IVIG treatment on hold because of insurance! What’s wrong with this???

I certainly can understand your irritation with your insurance company. While at my worst, basically for 3 years, I had to wait 7 1/2 months for pre-approval for a power chair. I was even unable to sit in a wheelchair at this time, without a plastic tray to hold me up.
But don’t assume that if you were uninsured you would get IVIG; this is a very pricy treatment, & I know in my area, many hospitals are being forced to not even take patients with Medicaid, even losing money on those with Medicare. Luckily my supplement pays for what Medicare doesn’t. Things are only likely to get worse when the new healthcare plan passes. Some 45% of doctors are talking about getting out of the profession, as they are already losing too much money on Medicaid & Medicare patients. Our local hospital is losing over a million dollars each year, because we have so many here on these programs. I am so sorry you had to go through the holidays in such a bad condition, I hope the new year brings treatment & relief for you…
Pam

This may not work for you, but my doctor just went ahead and started the IVIG and wrote letters on my behalf when the insurance co didn’t want to cover it. He basically said there was a chance that my lungs would stop functioning and I could die. Which _could_ have happened, I guess 🙂

But if you’re looking for an interim solution while you wait, ask your doctor about putting you on prednisone and see how you respond. At least it would be something. In pill form, pred is very very cheap.

I paid a lifetime of taxes into the Medicare system along with millions and millions of other Americans. Now, when I really need my Government-run Healthcare I am apalled at the poor offerings of services and benefits. The Medicare Advantage plan I purchased along with Medicare is inadequate. The Reform Bill wants to cut a half trillion dollars from Medicare Advantage Plans which will further reduce benefits and services.

Socialized Medicine will not work in America. Regulating Insurance Companies and Big Drug Companies is the first step towards affordable Healthcare Premiums and Coverage. Tort Reform and allowing us to buy health insurance across state lines like we can with automobile insurance will lower premiums by creating competition among the insurance companies.

The purchase of drugs from Canada, Mexico and Europe which would be more affordable is not allowed. Not safe the Government says, but of course the FDA could easily check out these foreign Drugs.

Socialized Medicine will cause Insurance Companies to make decisions that a Doctor should make. Allowing pre-existing Conditions can and should be done but without the skyrocketing premiums which will no doubt happen under the HR Bill.

Who is going to stand up to the Insurance Companies and Big Pharma? What happened to all the tax money hard-working Americans paid to the Government? Socialized Medicine will not work in America.

I could go on and on about the Louisiana Purchase, the Cornhusker buyout and other states whose votes were bought with our hard-earned tax money.
I am going to keep the Faith and trust that this very unpopular Reform Bill will not be tolerated by the 70 per cent of the American public who will rebel when this unfair, messy bill that is will be full of nasty surprises and secrets manages to pass.

[QUOTE=KatyK]I paid a lifetime of taxes into the Medicare system along with millions and millions of other Americans. Now, when I really need my Government-run Healthcare I am apalled at the poor offerings of services and benefits. The Medicare Advantage plan I purchased along with Medicare is inadequate. The Reform Bill wants to cut a half trillion dollars from Medicare Advantage Plans which will further reduce benefits and services.

[COLOR=”Navy”]The Medicare Advantage plans are pure gold for whatever physicians’ group or insurance company are pushing them. In the long run, it is no more, and possibly less, expensive to buy one of the original supplement plans. If I had been in one of the medicare advantage plans, I would never have been able to seek out the neuro specialist in Houston.[/COLOR]

Socialized Medicine will not work in America. Regulating Insurance Companies and Big Drug Companies is the first step towards affordable Healthcare Premiums and Coverage. Tort Reform and allowing us to buy health insurance across state lines like we can with automobile insurance will lower premiums by creating competition among the insurance companies.

[COLOR=”Navy”]Socialized medicine, along the lines of that in Canada and England, or a hybrid such as is in place in Germany, would be the [U]only[/U] thing that would truly work here. [/COLOR]

The purchase of drugs from Canada, Mexico and Europe which would be more affordable is not allowed. Not safe the Government says, but of course the FDA could easily check out these foreign Drugs.

[COLOR=”Navy”]The prescription drug plans have pretty much eliminated the need to go to Canada or Mexico to purchase drugs … until, of course, one hits the infamous “donut hole”. And that is, of course, yet another reason to consider a universal health option as meds are covered automatically.[/COLOR]

Socialized Medicine will cause Insurance Companies to make decisions that a Doctor should make.

[COLOR=”Navy”]Medicare advantage plans, whether physician plans or insurance company plans are the ones who[U] now[/U] decide who can have what coverage. [/COLOR]

I could go on and on about the Louisiana Purchase, the Cornhusker buyout and other states whose votes were bought with our hard-earned tax money.
[/QUOTE]

[COLOR=”Navy”]And reading that, I understand where and from whom you are getting your information.

I worked for docs and in hospitals for 35 years. As far back as the 70s it was considered by many many of the docs of my acquaintance that some form of universal health care, be it socialized or hybrid, was an absolute necessity. I know that non-profit hospitals are swimming in pro bono health care … hundreds of millions per year per hospital. Costs have to be made up somewhere. That’s you. That’s me. For profit hospitals are in the same shamefull category as Big Pharma and the insurance companies.

Even the playing field. Put in place standards and regulations and then enforce them.

Then it just may be that our taxes or our health costs will no long go up.

While no one is pleased with the health plan as it seems to be progressing through Congress, it is, at least, a start toward some more fair way of providing the health care that is in place in every other industrialized country on this little planet of ours.

