Guest guest Posted November 9, 2007 Report Share Posted November 9, 2007 Yes, find out more. Be sure to get info on what the appeal policy is for your insurance. ERGH. That's just ridiculous. Good luck. Addy --- In , " meencantador " <meencantador@...> wrote: > > BCBS feels asthma. allergies are steady the course so they want to > discontinue the Xolair. Do they not get that is what is having me on an > even keel? > > I will find out more later > > I think if it happens and the allergies/asthma flare up, I will be > singing Tis the season to be wheezing > > Take care > > :-\ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 9, 2007 Report Share Posted November 9, 2007 I recently switched to BCBS from Aetna and my prescription will probably go in sometime next week. I'm dreading their response. I have a feeling I'm going to be paying $12,000 per year or contacting SPOC. meencantador <meencantador@...> wrote: BCBS feels asthma. allergies are steady the course so they want to discontinue the Xolair. Do they not get that is what is having me on an even keel? I will find out more later I think if it happens and the allergies/asthma flare up, I will be singing Tis the season to be wheezing Take care :-\ __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2007 Report Share Posted November 10, 2007 I have BCBS also. It is Highmark BCBS out of Pennsylvania offered through a large church group. Every year, I am offered several different plans to chose from. For 2008, I have choosen a new higher deductible plan that offers a lower monthly premium and much higher benefits. After I meet that deductible, everything is covered 100% including Xolair. With the money I save in premiums I can better afford the deductible. With my old plan, I had high co pays on drugs and also for the doctors office to give me the shots. At one time, my doctors office was NOT in network with BCBS and they were the only people within 130 miles that gave the shots. Of course, my doctor would not let me self inject. This ate up my monthly budget and I almost went broke. As many health problems as I have, this higher deductible will be met in the first week after I refill my first xolair prescription. Yes, it all depends on the kind of BCBS policy your company or organization offers. Doug Group founder On Xolair since 2003 Breathing GREAT!! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2007 Report Share Posted November 10, 2007 IF BCBS covers Xolair I will be paying a $500 deductible and then 80% of the cost up to a max out of pocket of $1000. So Xolair will either cost me $1000 per year or $12,000 if they deny it. Aetna had Xolair on their prescription plan so it cost me $40 per month or $480 per year. Either way it will cost me more but I'll be paying my deductible early every year, which will be an advantage if I need to use it for other things -- hopefully not. uca79iii <bme1979@...> wrote: I have BCBS also. It is Highmark BCBS out of Pennsylvania offered through a large church group. Every year, I am offered several different plans to chose from. For 2008, I have choosen a new higher deductible plan that offers a lower monthly premium and much higher benefits. After I meet that deductible, everything is covered 100% including Xolair. With the money I save in premiums I can better afford the deductible. With my old plan, I had high co pays on drugs and also for the doctors office to give me the shots. At one time, my doctors office was NOT in network with BCBS and they were the only people within 130 miles that gave the shots. Of course, my doctor would not let me self inject. This ate up my monthly budget and I almost went broke. As many health problems as I have, this higher deductible will be met in the first week after I refill my first xolair prescription. Yes, it all depends on the kind of BCBS policy your company or organization offers. Doug Group founder On Xolair since 2003 Breathing GREAT!! __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2007 Report Share Posted November 10, 2007 I think it depends on what the company who contracts with BCBS decides. We have BCBS National coverage via EBay and Xolair is on our prescription plan so I pay $70 for a 3 month suppy. Now I did just get notice that my allergy antigen falls under preventative care and I have a cap of $750 a year and just received a bill for $1000 as my antigen set exceeded that cap. Argh! I have sicced my allergy office on the insurance company. Also something within our policy is pediatric asthma coverage, but separated adult coverage. Not sure what that is all about as it seems my kids asthma drugs cost the same as mine (Singulair, Flovent, Advair, Proventil, Maxair and Xopenex are what we use in the house depending on the person.) B. