDSA mis-guided guidelines.
Also, not likely to find a ILADS-educated LLMD who is able to be covered by any insurance company. The insurance companies just won't have it.
There may be a rare exception but, as the insurance companies are regulated within each state, and the state in which you live is adamantly opposed to the idea of chronic lyme and the IDSA anti-lyme stalwarts make their position known to the state insurance tycoons, it's certainly somethint to consider.
*** To explore the rare exceptions ****
it is best to talk with those who live in your state. All of the lyme support groups and your state group are the best place to begin.
There are some exceptions so do explore and if you find someone who has had coverage, be sure to find out all their variables regarding diagnosis, coding, etc.
And be certain of the state - even the region - for your insurance coverage when comparing with others' policies.
Mepron?
You may get mepron free now, due to your insurance not covering it. If you change policies, you may no longer be able to get mepron for free if your new insurance would cover it (even if not for you).
Be sure to check out the terms of your donation program. -
[ 05-06-2013, 02:02 PM: Message edited by: Keebler ]
Posts: 48021 | From Tree House | Registered: Jul 2007
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I guess BCBS would not be a good choice.
Posts: 251 | From Baltimore | Registered: Oct 2012
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
- You say: BCBS "has a section where you can type in your previous providers information and they can see all your medical history. Not sure if I should do that or not." (end quote)
Even if you don't supply the detail, they will have it if any regular doctor (especially in any university medical center) has you information, it's likely already in the grand computer system of all time.
No matter what other states you may have resided in, especially now, your medical file is no secret to any insurance companies or to any new doctor you will ever see.
There are no secrets in our medical files when it comes to insurance companies. Just about every "regular" doctor and every specialist is connnected to a computer sytsem. -
Posts: 48021 | From Tree House | Registered: Jul 2007
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
- You say that you are "very worried about my heart pain and I am not sure how to go about that." (end quote)
SEE A DOCTOR about that. Not everything is lyme and, even some things with lyme connections can require other doctors to prevent a bad situation and to give us some specifics.
It seems that you have a LLMD now, be sure they are aware of this. Also realize that pain in the chest - while always important to address with a medical person - may not be from the heart.
Inflammation of all kinds can cause chest pain, too. GI tract irritations, too. DO talk with your current doctor, even you do not have a LLMD, your regular doctor, then, about the chest pain. But you might browse through this set of links first and also get Stephen Sinatra, MDs book(s) and find his website.
A gluten-free and dairy-free (and GMO-free) diet is where I'd suggest starting if that's not already on tract. This is to lower inflammmation.
posted
Not true. My insurance covered me for over a year and the only reason that stopped is that my husband changed jobs and that insurance policy ended.
Now my Part D will cover my IV and so will Tricare when I go on that in a few months.
-------------------- Faithful
Just sharing my experience, I am not a doctor. Posts: 2682 | From Colorado | Registered: Oct 2009
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