And — bonanza! — it will, at least, gradually do away with that infamous “donut hole”.
[/COLOR]

I’m so sorry you have not started IVIG yet, and I hope when you do, it will make a world of difference for you.
I fought my insurance co for 21 months and filed 2 complaints with my state insurance commission. 2.5 yrs ago I started IVIG and it was worth all the fight, it did make a world of difference for me. Then this year I reached my lifetime max per diganosis for CIDP with my insurance co.

Fortunately I have been able to qualify for medicaid under a program for disabled individuals working part time, and medicaid agreed to pay for IVIG. I wish I could get off it, and not have to deal with such expensive treatment, but I relapse when we have treid to wean me off.

My best advise would be to hang in there and pester you insurance co for answers as often as you have the strength to. Keep notes and dates and names of people you talk to,and make sure you let them know if they are not following through on commitment for an answer to any part of you approval. If they do not give you answers then immediately file a complaint with your state insurance commission.

But with all that said, I hope your IVIg is approved tomorrow!

Erin

Hi Rocky 36 and thank you for your response! The Medicare Advantage I signed up for required a referral and then an authorization by the insurance. Somehow the referral got cancelled and the insurance said they could not authorize a visit to my Neuro (the Doctor who saved my life, wisely used all the resources at his disposal to diagnose me, EMG NVC, extensive blood tests and an expedited nerve and muscle biopsy which was sent to Salt Lake for a second opinion. He quickly got the right diagnosis and the prednisone worked. Had any more time passed I would have been more damaged than I am now. Lucky Me. The Doctor understood.
I called the authorization ins. dept. and explained that I had been seeing my Doctor for a year and a half with a very serious and rare disorder and that he was now in the process of weaning me off the medication. Lo and behold they did the right thing and put me in the computer immediately and said I could keep my appointment with My Doctor and I didn’t have to got to a different Neuro. Another Neuro???
No patient should be put throught hoops like that or even have to ask permission to see the doctor of their choice. I enrolled in another Medicare AD Plan right away. I do not need a referral and can set up an appointment with any specialist I want. This is a PPO and my Neuro is a regular on this plan and he is not an overlfow consultant like he was on the other plan.
This new plan costs a little more in premiums and co-pays and has a donut hole, but I found out the plan I was on will have a donut hole from this year on anyway
I’m baffled and bewildered by insurance terms, coverage, not getting answers from reps because they just don’t know and the sales People I have talked to
have never heard of IVIG or Plasma pheresis should it come to that. I do not trust anything anybody tells me, but I am investigating, studying terms and considersing other plans. I will be stuck with this plan for a year and I hope it works OK
I checked into the AARP supplemental plan and the premiums seemed very expensive and I would have to pay more because of pre-exisitng conditions –
Diabetes and CIDP. Plus the Part D drug coverage is confuisng and carries another premium.
I am stuck witht my new Medicare Ad Plan for one year and in the meantime I can check out other plans and compare what will be best.
As far as Healthcare Reform “The Devil is in the Details”.

Hi Rocky 36

i am still waiting on approval through medicare. my dr is working on it. i had gbs first now cidp i feel like pins and needles from the chin down.this has been going on for 3 years.i am having incontinence issues as well. i am very frustrated.there doesnt seem to be an end in sight. i already have permanent damage to my feet, i am afraid my hands may be permantly damaged as well. I have learned to deal with my feet and use forarm crutches. my doctor says eventually i will be back in a wheelchair(with the gbs i was paralyzed to my eyes and eventually got into a power chair then had achilles tendons released to correct my drop foot of both feet. i wore afos and learned to walk with a walker and the crutches and now a cane around the house.) i still wear an afo on the left because that side is too weak to go without one. the numbness and tingling seem to getting stronger. they are going to do ivig as soon as i get rid of a kidney stone. had lithotrypsy done once for the stone but appearently they just chipped it and now i have to do it all again. i am feeling very anxious and depressed. i want to be better. i feel lucky that i am able to get around, i drive short distances like to work and the Y. and feel lucky that i can work partime they are very understanding about my health issues(i am bipolar as well). i just get so overwhelmed these days. i seem to be more aware of the things i cant do.
i know ivig wont fix me completley but would like to have the opprotunity to see what it can do. jojo

Hi,
In order to get IVIG, my Doctor was forced to write a letter to my insurance company. The letter said that he would not be responsible if I died because of lack of IVIG. He said, that the full responsibility for my death would fall on the insurance company for failing to authorize IVIG in a timely manner. He volunteered to testify for my family when it went to court so they could get maximum in damages.

The letter was a masterpiece! Within a week I had my IVIG for as long as I needed it. Sometimes we need our doctors to step up and advocate for us against insurance companies. It can work.

Sandila 🙂

I would call the number on the back of your card everyday until they are tired of hearing from you. I might do the thing that was suggested about starting ivig before it is approved. If you look into the literature, cidp is one of the only diagnoses that has been approved by the FDA for ivig automatic approval. I am so glad with the healthcare reform and everything that it is. If the govt. ever comes along and says that my three year old cannot have ivig because of the cost, I will carry her cute little self into the floor of the Senate and let them see her not be able to walk. My husband and I have already decided that we will take a trip to Washington DC and we will USE our daughter as an example to help EVERYONE. They can say no to a 50 year old man but I don’t think they will when the see a cute little 3 year old girl with pigtails! Call your insurance.