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Insurance choice?


mom md

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We just had our IVIG denied by BCBS(said it was experimental). They had paid for PEX and two IVIGs already which is strange. I think they finally connected the dots. We are waiting for the appeal.

I realized today I can change to Cigna at work? I have a call into the liasion between my hospital I work for and Cigna but wondered if anyone had any input. PANDAS is on the approved list for plasmaphoresis but not IVIG.

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We just had our IVIG denied by BCBS(said it was experimental). They had paid for PEX and two IVIGs already which is strange. I think they finally connected the dots. We are waiting for the appeal.

I realized today I can change to Cigna at work? I have a call into the liasion between my hospital I work for and Cigna but wondered if anyone had any input. PANDAS is on the approved list for plasmaphoresis but not IVIG.

We are VERY happy with Cigna so far. But I do think depends on each indidual employer what kind of benefits you get. PM me if you want more info.

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This just shows the discrepancy between insurance plans. I talked to my hospital's Cigna representative and she said they cover medical but my hospital has a contract with Walgreens for drugs and I would need to ask these questions to the pharmacy benefits manager at the hospital. She did say Cigna would cover the facility fee, etc as long as I used my hospital. The pharmacy manager said the hospital is huge and self-insured so it buys its ivig in such bulk that it would be 100% COVERED WITH NO LIFETIME MAX! Unbelievavble. I can't switch uneil January 1 but believe me I will be switching. In the meantime I will just battle BCBS. Makes you think PANDAS parents should just go get a job doing something in a hospital. This reminds me of when I trained at Wake Forest/Bowman Gray. Employees of the hospital had the hospital insurance and IVF was covered 100% as many times as you wanted to do it. I actually had a patient who started working for environmental services and cleaning rooms to get it.

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WE have BCBS and use walgreens for the IVs we have a dx for PID so we are covered for monthly infussions

 

Melanie

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