Does Medicaid cover PANDAS?

[jrjunction]

What has been your experience with medicaid coverage for this? Do any PANDAS dr.s accept insurance/medicaid?

Thank you

Marcy

[4Nikki]

It covers Mental Illness. No one understands PANDAS.

 

I made too much money to qualify for Medicaid but In Southern California, I used the school system. My DD qualified for services but it took me a year to understand the problems with the system and how to get anything done. You have to make a good relationship with the case manager and at the same time get them to understand urgency.

 

Problem is most doctors that accept MC do only traditional treatments and diagnosis. In California most doctors treating PANDAS, PANS, DANS doctors don't accept ins. I'm not sure about the Standford clinic I'm pretty sure they do.

Edited July 7, 2014 by 4nikki

[qannie47]

This is a very tricky area. Medicaid or not, Pandas is just now on the brink of being excepted by the medical community: translation: still some more time for insurance to embrace it.

 

They will hold off as long as they can.

 

What you need to find is a doc whom is willing to run tests and not code for Pandas. Many of the tests are very run of the mill along with treatments. You just have to make sure the right insurance codes are in placed.

 

Any good doc knows this info and will take care of this.....

[BeeRae22]

I have Medicaid, and have not had any luck getting coverage for my dd. I don't know where you are in the pandas path with your child, but you can get certain things covered if you go through the right channels. For instance, you can likely get some lab work done, antibiotics covered, CBT and other types of therapy, etc. My daughter was on a basically liquid diet and living on a protein drink (because of severe ocd and fear of choking) and I did (after many frustrating phone calls and visits!) get the protein drink covered. We pay her doctor out of pocket though.... He is excellent, but sure doesn't come cheap.