IVIg coverage from BCBSTX?

[Packer Fan]

I remember a week or so ago that someone said they got coverage for IVIG from Blue Cross Blue Shield of Texas. If you see this, could you please remind me what you submitted to help get authorization? Our predetermination is still under review but I wanted to "arm myself" with as much information as possible. Does anyone have the statement from United Healthcare or any other helpful info? Thank you - this forum is an amazing blessing!

[mom md]

I googled United Healthcare IVIG PANDAS and you can pull up their IVIG statement. It is all in there. Interesting though, Aetna reports an article by Orange 2006 as why they won't pay for IVIG and United Healthcare posts it as why they will pay. Makes no sense.

[GraceUnderPressure]

Oh thanks be to God that our insurance just switched from Aetna to United Healthcare this past June! A ray of sunshine in my day at last!

[saidie10]

Hi there! I am the very fortunate one whose son's IVIG was approved by BCBSTX. My doctor used Autoimmune Disorder NOS (Not Otherwise Specified). He did mention in the very well written cover letter to BCBS that our son had PANDAS and that strep was his trigger for the immune disorder. The doctor submitted the United Bulletin along with studies about IVIG/PANDAS. I was honestly in shock when the case worker said they approved it. He submitted all his labs too. My son definitely has the peanut allergy effect...PANDAS symptoms with just strep exposure and his titers increase in response as well so it appears to be pretty classic symptoms. He also developed an immune deficiency in one of his subclasses as a result of the disorder. It doesn't look as though he has any other underlying bacterial/viral triggers, so it appeared to be pretty cut and dry PANDAS. Still again, SHOCKED they approved it.

 

If I can help in any way, PLEASE PM me and I will get you any information I can!

 

Cindy

[Packer Fan]

Hi there! I am the very fortunate one whose son's IVIG was approved by BCBSTX. My doctor used Autoimmune Disorder NOS (Not Otherwise Specified). He did mention in the very well written cover letter to BCBS that our son had PANDAS and that strep was his trigger for the immune disorder. The doctor submitted the United Bulletin along with studies about IVIG/PANDAS. I was honestly in shock when the case worker said they approved it. He submitted all his labs too. My son definitely has the peanut allergy effect...PANDAS symptoms with just strep exposure and his titers increase in response as well so it appears to be pretty classic symptoms. He also developed an immune deficiency in one of his subclasses as a result of the disorder. It doesn't look as though he has any other underlying bacterial/viral triggers, so it appeared to be pretty cut and dry PANDAS. Still again, SHOCKED they approved it.

 

If I can help in any way, PLEASE PM me and I will get you any information I can!

 

Cindy

[Packer Fan]

Thank you so much to everyone who replied...we are waiting and praying. Ibuprofen helped but is becoming less effective. Starting steroid burst today...we'll see!