posted
Health insurance will be changing in January. We had 100% coverage for treatment & diagnostics for Lyme. (Amazing, I know!)
Now members have agreed to Lyme being covered just like everything else - subject to whether or not the dr. is in- or out-of-network.
Husband's present LLMD is Out-of-Network. Come January that means we'll have to pay $2,000 Deductible and 30% cost until we hit the $10,000 Out-of-Pocket Max. We just can't afford it.
Trying to see what other LLMD's may be in the area that may possibly be In-Network.
Also trying to connect with RI Legislature as there is a RI Law specifying that Insurance Co's licensing in RI cannot deny ongoing antibiotic tx & diagnostics for Lyme.
I believe the intent of the Law was to protect RI Lyme patients. Unfortunately, Health Ins. co's have found a work around. They're not denying coverage, just making it so unaffordable we can't get appropriate tx. The Law needs strengthening.
Posts: 2 | From USA | Registered: Sep 2015
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Bartenderbonnie
Frequent Contributor (1K+ posts)
Member # 49177
posted
Sending you a private message, Michcat.
Posts: 2977 | From Florida | Registered: Nov 2016
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Bartenderbonnie
Frequent Contributor (1K+ posts)
Member # 49177
posted
I'm from RI, and what I see the insurance companies do is to eliminate some common Lyme Rx from their formulary or just increase the Rx copay to make it unaffordable. I saw BC/BS of RI drop VSL#3 DP from their supported list of Rx, and triple the co-pay cost for Doxy and Tetracycline mid way thru the coverage year.
I know... we are still better off that most other states when it comes to Lyme treatment coverage.
Posts: 119 | From ground zero | Registered: Mar 2014
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