UHC Coverage

[hawks]

Anyone had success getting multiple doses of HD ivig covered through United Healthcare. They covered our first one that we did 5 weeks ago but have denied multiple doses. They basically said that "medical literature including peer reviewed and evidence based references do not advocate chronic use of IVIG for PANDAS."

 

One of the PANDAS docs had suggested for our case monthly hd ivig - 3 or 4 treatments. I wouldn't consider that chronic use of ivig? I would appreciate any input anyone may have. Thanks much.

[EAMom]

Anyone had success getting multiple doses of HD ivig covered through United Healthcare. They covered our first one that we did 5 weeks ago but have denied multiple doses. They basically said that "medical literature including peer reviewed and evidence based references do not advocate chronic use of IVIG for PANDAS."

 

One of the PANDAS docs had suggested for our case monthly hd ivig - 3 or 4 treatments. I wouldn't consider that chronic use of ivig? I would appreciate any input anyone may have. Thanks much.

 

We've had 3 HD IVIG's covered, but they were not monthly. They were 6mo-1+ year apart.

[Iowadawn]

Anyone had success getting multiple doses of HD ivig covered through United Healthcare. They covered our first one that we did 5 weeks ago but have denied multiple doses. They basically said that "medical literature including peer reviewed and evidence based references do not advocate chronic use of IVIG for PANDAS."

 

One of the PANDAS docs had suggested for our case monthly hd ivig - 3 or 4 treatments. I wouldn't consider that chronic use of ivig? I would appreciate any input anyone may have. Thanks much.

 

 

Hawks-

 

I am in the process of loading up for bear for our IVIG pre-auth. I am using thenMama's EXCELLENT appeal letter template. It is awesome. Our doc said we can include the info with the pre-auth in an attempt to avoid a denial. I'll save some ammo

in case a denial does happen (wouldn't be a surprise). Dr. K said one time to ask them--"you don't like what our doctor is using, then WHAT DO you propose we use. He wants to know!" I also like to throw at them the whole list of drugs NOT EVEN APPROVED for use in the pediatric population, let alone for the conditions and they have NO problem covering these. I am mostly going to include the scientific info and how IVIG has been the most efficacious of ANYTHING we have tried. Gotta run. Dawn

Edited January 20, 2012 by Iowadawn