insurance question

[Guest Lucia]

Hello, I'm just getting started...and a little scared. Has anyone had difficulty with getting or changing insurance after a diagnosis of Tourette's syndrome?

[sarah]

test

[kim]

Lucia,

 

I have not read where that has been a problem for anyone here. I'm in the process of switching right now. My husbands benefit center is sending info. on the plans that are available to us. We currently have Health Plus. I'm thinking that Blue Cross would be a better way to go, but will need to review what they send. The gentlemen I spoke with said he didn't think that Blue cross/Blue shield covered allergy testing. I hope he was wrong. Andy that posts here said to check into coverages as it can save a ton of money. I have two sons that I would like to have testing on and I certainly would like the help. It blows me away, that these things that can clearly be of such benefit to our childrens health, is so hard to access. I believe Dr. Walsh from Pfeiffer said 60 percent of his patients that have bluecross blueshield get covered. An hmo like health plus almost never. I didn't understand that remark, but when I talked to the benefit rep. he said what plans are available are determined by your zip code. So apparently there must be differences within the plans themselves, for different areas. Go figure. I would be happy to let you know how it goes. Feel free to PM me or a reminder post here.

If you learn anything, please let me know!

 

Kim

[Claire]

I called Elisaact and they said Blue Cross covered them. AETNA does not, as we recently found out. One Health Plan does.

 

Don't know about having a prior dx. If you are employed, they have to cover you. If you are self-employed and have a two person business (e.g. husband and wife) they have to cover you. Not so for just your average Joe getting insurance.

 

So I would check it out (call an insurance rep to ask). If so, there is a good reason not to get a Dx from a neurologist, wouldn't that be a shame? Tics/TS don't strike me as a high cost thing for most, this board excluded--we aren't the mainstream.

 

Claire

[Andy]

I have read in the standard TS books, I have long since threw them away, that it is hard to get insurance if you mentioned the TS label. I found alot of falsehoods in the standard TS books so I am not incline to take that as a fact.

 

We could not get money back with an out of network doctor while his office was stating that my child was being treated for TS. AS far as the insurance company was concerned, prescribed pills was the treatment and their network doctors could give it. The trick is getting the right codes. We are now using the code for toxic metal posioning. As Claire stated check with an insurance representative and I would also check with the doctor as well and make sure that the billing department knows what codes to use. Apparently Pfeiffer got that part down for so much depends on the doctor's billing office.