sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
Dear friends,
Will you please pray for me? My insurance changed with this new year and I've been struggling to get my IVIG and IV antibiotics authorized through the new company.
It's been very difficult trying to arrange things through my Walgreens Home Infusion co, get what's needed from both of my doctor's offices, and deal with the different departments in the insurance company.
I was supposed to have my IVIG dose on Jan 3, every day that I miss a dose I get sicker. This is my immune system. This is what protects me and helps keep me out of the hospital.
I've missed a whole week of IVIG and I feel like I'm really crashing now.
Please pray that the insurance company will please review the information that my doctor submitted and approve me ASAP. I have a primary immune deficiency, the only treatment available is IVIG for life!
If I miss a whole 2 weeks of treatment that will drop my trough levels and it will take me a very long time to pick back up. Most of all, I feel terrible. How am I supposed to fight off my Lyme and coinfections with such a compromised deficient immune system? I can't do it!
So if you will, please pray for me. I've been calling the insurance company and Walgreens every day, at least once a day.
I'm scared and don't want to end up in the hospital again because I feel my body getting so much weaker.
Thank you friends
[ 05-04-2013, 04:00 PM: Message edited by: sammy ]
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lax mom
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-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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sammy
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Member # 13952
posted
Thank you for praying friends. They still have not approved my IVIG or my IV antibiotics. I called them every day last week and spent several hours on the phone with them trying to find out what was going on, what needed to be done, what the hold up was, how can I get the process expedited....
Friday I was told that my case was complete and now it was ready for review. They were going to send it to the managers to review it as "Urgent". I hope that this is true.
If is is stuck in the regular pool of prior auths then it will take 2wks-30days for a decision!
So I'm still stressed about this. And feeling sicker every day. I get my IVIG every other wk because my body uses it up so fast. My last dose was Dec 20th. I was due for my IVIG on thurs the 3rd.
I'm 10 days late for my treatment and I'm miserable. Every part of my body hurts so bad, I'm so tired I keep falling asleep even though I desperately want to stay awake, I just feel very fluey very terrible.
So if you will, please pray for me that I won't get any sicker and that my ins will approve my IVIG and IV antibiotics early this week.
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Dekrator48
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posted
Praying for you sammy!!!
Trusting that it will all work out.
-------------------- The fibromyalgia I've had for 32 years was an undiagnosed Lyme symptom.
"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". -Jeremiah 29:11 Posts: 6076 | From Pennsylvania, USA | Registered: Nov 2008
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sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
Update
I missed my 2nd scheduled IVIG treatment today. Now I'm 4wks behind in my treatments. I can really feel it. I'm totally drained, weak, lifeless...
I've started running more fevers again. My cough is deep, harsh, and in my chest now. It hurts. I've had more headaches and feel fluey all the time too.
Heard from the Ins company today that they still have not approved my request for IVIG or IV antibiotics. They said that they needed more info for the IVIG and the requested it from my LLMD!?
My LLMD does not treat me for my CVID, my immunologist treats me for my immune deficiency!
Clearly the ins co does not want to pay for the treatments that are necessary and they are trying to drag it out a long as possible.
They don't realize how much it hurts me.
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poppy
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posted
And you told them they contacted the wrong doc? If they can tie it to lyme, they will try to deny. It is the justification that comes from immunologist that needs to be used. Surely this was already done before you ever started it for the first time.
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susank
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posted
Sammy - so sorry this is happening to you.
You have probably poo-poo'ed trying Colostrum.
But I tell you - were I without IVIG I would surely try it.
Please read the following links which made even me re-think Colostrum:
This first one I do not think English is their first language and I do not find the tables to which they refer:
-------------------- Pos.Bb culture 2012 Labcorp - no bands ever Igenex - Neg. 4 times With overall bands: IGM 18,28,41,66 IND: 23-25,34,39 IGG 41,58 IND: 39 Bart H IGG 40 Posts: 1613 | From Texas | Registered: Aug 2009
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Sammi
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posted
sammy, I am so sorry you are dealing with this. I was late on my infusion also because the infusion company stopped doing infusions right before my appointment. I know it is not good to be off schedule. It is terrible you are a month behind.
