Both myself and my boyfriend have long-term Lyme and multiple co-infections. We're trying to negotiate new insurance and our COBRA months are running out soon. We have two possible options, HealthPartners or a high-risk-pool option through Medica. Do any of you have experience with either of these specific plans, particularly as far as how they deal with covering (or denying) longer treatment of oral and IV antibiotics for neuro-Lyme & co-infection tx? Does anyone know if either of these companies has clear policies/patterns dealing with other lyme treatment?
Of course, one or both of us may be denied, so it may not even be up to us which we have... but we're hoping to figure out what to try for first.
If anyone has experience with any of these specific plans, we'd love to hear it, either here or privately. My email is [email protected]
Thanks much, and greetings to all, flossie
Posts: 773 | From yahoo.com | Registered: Dec 2002
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
- Much can depend on the state or region you are in as, even for the same company, they may cover things differently from region to region.
You might also check with those in the area support groups:
I wondered how you guys were doing. I don't know if you remember me, I'm the one that lives in Washington County, MN. I live a couple of miles from Lake Elmo Park Reserve.
Where are you living? Are you back in MN?
We have HealthPartners insurance and had great coverage when the kids were on IV antibiotics. I do know every policy is different.
-------------------- Peggy
~ ~ Hope is a powerful medicine. ~ ~ Posts: 2775 | From MN | Registered: Apr 2001
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posted
I just started with Health Net added to my Medicare. They are the only ones we found who would pay for the costly Bicillin shots.
-------------------- DOCTOR: "I don't think you are sick." PATIENT: "We are all entitled to our opinions. I don't think you are a doctor." Posts: 697 | From Northern California | Registered: Jul 2009
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Rumigirl
Frequent Contributor (1K+ posts)
Member # 15091
posted
Keebler is right, that each state is different. In addition, each policy within a particular state and particular company is different as to what they will cover and not.
But companies also have published policies on Lyme Disease coverage (at least Oxford does on it's website). Do a lot of research; this is a big deal, unfortuately.
Posts: 3792 | From around | Registered: Mar 2008
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yeah, we've checked local support groups and for official policies on both options, not much info at all...
on paper, without taking the specific foibles of Lyme coverage into account, it's easy to compare. but what we don't know is whether those particular companies/policies will pull out that classic "standard of care" or "investigative" denial after one month of IV. as to which exact plans -- it would be the Medica high risk pool as administered in Minnesota, and HealthPartners Empower... anyone with specific experience with those, we'd love to hear.
pab -- HI!!! of course i remember you. good to hear about your experience with HelathPartners... but what i really want to know is how are your boys doing?! we're sort of back in MN... email me...
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