Which Insurance covers IVIG?

[NVAmom]

Hi All, ds12 and dd8 had follow up with Dr L today. Both have had significant setbacks since our last visit. She said they both need IVIG - 1/month for 6 months. Insurance does not cover Dr L nor ds12's zith.... let alone IVIG. My husband is up for a change in insurance in June and wondering who covers IVIG. Also curious to help in appealing to our current insurance company. Thank you!!!

[ShaesMom]

We have BCBS and they have paid for all of dd's IVIg's for the last two years BUT she has also been dx'd with an Immune Deficiency Disease.

[peglem]

Immune deficiency here, too. United Health Care has paid for 15 or so- I've lost count.

[lmkmip67]

United Healthcare here, too. Easy peasy.

[NVAmom]

Thanks for the info!!!

[TexasDad]

Aetna covered ours. I have the dx code, if needed. United Healthcare is very good about covering it, I hear. BCBS is mixed.

[monarchcat]

Cigna covered our IVIGs based on a diagnosis of immune deficiency. They clearly state that they do not cover for PANDAS because it is "experimental."

[NancyD]

Harvard Pilgrim Healthcare covers for immune deficiency and PANDAS. They also cover plasmapheresis.

[airial95]

United Healthcare here, too. Easy peasy.

 

 

Was it for PANDAS or for Immune Deficiency in your case? Our company just switched to UHC, and I remember from previous posts that they were one of the better ones at getting it covered. We're not there yet...but it's a constant discussion with my husband!

 

Thanks

[lmkmip67]

United Healthcare here, too. Easy peasy.

 

 

Was it for PANDAS or for Immune Deficiency in your case? Our company just switched to UHC, and I remember from previous posts that they were one of the better ones at getting it covered. We're not there yet...but it's a constant discussion with my husband!

 

Thanks

 

To be honest, I am not sure. I didn't ask. They just told me at Dr. B's office that it was covered. But they did say that UHC is one of the easy ones to work with.

[dabel]

United Health Care covers for PANDAS. It is listed under miscellaneous use in their coverage guidelines. They paid for ours with no problems.

[GraceUnderPressure]

Those of you with United Healthcare - did you get a single dose infusion or Dr K's 2-day HD infusion? Did you need to get approval for the 2-day HD or get any kind of flack from them for it?

 

After all the experiences that I have read on this forum, esp since my ds is 18, I am inclined to push for Dr K's, but I don't know if or how hard I will have to fight for it.

[peglem]

Those of you with United Healthcare - did you get a single dose infusion or Dr K's 2-day HD infusion? Did you need to get approval for the 2-day HD or get any kind of flack from them for it?

 

After all the experiences that I have read on this forum, esp since my ds is 18, I am inclined to push for Dr K's, but I don't know if or how hard I will have to fight for it.

 

For us, the pre-approval was all handled by the doctor's office and there was no hassle at all. I'm not sure how it was coded for insurance, but I know that the paperwork for admitting (we have it done at the outpatient unit of a children's hospital) said PANDAS for the dx.

[EAMom]

Those of you with United Healthcare - did you get a single dose infusion or Dr K's 2-day HD infusion? Did you need to get approval for the 2-day HD or get any kind of flack from them for it?

 

After all the experiences that I have read on this forum, esp since my ds is 18, I am inclined to push for Dr K's, but I don't know if or how hard I will have to fight for it.

 

We have UHC (no immune def.)...it covered HD IVIG (2gm/kg over 2 days) done locally (in network) on 2 separate occasions. The first time we didn't code for PANDAS ...not sure if we coded for PANDAS the 2nd time but I think we did.

 

Note: There is a parent on FB who had UHC decline coverage for IVIG b/c titers were not high (no "proof" of strep caused PANDAS?). This person was trying to get IVIG done with Dr. K. She is going to try again with an in network local doc. My dh (Buster) thinks that is why UHC didn't want to cover her(out of network non-local doc). ....which is actually kind of funny, b/c Dr. K. charges far less than our local hospital in N. Ca so you would think UHC wouldn't mind covering as long as the price is reasonable!