Can the IDF insurance gurus help at all?
I am praying you are approved ASAP.
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sammy
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posted
Thank you for continuing to pray for me Poppy, Susan, and Sammi.
I feel so sick right now that I'm having a hard time seeing hope. I'm feeling very defeated and depressed.
I can hardly stay awake for more than a few minutes at a time now. My body just shuts down. I can't even stay awake during conversations with family, while watching my favorite TV shows, or while reading my favorite things.
I don't understand why my new insurance won't authorize my IVIG treatments. I got a letter in the mail yesterday saying that they do not have enough proof of medical necessity.
They are requesting more medical proof and have until 3/7/13 to make a final decision on my case! When I read that it broke what little hope I had left and I couldn't stop crying all night. (Walgreens, my immunologist, and LLMD, have sent copies of this information in at their request.)
My diagnosis of CVID is textbook, very low IgG, almost absent IgA, & no response to vaccine challenge. I also have very low NK cells. My body cannot fight infections on it's own. I need IVIG!
I've had the work-up done twice and my diagnosis has been confirmed by one of the most respected immunologists in the country.
I have a follow up with my LLMD on Wed and I'm embarrassed at my current condition. Since I've missed a whole month of IVIG, I've had no chance to see how my new antibiotic combo would work. It's barely keeping me here.
Poppy, I don't know why they want more records from my LLMD to approve my IVIG. I've spoken with the ins co and made it clear the my immunologist prescribes it, not my ID LLMD. They did not seem to care, they still wanted to see more records from him specifically.
Susan, I have taken colostrum and was on it when I was diagnosed. It does not work to support my immune system I am on some other immune supplements that my LLMD recommended for NK cells (Immunotix 3-6).
Sammi, thank you for reminding me of the IDF. I will try to call them on Monday. Hopefully they will be able to help me. They've had plenty of time to review my medical records and they need to go ahead and approve my treatment. It is wrong to keep withholding a necessary lifesaving treatment like IVIG.
It's almost like they want to see how far they can push to make me end up in the hospital or worse.
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Pocono Lyme
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posted
I'm so sorry Sammy. I will pray for you. I would give you my IVIG if it were possible and it's tomorrow.
Maybe try your state's health insurance commission/er? This is a link to a national site. I don't know if it's health or not. http://naic.org/state_web_map.htm
Maybe call an attorney? Not sure if a malpractice attorney would be helpful? Just brain storming here.
-------------------- 2 Corinthians 12:9-11
9 But he said to me, �My grace is sufficient for you, for my power is made perfect in weakness.� Therefore I will boast all the more gladly about my weaknesses, so that Christ�s power may rest on me. Posts: 1445 | From Poconos, PA | Registered: Jul 2004
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susank
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posted
Sammy - do you have any idea what your levels would be now - having missed two infusions?
Below the reference range? Assuming they are - would it be helpful to test to be able to give proof that your levels fall below normal when off IVIG?
I assume at this point they might be that low. Also assuming whatever you are managing to take in the interim are not "artificially" "maintaning" the lab's normal levels.
BTW - is your lab Quest? I just realized that when the IGG and subclasses are run - at least for me - they are tested at a different Quest lab vs when just the GAM panel is run -and tested at local Quest lab. The results of the total IGG have been different. One time the California lab IGG results were 80 units lower. Just watch for this if you use Quest. ie make sure your blood goes to the same lab and is tested the same way.
-------------------- Pos.Bb culture 2012 Labcorp - no bands ever Igenex - Neg. 4 times With overall bands: IGM 18,28,41,66 IND: 23-25,34,39 IGG 41,58 IND: 39 Bart H IGG 40 Posts: 1613 | From Texas | Registered: Aug 2009
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lax mom
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posted
sammy: can you keep going up the ranks in the insurance company until you get someone who will approve you?
There is someone in that building with the authority to approve you. I would threaten a lawsuit, etc, etc.
If it's Medicare, tell them you are going to contact the Center's for Medicare and Medicaid Services, etc.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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beaches
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posted
Like you said, CVID is "textbook."
