Looking for insurance advice

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This topic contains 3 replies, has 3 voices, and was last updated by  sophia edward 3 weeks ago.

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  • #116286

    traveling_chica
    Participant

    Hello, I am hoping someone can provide insurance advice. In 2016, I was diagnosed with WBC disorder (D72.9), Polyclonal hypergammaglobulinemia (D89.0), and
    coagulation disorder Hereditary Thrombophilia (D68.59). My doctor applied for IVIG in January 2018, and Aetna approved the request. In July 2018, I was up for reauthorization. Aetna initially denied the request, stating that I did not meet the plan’s guideline criteria due to the diagnosis (the same diagnosis as in January 2018). However, after a written appeal from my doctor, they approved the IVIG the same day. Fast forward to January 2019 when my reauthorization was up again. Aetna denied the request as well as the appeal, again stating that I did not meet the plan’s guideline criteria due to the diagnosis (the same diagnosis as before). I am now pregnant and want to do everything I can to calm my immune system in order to give this baby a fighting chance. Does anyone have any advice about next steps? I would appreciate any input. Thank you!

    #116288

    Jim-LA
    Participant

    Hi Chica, sorry to hear Aetna has denied your IVIg treatments. They are under fire for this already and there are legal proceedings underway against them for it, see the following CNN article:
    https://www.cnn.com/2018/02/11/health/aetna-california-investigation/index.html

    You may find some helpful information in the following thread:
    https://forum.gbs-cidp.org/forums/topic/denieddelayed-ivig

    You can also request help from the GBS/CIDP Foundation here:
    https://www.gbs-cidp.org/support/denied-ivig-treatments

    #116289

    traveling_chica
    Participant

    Hi Jim-LA,

    Thank you so much for your time and for the above information. I had previously read the CNN article about Aetna–it is simply infuriating!! I will check out the other links you provided as well. I really appreciate it!

    All the best to you!

    #116424

    sophia edward
    Participant

    Really feel much sad to hear about you, but dont be sad, must follow the above link, from there you will get much help.

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