Your Replies
-
It seems you are reluctant to share your Medicare health plan type here and that limits researching further recommendations. Did you read the CMS link about ‘Accepted Off-label Uses’? Since you already have experience getting off-label use approved for CIDP, you may need to leverage that experience again.
Off-label use of ocrelizumab to treat cidp (off-label because it isn’t yet approved for CIDP by the FDA):
You may also find the following information helpful:
https://www.gbs-cidp.org/support/resources/insurance-information
There is a center of excellence in Kansas City, about 250 miles West of you. Please contact them to see if they take your insurance:
There is also the Neurology Department at Washington University in St Louis:
https://profiles.wustl.edu/en/organisations/department-of-neurology
The link above takes you to a Conduit login. This is part of PlatformQ Health, which hosted the GBS/CIDP Virtual Summits for 2020 & 2021. More here:
PlatformQ Health to Host the GBS|CIDP Foundation’s 2020 Virtual Summit
Medicare covers Rituximab costs under Part B for certain conditions. Following is the latest summary:
https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35026&ver=69
Depending on which Medicare Advantage plan you have, coverage will vary. Here is the Blue Shield California coverage statement:
Billing and Coding is crucial in getting Medicare coverage:
https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56380&ver=43
I had my Rituximab treatment covered under Medicare. My experience with the treatments can be found here:
I wouldn’t get either vaccine. These two vaccines (Shingles and Pneumonia) are known as high risk in bringing on GBS/CIDP/MFS in those who have already had such.
Read about Shingles here: https://forum.gbs-cidp.org/forums/topic/shingles-2
There are many discussions here about the Pneumonia vaccine and adverse reactions. Simply search the forums for “Pneumonia vaccine”.
What are the two insurance plans (details please)?
Here are some links to discussions about insurance. I hope they may provide some insight for you.
Insurance asking for "Medical Necessity" for IVIg treatments
Please post in one these other threads that is the closest to your situation. Your input can help others experiencing a similar dilemma about insurance.
Looks like my anemia has returned. My RBC was 8.0 last month and they gave me 2 pints of blood. I go for blood tests this week and a PET Scan next Monday to help them confirm the Lymphoma. My Hematologist will probably put me back on Rituximab. I’ll update this thread when I learn more.
I have never had mononucleosis but I understand it can trigger GBS in some. Without the tests to confirm GBS (check for elevated protein, EMG, etc.) it could also be Epstein—Barr Virus (EBV). Some symptoms are similar. Here is a CDC overview:
Most presentations are not recorded. Some may be watched on the Foundation Twitter feed. A few more are available on the YouTube feed.
Doctors and hospitals in the Miami area are listed here:
For some alternatives to Prednisone please read the following forum thread:
A rapid onset of CIDP symptoms and worsening conditions are best treated (in my opinion and based on my experiences with the disease) first with 3-4 days of Plasma Exchange, followed by 8-10 days of IVIg or SCIg. Sometimes an immunosuppressant drug may be needed to help the treatment to work.
It should be noted that PE will cancel out IVIg/SCIg and Rituximab. Ig will cancel the effects of PE and seriously reduce the benefit of Rituxan. So the order of treatments would be important for best results.
IVIg never worked for me. I kept getting worse while on it. Then I transferred to a center of excellence where the neurologists had extensive experience with GBS/CIDP. They put me on a combination of Plasma Exchange and Prednisone. Within 2 days I felt improvement.
Unfortunately, Prednisone can have many side effects and I seemed susceptible to most of its side effects. If I had to do this again I would get an alternative to Prednisone, I have since learned there are many.
I dumped the Ropinirole because of its side effects for me. More info about RLS here: