Will insurance cover IVIG based on symptoms?

[trintiybella]

My daughter REALLY needs IVIG but does not have any test results to back it up other than A-Bart and Lyme disease. Is it a lost cause trying to get insurance to pay?

[pr40]

you don't really need tests, but a diagnosis. find a dr willing to make an acceptable one. Some insurances, I heard, accept encephalitis. See if there are others – you can call your insurance and ask them.

good luck. keep us posted

[PowPow]

why do you think ivig is so necessary, if nothing but bart and lyme are the issue. try not to focus on that, esp with the ins issue. it might be like banging your head into a wall. what else are you trying now?

how is she?

[trintiybella]

All of her doctors recommend IVIG since nothing has worked thus far. Been at it for many years. She is quite ill and any med/supplement we try makes her rage. Even the teeniest little bit.

[kmacdonald34]

My daughter has borderline immune deficiency and her drs are documenting it in case she needs IVIG down the line. She said many insurances have a hard time accepting IVIG but for immune deficiency they will . She would only be doing low dose IVIG though, not sure if that is what your dr want for your child.

[KKGmom]

We participated in clinical trials to get IVIG (Immunoehealth in CO, may have another trial in next 6 months or so) and now get it reimbursed at lower doses than ideal with an immune deficiency diagnosis as well as a Lyme diagnoses. We were denied when they put it through for PANDAS. Good luck! We have also had good outcomes from recent IV trial of colloidal silver for Lyme and co-infecitons. IVIG worked very well for us at PANDAS doses but wasn't enough at lower doses (even thought still helpful).

[BeeRae22]

My dd's doctor thought ivig might be a good choice for her when she was in crisis/exacerbation, but felt that without a positive strep there was zero to no chance that we could get it covered by insurance..... He even joked (in a compassionate way) that we should find a kid with step in her school to give it to her so we could get a + strep. Although she is now fairly close to baseline (depending on the day) I still wish we could've tried ivig. I have to wonder if it would've been more effective and/or beneficial for her than abx alone. -- or if it would get her closer to baseline than she is now. Good luck.