And that dx has nothing whatsoever to do with LD from an insurance POV.
That CVID dx alone ought to be enough to justify continual tx with IVIG.
As Susan suggests, it would be a good idea to have bloodwork drawn if for anything else, documentation.
And laxmom is correct in that someone in the building has the authority to "approve" you.
IMO phone calls are ineffective. Put everything in writing from now on, as difficult as that is considering your current state.
Do you have someone to help you re: putting things in writing?? If not, perhaps ppl here can help you with that? Is this something you need?
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lyme in Putnam
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Prayers Sammy.
-------------------- He took u to it, He'll you through Posts: 2837 | From NE. | Registered: Apr 2007
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Sammi
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posted
sammy, have you heard anything else? Still praying!
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nonna05
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Sammy , so sorry to see that you are going through this.
You've had more than your share ( there is no Fair to this).
wILL BE PRAYING FOR YOU.. Is your back any better? Posts: 2563 | From Denver,CO | Registered: Aug 2011
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susank
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posted
Sammy - IIRC you contacted someone - Baxter - and were denied?
Were these the programs? Gammassist? GammaGardian?
-------------------- Pos.Bb culture 2012 Labcorp - no bands ever Igenex - Neg. 4 times With overall bands: IGM 18,28,41,66 IND: 23-25,34,39 IGG 41,58 IND: 39 Bart H IGG 40 Posts: 1613 | From Texas | Registered: Aug 2009
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Dekrator48
Frequent Contributor (5K+ posts)
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posted
Praying for you, sammy!!
-------------------- The fibromyalgia I've had for 32 years was an undiagnosed Lyme symptom.
"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". -Jeremiah 29:11 Posts: 6076 | From Pennsylvania, USA | Registered: Nov 2008
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sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
**Update Wed 1/30**
Please keep praying for me. My IVIG request was denied on 1/22, my doctors flooded my ins co with more supporting information and it was denied again on 1/28.
I feel so sick. This is the worst I've ever been. I can barely force myself to get out of bed because I want to so bad. I'm deteriorating fast being off of my IVIG. All of my infection symptoms are getting worse. My antibiotics are not holding.
I just don't understand how they could deny me. They must not have looked at my records.
The next step is for my doctor to request a peer to peer review. Please pray that my IVIG gets approved at this level. It is my last chance.
I tried contacting my state insurance board, they told me that they no longer work with the public with problems like mine. They said that there is some new law that prevents them from helping in situations like this.
I didn't know what else to do so I tried calling my dad's HR to see if they could help. They are assigning an advocate to guide me through the appeal process. So far I haven't heard anything from my advocate... But maybe still she will be helpful in the end.
I feel like I'm losing the battle, no matter how hard I try.
I am so sick and it scares me.
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Pocono Lyme
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posted
Sammy,
I'll continue to keep you in my prayers.
Just a thought but maybe contact the media. I've seen where people get quick results when the public is made aware of such things.
This is criminal!!! Try to not be scared.
``Fear not!'' is the most repeated command in the Bible. In fact, it's been said that there are 365 ``Fear nots'' in the Bible -- one ``Fear not'' for every day of the year! In fact, Lloyd Ogilvie in Facing the Future without Fear said there are 366 ``Fear nots'' in the Bible, one for every day of the year, including Leap Year! God doesn't want us to go a single day without hearing his word of comfort, ``Fear not!''
Actually, there are more than 365 ``Fear nots'' in the Bible! Thank God because we need to be reminded to ``Fear not'' and trust God everyday.
When I am afraid,
I will trust in you.
In God, whose word I praise,
In God I trust; I will not be afraid.
What can mortal man do to me?
(Psalm 56:3-4, repeated in similar words in verses 10-11.)
-------------------- 2 Corinthians 12:9-11
9 But he said to me, �My grace is sufficient for you, for my power is made perfect in weakness.� Therefore I will boast all the more gladly about my weaknesses, so that Christ�s power may rest on me. Posts: 1445 | From Poconos, PA | Registered: Jul 2004
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"I tried contacting my state insurance board, they told me that they no longer work with the public with problems like mine. They said that there is some new law that prevents them from helping in situations like this."
