momindeep
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I'm still praying for you.v
Posts: 1512 | From Glenwood City WI | Registered: Jul 2005
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momindeep
Frequent Contributor (1K+ posts)
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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.
Posts: 1512 | From Glenwood City WI | Registered: Jul 2005
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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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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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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
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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
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sammy, how are you doing? Please let us know when you can. Prayers continue for you.
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-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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momindeep
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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
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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...)
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poppy
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Keeping our fingers crossed for you. Great that the Walgreen's pharm is sharp.
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Sammi
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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!
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susank
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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
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-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | 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
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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
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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
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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.
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momindeep
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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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posted
Really sorry to hear Sammy...you are in my thoughts and hopefully something will come through...you are a very strong person and have gone through a lot.
I really hope the ivig pulls through...
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momindeep
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posted
Prayers continue and praying that you can trust the Lord.
Posts: 1512 | From Glenwood City WI | Registered: Jul 2005
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momindeep
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posted
Still praying and hoping positive news comes to you soon.
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Rumigirl
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posted
OMG!!! I just saw this (I've been off LN for a long time until now). I've been wondering how you were and meant to email you.
This is beyond belief!!! They are denying the absolute diagnosis that you have and ramifications of not getting the IVIG.
Please, please, make a strongly worded written complaint to your state AG"s office, making sure that you stress that this if life-threatening (or whatever words you want to use---it's an emergency) and that you need their help immediately.
You can start the complaint process verbally on the phone, and follow up with written statements from yourself and your immunologist (ask his office for a copy of whatever he has already sent the insurance co).
This is your best bet right now. I did it, and it is the only reason I got my IVIG denial overturned in a matter of days. My insurance co had without warning revoked an authorization already given for IVIG and my port care!! And I was not allowed to do the port care myself---so it was life=threatening.
I got NOWHERE with the insurance co repeatedly. They'd be very happy if I kicked the bucket! But the state AG's office got on their case immediately, because it was an emergency, and my insurance co reversed the denial! And I've had no trouble ever since on this matter.
Don't delay on this, in spite of how horrible you feel.
Pneumonia??!! Good God, this is terrible! Please, just start with a call to the AG's.
PS It seems to me that this belongs in Medical Questions, except that you are asking for prayers, so . . .
[ 02-21-2013, 09:48 AM: Message edited by: Rumigirl ]
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momindeep
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posted
Hoping to hear from you soon and wondering how you are getting along. Still keeping you in my thoughts and prayers.
Posts: 1512 | From Glenwood City WI | Registered: Jul 2005
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Sammi
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Dekrator48
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posted
Praying for you, sammy.
Hope you are able to give us some good news soon.
-------------------- 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 2/21*
Hi friends,
I haven't been here much lately because I've been feeling worse. I ended up developing some cellulitis in my feet. I'm in extreme pain and can hardly walk.
It started out as severe swelling in my feet and legs and just got worse. I've also had fevers all week.
So I really need to get back on my IVIG...
Next week I will finally be able to get the specialty labs for my immunologist. I have to go through the full diagnostic testing again to prove that I have CVID to my ins co (so I will have tests next week and the first week of March).
My doctor is allowing me to do the tests back to back because he is certain of my diagnosis, otherwise I would have to wait a month for that second week's test.
After we get all the test results my doctor will try to appeal again.
In the mean time my home infusion nurse has decided to try to help by coming out every week to show that I am home bound and document how sick I am without the IVIG. She thinks that this will help.
Right now I am trying to take everything one day at a time. Trying to hang on.
This has been a very difficult month for me. I greatly appreciate all of your continued prayers, encouraging thoughts, and any advice.
Thank you.
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Sammi
Frequent Contributor (1K+ posts)
Member # 110
posted
sammy, thanks for the update. I am so upset this has happened to you, but I am glad the ball is starting to get rolling.
So many people are on your side! If only the insurance company was. Your infusion nurse sounds very nice.
