IVIG INSURANCE Coverage ..any success?

[Burnell]

We are looking into IVIG insurance coverage with united healthcare (UHC), but It does not go effective until january 1st. I have Highmark Blue Sheild now. They only said they would cover the administration.

I know the IVIG will cost $10,000 each. I have read that UHC covers IVIG for PANDAS. We are trying to get pre-approvals from Highmark and UHC now, but it goes slow.

So anyone have any success stories of having IVIG covered with insurance?

[cab40]

We are looking into IVIG insurance coverage with united healthcare (UHC), but It does not go effective until january 1st. I have Highmark Blue Sheild now. They only said they would cover the administration.

I know the IVIG will cost $10,000 each. I have read that UHC covers IVIG for PANDAS. We are trying to get pre-approvals from Highmark and UHC now, but it goes slow.

So anyone have any success stories of having IVIG covered with insurance?

[cab40]

Anyone know about Coram Labs where they are?

Edited March 23, 2012 by cab40

[Christianmom]

Anyone know about Coram Labs where they are - states, for IVIG (Arizona) Thanks....Exp w/ Coram??

Here is a map of the Coram locations:

http://www.coramhc.com/Map/

[tpotter]

We are looking into IVIG insurance coverage with united healthcare (UHC), but It does not go effective until january 1st. I have Highmark Blue Sheild now. They only said they would cover the administration.

I know the IVIG will cost $10,000 each. I have read that UHC covers IVIG for PANDAS. We are trying to get pre-approvals from Highmark and UHC now, but it goes slow.

So anyone have any success stories of having IVIG covered with insurance?

 

It depends on the diagnosis and code used. Do you have an immunological dx (primary or specific immune deficiency, for instance?) Or do you have a dx code, such as encephalitis (some people also get by with encephalopathy.) Just make sure you stay away from using the dx of PANDAS, and have documentation (labwork, xrays, CT, PET scans, etc.) to backup your diagnosis.

[Rain]

BCBS of CA covered our DS's IViG - PANDAS was the code. I did not expect coverage and was pleasantly surprised. The pre-auth was denied - so we (unprompted) sent in our documentation (letters of various Drs., psych records, lab records) - and then they just paid! Not what we expected. Good luck to you!