I would also call the media.. I know you don't have the energy for it, but perhaps your family could be interviewed?
and prayers
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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Dekrator48
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posted
Dear sammy,
I agree that you may have to be the "squeaky wheel" in order to get what you need...you know the saying.
I am praying fervently for you, dear.
May you feel God's unending love and grace.
Big hugs to you!!
-------------------- The fibromyalgia I've had for 32 years was an undiagnosed Lyme symptom.
"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". -Jeremiah 29:11 Posts: 6076 | From Pennsylvania, USA | Registered: Nov 2008
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Sammi
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posted
sammy, I am so sorry you are still dealing with this. Have you contacted IDF?
I recommend doing a Google search to get the name and contact information of your insurance company's CEO. Try emailing this person or sending a certified letter describing your need and stating that IVIG is medically necessary. End the correspondence with "Can you help?"
susank
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Member # 22150
posted
Sammy - so sorry.
Is there the remotest chance you could get back on the insurance plan you were on before?
-------------------- Pos.Bb culture 2012 Labcorp - no bands ever Igenex - Neg. 4 times With overall bands: IGM 18,28,41,66 IND: 23-25,34,39 IGG 41,58 IND: 39 Bart H IGG 40 Posts: 1613 | From Texas | Registered: Aug 2009
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momindeep
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posted
I'll pray for you Sammy...and will continue till I hear differently.
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sammy
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posted
**Update 1/31**
My doctor's office was able to get a peer to peer review appt with the medical director for this afternoon.
So if you will, please continue to pray for me, for my doctor, that this situation would work out for the best.
Thank you
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Sammi
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posted
Big prayers continue for you sammy.
I cannot see how they could possibly deny this. I am praying for approval and that you will be able to get your IVIG asap!
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Dekrator48
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posted
Praying sammy!!!!!!
-------------------- The fibromyalgia I've had for 32 years was an undiagnosed Lyme symptom.
"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". -Jeremiah 29:11 Posts: 6076 | From Pennsylvania, USA | Registered: Nov 2008
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momindeep
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Continuing prayer for you.
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posted
Praying
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Sammi
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posted
sammy, one more thing you may try is to contact the manufacturer of the IVIG you need to see if they have an assistance program. Many do. This may allow you to get your infusion while the insurance company is reviewing your case (which they should not need to do because you need it!).
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poppy
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If this peer to peer thing does not work out, and you run out of other options, maybe consider the suggestions in other posts here about contacting the media.
The story that might attract a journalist is that the state has stopped helping people with insurance problems. That is a bigger story, and you are the personal face they could use.
I am a bit worried that the cost of the IVIG to the insurance company might affect what they are charging for the group coverage. This is why having health insurance tied to employment is not a good idea. Maybe the insurance exchanges will make some improvement in that situation eventually.
Don't understand the state insurance people not helping. They have not changed their website info on this subject:
[ 02-02-2013, 02:51 PM: Message edited by: poppy ]
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sammy
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posted
Thank you for all your continued thoughts and prayers.
I know I need to but I haven't been able to bring myself to type the words of this update until now. I haven't been able to stop crying when I think about it then my thoughts and words get all jumbled up.
Sadly, my appeal with the "peer to peer review" was denied. They are saying that I don't have enough medical evidence to prove my diagnosis.
They are not accepting my initial testing done by my immunologist. They wanted him to have repeated the all of the tests one month and then two months later to verify that I truly have the immune deficiency.
My doctor says that this is not the standard way to diagnose because testing once is adequate. He says that a person will not get better, that they will only get worse with further testing. So the insurance company is holding me to extremely high standards.
They told my doctor that we can wait until March and retest everything, if we want to resubmit the appeal.
When I heard that, I lost all composure and broke down. I can't wait until March! I've been off IVIG since Dec 20, I've already missed 3 doses! I'm just feeling to sick...
After much crying (I couldn't stop at that point) and discussing this with my doctor on the phone, he decided that there is no reason to wait until March. All the IVIG should be out of my system by 4 wks so it would be safe to retest by 8wks. So he will let me retest after the second week of Feb.