Taking things one day at a time is the best. We are all still praying for you. I hope your next IVIG is really soon.
Hang in there okay?
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lpkayak
Honored Contributor (10K+ posts)
Member # 5230
posted
sammy-i think of you a lot even tho i havent been writing much. i hate what is going on and cant think of anything to suggest or do for you. it sounds like some things are moving forward and you have a few importatnt people fighting for you. i hope it gets resolved as quick as it can so you can get your meds.
-------------------- Lyme? Its complicated. Educate yourself. Posts: 13712 | From new england | Registered: Feb 2004
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posted
I think that WILL help with your home health nurse! That was good of her to suggest it!
Does the testing make you feel ill?? I HOPE NOT!!
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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Dekrator48
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posted
Good to hear from you, sammy.
I think that will also be helpful for the home health nurse to document your home bound status and increasing illness.
I was a home health nurse for 10 years. Proving home bound status is one of the most important things between the nursing agency and the insurance company. Documenting a steady decline in your health will be helpful too. She should be as detailed as possible...she probably already knows that.
I'm glad you can get your labs done soon.
I will continue to pray that this all works out for you very soon and your health improves greatly.
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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AuntyLynn
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posted
Praying for your miracle Sammy.
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Rumigirl
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Member # 15091
posted
Sammy, this is terrible!
I know that it is an extreme burden for you to do this, but I can't emphasize enough how important it is that you make an emergency complaint with your state AG's office in their Health Bureau.
Don't depend just on the tests alone. This insurance company (and Medicare!) has not shown that they are on the right side of the fence.
So let the State AG's office be your lawyer to make them do what they should!
When my insurance co dumped me from IVIG, and even withdrew their existing authorization---all without notice---they also dumped EVERY patient on IVIG,
according to my dr. MS patients, etc., etc. He said that hardly anyone got back on, except me. The ONLY reason that I got it back was that I was willing to "take it to the mat" with the State AG"s office. And now they've given me no trouble ever since. Pretty much no one else was willing to fight it the way I did.
So the squeaky wheel gets the grease! But you have to do the thing that stands the best chance of forcing them to do what they should---and this is it from my hard won experience.
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AuntyLynn
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Member # 35938
posted
Sammy -
I know this is a fight over IVIG, but for what it's worth ... lymedisease dot org's advice on fighting (IDSA based) Insurance denials.
Rumigirl
Frequent Contributor (1K+ posts)
Member # 15091
posted
up for sammy.
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Sammi
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posted
Sammy, prayers continue for you.
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Sammi
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posted
Sammy, prayers continue for you.
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momindeep
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posted
Asking the Lord for a resolution for you Sammy and that the plan will be exactly what you need and in the meantime that He will be close to you, reassuring you that it will be okay.
Praying for you daily.
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sammy
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Member # 13952
posted
Thank you for your continued prayers friends. Today is a very important day, I'm getting my specialty labs drawn at noon to be used for my IVIG appeal.
I am so nervous. I really need them to reflect how I feel, not good at all, so I can finally be approved.
So if you will, please pray for me today and pray specifically for my labs that they will be what we need.
Thank you!
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Sammi
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posted
sammy, I am glad you are getting your labs today. I pray that they will reflect how you are feeling and that you will be approved ASAP.
Do you know when you will get the results?
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Dekrator48
Frequent Contributor (5K+ posts)
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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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Rumigirl
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posted
Keep us posted!
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susank
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posted
Sammy - still praying for you. Any news?
I think the GAM panel takes just a few day to get results back. The subclasses longer I think. (Because they are sometimes sent to different/ out of state labs and/or just take longer?)
Did your doctor sign for "partial" results to be released? So maybe you could get the GAM results back pretty soon - then wait a few more days for the subclass results?
-------------------- 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
Each day I pray for you and bring your case to the Lord...He is faithful.
Posts: 1512 | From Glenwood City WI | Registered: Jul 2005
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