posted
so far so good...but it took some work LLMd's office contacted a non profit mediation co that worked btn dr's orders and got insurance approval and waiver...
e.g.- insurance requires 3 days in pateint hospitalization prior to home nursing care and home infusion therapy...got that waived.
I still have to constantly check up on all forms to make sure ins co pays as stated..
posted
Yes..........depending on the insurance ....some policies require that we only use their labs and doctors........so that doesn't covered Bowen or Igenex or Smokey Mountain labs or anything else fancy. At the moment I can have 3 EKG's in my lifetime.......duh.........I have prolaped valves and am hypotensive......and so it goes.
Posts: 575 | From Houston, TX | Registered: Oct 2000
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Linda LD
Frequent Contributor (1K+ posts)
Member # 6663
posted
Tincup,
no problems yet--but we are only taking one abx a month so we can continue to work and so we can stay under the radar of the insurance companies. We just changed insurance but I understand people on BCBS (my insurance before I got layed off last year--is reallly hitting their people hard and fast. If we had more confidence in the insurance we would take more medicine--but we are in diar straits and must keep our jobs or risk losing the house.
L
Posts: 1171 | From Knoxville, TN US | Registered: Dec 2004
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Mowanda
Unregistered
posted
Hi really knew to this so not sure I will be too helpful. We are military which automatically covers everything provided you work within there system. I have a more limited selection of doctors and the procedures they will try. I'm not sure to what extent this will limit me with treatment, I will find out more tommorow as I talk to one doc about finding the best availbe doct to treat. I think with enough justification they will provide and cover for most procedures. The biggest challenge will be to find the right doc willing to try in a time period acceptable for treatment.
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posted
Yes, so far they paid for my daughter's test and antibiotics.
Posts: 441 | From USA | Registered: Jul 2004
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mbroderick
Frequent Contributor (1K+ posts)
Member # 5220
posted
Jordan has been under treatment since January of 2004 and has been on constant oral antibiotics on some sort or another since then. All antibiotics and other Lyme-related prescriptions have been paid for (aside from my copay) through Blue Cross. This may be the only perk of teaching in a public high school!
Marian
[This message has been edited by mbroderick (edited 08 March 2005).]
posted
i have kaiser and they wont even believe i have lyme. let alone pay for any outside tests, doc visits and meds.
Posts: 15 | From ca | Registered: Feb 2005
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posted
I have discovered the hard way that, too often, ...'insurance'.... corpanies are crooks. They don't pay, then the hospitals sic ..'credit agencies'... on you and you are screwed. Hopefully, I will be able to sue, but so far the scumbags apparently think I won't get it together to do so. We'll see. DS Posts: 4567 | From ithaca, NY, usa | Registered: Nov 2000
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posted
Like sunshine24, I too, have HMO Kaiser. They never diagnosis lyme, so never treat. Have had to pay ALL treatments out of pocket. They refuse to consider Igenex's lab results.
Posts: 108 | From CA usa | Registered: Jun 2002
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Michelle M
Frequent Contributor (1K+ posts)
Member # 7200
posted
So far so good. Have only been in treatment for two months. I have Blue Cross PPO and my LLMD is a Blue Cross provider. Also I'm on orals only so far, so haven't heard any flak from Blue Cross. My LLMD does tell me they'll only authorize ONE month of IV treatment so I guess he knows what he's talking about.
Michelle M
Posts: 3193 | From Northern California | Registered: Apr 2005
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posted
No for hubby. He filed so many out of network claims the insurance company gave him his own personal claims processor. He is on the 3rd one now -- one he probably got fired and one was promoted. He also made a friend in the appeals dept. which has been a big help.
We have learned to call any new lab or doctor before tests or appointments and ask for info regarding codes etc. Hubby calls insurance with info and finds out what bottom line cost of test or office visit is beforehand. He sends tons of documentation to his designated claims processor and calls and harasses them if things don't get processed like we think they should be.
Of course the out of pocket costs are prohibitive (mostly paid at 70 % of reasonable and customary). We pretty much gave up on in network doctors although we try to use in network labs and hospitals for tests and procedures.
Most prescription nutritional supplements are not covered and annual prescription cap is $5000 which is not high enough even without IV antibiotics.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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posted
insurance pays about 1/16th of what i put out in cash and i am now broke
Posts: 121 | From Gaithersburg, MD USA | Registered: Apr 2005
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posted
BCBS of South Carolina refuses to pay for PCR because it is "considered investigational"! To me a urine test is "investigational" I went to my llmd, "donated" my blood in November. I am still fighting BCBS of SC to pay the $1200 I am being billed.
NEW question: IF we refuse testing sre we going AMA (against medical advice)??????
Great question! Thanks, Tykee
Posts: 89 | From South Carolina | Registered: Mar 2002
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