He did not like the idea of taking my situation to the media and said that he would not support me in it.
So even though I feel so incredibly sick and am struggling, I have to try and hang in there for a few more weeks.
I have talked with my infusion company and my dad's HR and there may be some other options if this doesn't work out. But we have to wait and see what happens with this appeal first and if I could be approved then.
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sammy
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posted
Poppy, I did call that phone number. Maybe the person that I talked with didn't listen to me? I don't know...
Sammi, I also tried calling Baxter to see if there were any programs to help me. They had no advise and no programs for people like me, loyal long-term customers, that are stuck in a temporary bad situation due to ins changes.
I also called IDF. They told me that I was doing all that I could be doing and wanted to know the outcome. Guess I should call them back...
I've been wishing I could go back on my old ins but my family was paying out of pocket (way too much $$$) for it each month. As soon as I was eligible, my dad signed me on to his ins this year. We thought that this was such a blessing but really it has been a nightmare. It has not covered anything for me!
To everyone who has been praying for me and encouraging me during this time, you have been a lifesaver. Thank you so much!
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Sammi
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posted
sammy, this makes me sick to my stomach. I am so sorry. You need your infusions!
It is a shame the IDF cannot help.
I recommend contacting the CEO of the insurance company. I did this once when my insurance company was going to stop coverage of my IV antibiotics. Clearly state your case in writing and be sure to include that the IVIG is deemed medically necessary. You may also want to mention that not getting the infusions may cause you to get much sicker. End the letter with "Can you help?" It is worth a shot.
I am so sorry you are dealing with this. It is unfair, unfair, unfair! I have been praying constantly for you, and I will continue.
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lax mom
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posted
sammy: what about calling a patient advocate agency so they can do the fighting for you?
momindeep
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posted
will continue prayer for you.
Posts: 1512 | From Glenwood City WI | Registered: Jul 2005
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Dekrator48
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posted
sammy,
I'm so sorry that you are going through this.
You said, "My doctor says that this is not the standard way to diagnose because testing once is adequate."
Can you ask your immunologist to point you to that standard in writing?...you know...like the IDSA guidelines are "the standard".
If you can show the insurance company that the accepted standard is the same standard that your immunologist followed, then I think you would have acceptable proof of your medical diagnosis....right?
I am continuing to pray for you, dear sammy.
-------------------- The fibromyalgia I've had for 32 years was an undiagnosed Lyme symptom.
"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". -Jeremiah 29:11 Posts: 6076 | From Pennsylvania, USA | Registered: Nov 2008
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susank
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Member # 22150
posted
Oh Sammy!! So sorry. Do you know all the criteria - exactly - what you need to prove to them that you have CVID and require IVIG?
Before I was approved I had to show subnormal IGG levels ie was tested three times - one time per month.
Also was tested to see if I had sufficient protection against things like Strep - which I did not.
I think some require something like a vaccine challenge?
What all will yours require?
They want you to do a GAM and subclass panel - then wait and do another one?
What lab have you tested through? Quest? Labcorp?
Your levels might be really low now - low enough. Again - I would test now - off the record - where only you know the results - with Privatemdlabs where the GAM test is $60. That is a discounted rate to that online service.
If your levels are as low as I expect they would be by now - if the test through PMDlabs/(they use Labcorp) - then test officially immediately upon getting those results.
That might put you ahead by two weeks.
I don't know the turn-around time for the basic GAM panel - but I do know you could order the test tonight and go to the lab tomorrow. The results are sent to you - accessed by your computer.
------- Your insurance company will be paying for the official testing they require?
And if you get sick enough to be in the hospital -they pay for that also? Don't they realize that is what can easily happen when a CVID person is off IVIG?
Have you had any tests run since your last infusion? A CBC? Abnormal results?
Still praying for you.
-------------------- Pos.Bb culture 2012 Labcorp - no bands ever Igenex - Neg. 4 times With overall bands: IGM 18,28,41,66 IND: 23-25,34,39 IGG 41,58 IND: 39 Bart H IGG 40 Posts: 1613 | From Texas | Registered: Aug 2009
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posted
Just adding my prayers. I am so sorry for what you are going through.
