posted
Relatively recently diagnosed with Lyme and coinfections via Western Blot (CDC criteria) and my differential symptoms.
Been suffering with major musculo-skeletal and neurologic symptoms for 4+ years and lesser symtoms for a good number of years before that.
Any advice on how to get the best coverage from my HMO (if any is possible)??
My Primary Care Physician did not perceive Lyme as an issue (negative ELISA) and I was finally diagnosed by a LLMD. So given that this was not a referral but I now have a diagnosis how do I proceed. Any suggestions from past experience?
Posts: 6 | From California | Registered: Jan 2006
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trails
Frequent Contributor (1K+ posts)
Member # 1620
posted
You might be able to find a sympathetic PCP IN-network. By this I mean, not a LLMD, but someone who is willing to learn and willing to listen.
I know, it is a long shot, but I have found some out there.
Depends on the HMO too...take a look at the recent Kaiser posts.
In some areas that are not endemic, docs can be scared of and curious about Lyme. Some places docs are hostile.
WHere are you?
I would be looking for a new PCP or asking the PCP for referral out to a specialist. Your best bet at getting a sympathetic specialist is either Neurologist. Infectious disease is a BIG OLD NO NO--they have strict guidelines about lyme and do not work with Igenex results.
Some nueros are curious about this disease especially if you bring it up right. I mean, it is hard to let them take their podium when you already know everything they are saying, but let them do it and see if you can make things you want seem like they were originally THEIR idea. ya know? Isnt that ridiculous that we have to do that?
but I found it so helpful.
I would point out the simple resemblence of the Lyme disease spirochete to the syphulis spirochete. Most neuros know about how syph causes great neuro problems. It is well documented.
That would be my advice except also get out of the HMO asap. Hope it helps, Trails
Posts: 1950 | From New Mexico | Registered: Sep 2001
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David95928
Frequent Contributor (1K+ posts)
Member # 3521
posted
Get out of HMO and into a PPO as soon as possible. That will widen your options. My experience has been that a local support group member referred me to a local GP who believes in long-term treatment and who is open to my ideas. He's in my PPO, no problem. With my insurance plan, oral antibiotics seem to stay under their radar. They would not cover Bicillin under the pharmacy plan but did cover it at 80% under major medical. Here in Chico, many docs are relatively informed due to the efforts of a couple of physicians and a pharmacist.
-------------------- Dave Posts: 2034 | From CA | Registered: Jan 2003
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