It has been about 1 yr since I last posted my interesting story about an neurologist who had the correct testing to prove on several DX's that I was in GREAT need of IVIG, and due to the fact that they did not seem to like what my insurance company was willing to pay regarding this type of treatment, decided not to pursue the treatment---even though the insurance company had approved the DX, and had approved TX( this is NOT a LLMD, but is well known to be lyme friendly, and has written about the subject matter)I happen to consider them a true **DUCK**.

I happened to find this out though my case manager. It is a very long story--so the above is just the icing on the cake!!

Since then, both my ID doctor and Immunilogist(yes, the the ID doc is an LLMD, and immuno doc is very, very lyme friendily)
started me on the treatment protocal---which I must say, has been of great help to me( I have posted about this on prior topic matters)

But once again, I have run into a very strange problem here......and feel that I must thread lightly............

My insurance company case manages all chronic illnesses that use IVIG as part of it's treatment protocals, since it is such an expensive blood product and has many precautions---I tend to agree with that...being from a pharmacy background(Pharm D)

This is very helpful to my insurance cap--or life-time maximium, since they are able to get the product directily from Bayer, and the insurance co. is not paying for the middle-man pharmacy, or doctors' in-house infusion centre.

It is safe to recieve IVIG at home, with a RN present, if you are basicly healthy

Here's the problem that I fought last yr--seems that I am going to have to prepare to fight this one every yr

My husbands employer changes insurance just about every yr----and this yr, it just happens to be much better coverage(lucky)

So the insurance rep in my doctors office sees the changes in my policy---and tries to send the prescription out to a local infusion company---who charges about 7-8 times what Great West/United Healthcare( and others) is charged by a nationally known and respected vender

You can imagine who recieves the **spare change**

Before I go any further, I need to let it be known that the doctors involved are great joes, and I am 100% behind docs making a great living----they spend many yrs in training, and basicly work their lives away.

But I have to admit.....the managed care company does a much better job of cordinating my treatment than the local infusion company, or the in-house infusion centre at the doctors office

Nurses are better trained( though I much like the nurse at the doctors office also), pharmacists are more helpful, and I like the product that they use much better than what I have recieved locally.

Plus--even though my DX is one that is a well known disease state---it is known that doctors who use alot of IVIG on large percentages of their patient population are watched by the insurance companies----because of cost concerns, and so forth.

So, my great concern lies in the fact of----I need this IVIG, and was not walking very well a year ago when they started me on the treatment protocal--and I am walking and running at 100% today because of this treatment( No amount of ABX over a 7 yr time helped before this--and I mean none!!)

I don't need my doctor to become non-complinate with my insurance company!! And Jeporidize my treatment!!!

I don't **think** it would be too smart on either side.....mine or the doctors', to not want to work with the insurance company.

I am at a loss as to how to approach this---since I went in to the doctors' office just last yr with all the information regarding this, in hand, and they were willing to let me be case managed then. Why the change?

I have seen doctors here( ALL types of doctors, not just certain specialists) in the Houston area be removed from being a provider on certain insurance plans for not wanting to work within the insurance companies case management

By the way--the plan still pays the doctor very well for just prescriping the TX--so I cannot imagine wanting to tempt fate on this one----since it involves such an expensive medical product

Any ideas, thoughts, life experinces to share--anyone ever ran into this with the IV ABX??

I never worked in home health-care, or even retail faculities for that matter--I worked for a research lab for over 20 yrs( short hosptial stint early on in career--like 200 yrs ago)---so this is pretty much, as they say, "Greek to Me""

HELP!!