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susank
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posted
Sammy I know we would all donate to help buy some Gammagard for you. But that would go against you - your levels would not be true. Wishing so badly I could help further. Will keep praying.
-------------------- Pos.Bb culture 2012 Labcorp - no bands ever Igenex - Neg. 4 times With overall bands: IGM 18,28,41,66 IND: 23-25,34,39 IGG 41,58 IND: 39 Bart H IGG 40 Posts: 1613 | From Texas | Registered: Aug 2009
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momindeep
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posted
Still praying.
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momindeep
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I'm still praying for you.v
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momindeep
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posted
Today I am praying for you. I will ask the Lord to help you feel not alone and to give you strength to endure.
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Dekrator48
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posted
Praying for you, sammy!!!
I am in agreement with momindeep...praying for you to have strength, hope, peace, comforted and not feel alone.
-------------------- The fibromyalgia I've had for 32 years was an undiagnosed Lyme symptom.
"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". -Jeremiah 29:11 Posts: 6076 | From Pennsylvania, USA | Registered: Nov 2008
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momindeep
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posted
Sammy, today I will ask the Lord to give you peace...not any old peace, but His peace. I will ask for calm for you in the midst of this storm taking place around you right now and that your mind will not be troubled but in realization that the Lord is in control and is indeed listening and acting even though it doesn't appear to be so at this time.
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momindeep
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Member # 7618
posted
His blessings are fresh and new each day and His thoughts of you are like the sand on the seashore. He loves you very much, Sammy and today I pray for you that you can cling to that promise that He will never forsake or leave you.
My prayers continue.
Posts: 1512 | From Glenwood City WI | Registered: Jul 2005
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momindeep
Frequent Contributor (1K+ posts)
Member # 7618
posted
Prayers for you today. The Lord is holding you in the palm of His hand.
Posts: 1512 | From Glenwood City WI | Registered: Jul 2005
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Sammi
Frequent Contributor (1K+ posts)
Member # 110
posted
sammy, how are you doing? Please let us know when you can. Prayers continue for you.
Posts: 4681 | Registered: Oct 2000
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-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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momindeep
Frequent Contributor (1K+ posts)
Member # 7618
posted
Praying for the Lord to keep you sheltered in the midst of your trials...that your faith will be renewed, and that you are able to get answers and help quickly.
Prayer for you continues.
Posts: 1512 | From Glenwood City WI | Registered: Jul 2005
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sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
Thank you friends, I do have a positive update
My Walgreens infusion pharmacist called me to tell me that they think Medicare should cover my IVIG based on my diagnosis. They are going to try to get it authorized now that I have the denial letter from Cigna.
They are hoping to get it approved in writing by the end of this week! So if you will, please continue to pray for me that God will work it out for me to resume my IVIG treatments as soon as possible!
Thanks so much!!!
(I should add that this couldn't come at a better time because I developed pneumonia over the weekend...)
Posts: 5237 | From here | Registered: Nov 2007
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poppy
Frequent Contributor (1K+ posts)
Member # 5355
posted
Keeping our fingers crossed for you. Great that the Walgreen's pharm is sharp.
Posts: 2888 | From USA | Registered: Mar 2004
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Sammi
Frequent Contributor (1K+ posts)
Member # 110
posted
sammy, I am so happy to hear possible good news!
I am very sorry you have pneumonia. Make sure the pharmacist tells Medicare it is a result of not getting your infusions.
Praying hard for good news ASAP!
Posts: 4681 | Registered: Oct 2000
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susank
Frequent Contributor (1K+ posts)
Member # 22150
posted
Sammy - more prayers that all works out with Medicare and you can start treatment soon.
Is your Cigna a PPO - or whatever?
I had thought Cigna was one of the least difficult insurance companies to deal with IVIG-wise.
I have been so worried about you. I thought that something had happened - like pneumonia. Geez. I don't suppose you were told what kind of pneumonia?
Assume you are on treatment for that and it is helping?
-------------------- Pos.Bb culture 2012 Labcorp - no bands ever Igenex - Neg. 4 times With overall bands: IGM 18,28,41,66 IND: 23-25,34,39 IGG 41,58 IND: 39 Bart H IGG 40 Posts: 1613 | From Texas | Registered: Aug 2009
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lax mom
Frequent Contributor (1K+ posts)
Member # 38743
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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Dekrator48
Frequent Contributor (5K+ posts)
Member # 18239
posted
So thankful to hear that Medicare should cover the IVIG!
Continued prayers for your healing.
Hugs!!
-------------------- The fibromyalgia I've had for 32 years was an undiagnosed Lyme symptom.
"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". -Jeremiah 29:11 Posts: 6076 | From Pennsylvania, USA | Registered: Nov 2008
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momindeep
Frequent Contributor (1K+ posts)
Member # 7618
posted
Good news...sorry about you getting sick, tho. I will pray that the Lord will use that to your advantage...if anyone can use illness to your advantage it will be Him.
Praising the Lord for His help in your troubles...and thanking Him for His continued support of your life. He is in charge, indeed, and He will not fail you.
Posts: 1512 | From Glenwood City WI | Registered: Jul 2005
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momindeep
Frequent Contributor (1K+ posts)
Member # 7618
posted
Today I pray that Sammy is comforted by Your presence and that she can sing your praises for blessings seen and unseen.
Asking the Lord for special favor for you today...that He will perfectly work out your situation for you and help you do what is necessary.
My prayers continue for you.
Posts: 1512 | From Glenwood City WI | Registered: Jul 2005
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sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
My IVIG was denied through Medicare. Just got the call. My heart is broken.
Now I have to wait until March to rerun all the labs two weeks in a row to prove that I have CVID and re-appeal to CIGNA.
I was hoping to get back on IVIG sooner because I'm scheduled for major back surgery on April 8th (posterior spinal fusion T3- L2) and i'll need my immune system functioning as best as it can.
I just feel so sick
Posts: 5237 | From here | Registered: Nov 2007
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Sammi
Frequent Contributor (1K+ posts)
Member # 110
posted
Oh no sammy! I am so very sorry. Did they give you a reason?
I am completely shocked and so upset. I wish there was something I could do to help.
Can your immunologist do anything?
It may help to write a letter to the CEO of CIGNA. Explain this treatment has been deemed medically necessary by your doctor. Let them know that you got pneumonia as a result of not getting the IVIG and that these type of infections are common for people with CVID (especially untreated). Hospitalization costs for infections will add up to much more than the infusions.
Please know that we are all praying so hard for you.
Posts: 4681 | Registered: Oct 2000
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momindeep
Frequent Contributor (1K+ posts)
Member # 7618
posted
aoh no! I will ask the LORD to show His glory by working this out for you! I will bombard the throne for you.
Posts: 1512 | From Glenwood City WI | Registered: Jul 2005
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lax mom
Frequent Contributor (1K+ posts)
Member # 38743
posted
sammy: You have to go through the appeal process through Medicare. It doesn't take months either.
It's much easier to get approval through appeal with Medicare than regular insurance.
Most people don't ever even try to appeal. This is how I got my Valtrex covered.
susank
Frequent Contributor (1K+ posts)
Member # 22150
posted
Sammy -I just don't know what to say. This is nuts. Perhaps do try to appeal with Medicare?
I feel certain that in March your bloodwork will prove you need IVIG. You sure you have to wait until March? What if your levels proved your case now?
Will continue to pray for you.
-------------------- Pos.Bb culture 2012 Labcorp - no bands ever Igenex - Neg. 4 times With overall bands: IGM 18,28,41,66 IND: 23-25,34,39 IGG 41,58 IND: 39 Bart H IGG 40 Posts: 1613 | From Texas | Registered: Aug 2009
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Dekrator48
Frequent Contributor (5K+ posts)
Member # 18239
posted
Praying that God will intervene to strengthen you, get your IVIG approved, and restore your health.
Big hugs, dear sammy!!!
-------------------- The fibromyalgia I've had for 32 years was an undiagnosed Lyme symptom.
"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". -Jeremiah 29:11 Posts: 6076 | From Pennsylvania, USA | Registered: Nov 2008
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