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2007 Report Share Posted November 11, 2007 We have BCBS and we have a $1000 deductible before they pay ANYTHING. We always use ours early regardless. After that, I pay $50 per month for Xolair. Our health insurance premium is $500 per month. I pay at least $150 per month on life saving meds, depending on how sick I get. So to keep me alive, I figure it costs $9K per year and that's in a good year. Sigh. > I have BCBS also. It is Highmark BCBS out of Pennsylvania > offered through a large church group. Every year, I am offered several > different plans to chose from. > > For 2008, I have choosen a new higher deductible plan that offers a > lower monthly premium and much higher benefits. After I meet that > deductible, everything is covered 100% including Xolair. With the > money I save in premiums I can better afford the deductible. > > With my old plan, I had high co pays on drugs and also for the doctors > office to give me the shots. At one time, my doctors office was NOT > in network with BCBS and they were the only people within 130 miles > that gave the shots. Of course, my doctor would not let me self > inject. This ate up my monthly budget and I almost went broke. > > As many health problems as I have, this higher deductible will be met > in the first week after I refill my first xolair prescription. > > Yes, it all depends on the kind of BCBS policy your company or > organization offers. > > Doug > Group founder > On Xolair since 2003 > Breathing GREAT!! > > > > > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 14, 2007 Report Share Posted November 14, 2007 I received a letter yesterday from BCBS saying xolair in Jan.08 wouldn't be covered under pharmacy but would be covered under medical. I called today and found out that it only meant that a person wouldn't be able to receive it on their own from the pharmacy or self inject. My medicine always went to the doctors anyway, where I would recieve the shots . I can't imagine life without it... Sharon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 14, 2007 Report Share Posted November 14, 2007 That is how my BCBS works at the moment. Did they explain to you that their " medical " has a $3,000.00 deductable?!!! Once the 3k has been met, then the Xolair is covered at 100%. I used to self inject. Did it for two years, it wasn't that bad, actually. PLUS it saved me $$ on gas! LOL!! Luckily my allergist, who is totally awesome, is oly 7 miles from my house, so I don't really have that far to go. --- sharon <psychoratzilla@...> wrote: > I received a letter yesterday from BCBS saying > xolair in Jan.08 > wouldn't be covered under pharmacy but would be > covered under medical. > I called today and found out that it only meant that > a person wouldn't > be able to receive it on their own from the pharmacy > or self inject. My > medicine always went to the doctors anyway, where I > would recieve the > shots . I can't imagine life without it... Sharon > > ________________________________________________________________________________\ ____ Be a better sports nut! Let your teams follow you with Mobile. Try it now. http://mobile./sports;_ylt=At9_qDKvtAbMuh1G1SQtBI7ntAcJ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 15, 2007 Report Share Posted November 15, 2007 I have not heard anything about a $3,000.00 deductable. I would imagine that it would be depending on what kind of coverage you have. I will look into it. It is alot of money but I cannot imagine going back to not breathing again and steroids. Was the $3000.00 deductible change enclosed in a letter you received when they said they were not allowing it to be covered under pharmacy? Sharon In , K K <grneyyedlady@...> wrote: > > That is how my BCBS works at the moment. Did they > explain to you that their " medical " has a $3,000.00 > deductable?!!! Once the 3k has been met, then the > Xolair is covered at 100%. > > I used to self inject. Did it for two years, it > wasn't that bad, actually. PLUS it saved me $$ on > gas! LOL!! Luckily my allergist, who is totally > awesome, is oly 7 miles from my house, so I don't > really have that far to go. > > --- sharon <psychoratzilla@...> wrote: > > > I received a letter yesterday from BCBS saying > > xolair in Jan.08 > > wouldn't be covered under pharmacy but would be > > covered under medical. > > I called today and found out that it only meant that > > a person wouldn't > > be able to receive it on their own from the pharmacy > > or self inject. My > > medicine always went to the doctors anyway, where I > > would recieve the > > shots . I can't imagine life without it... Sharon > > > > > > > > ______________________________________________________________________ ______________ > Be a better sports nut! Let your teams follow you > with Mobile. Try it now. http://mobile./sports;_ylt=At9_qDKvtAbMuh1G1SQtBI7ntAcJ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 15, 2007 Report Share Posted November 15, 2007 My BCBS has always (well the last 2-1/2 years) covered Xolair under medical. No deductible, and covered at 100%. I have a $200/year major medical deductible and possibly it is subject to that but my first refill of Advair for the year always covers that. > > > I received a letter yesterday from BCBS saying > > xolair in Jan.08 > > wouldn't be covered under pharmacy but would be > > covered under medical. > > I called today and found out that it only meant that > > a person wouldn't > > be able to receive it on their own from the pharmacy > > or self inject. My > > medicine always went to the doctors anyway, where I > > would recieve the > > shots . I can't imagine life without it... Sharon > > > > > > > > ______________________________________________________________________ ______________ > Be a better sports nut! Let your teams follow you > with Mobile. Try it now. http://mobile./sports;_ylt=At9_qDKvtAbMuh1G1SQtBI7ntAcJ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 15, 2007 Report Share Posted November 15, 2007 I'd like more info because at the open enrollment session I was told the $3000 had to come out of my pocket first, it was not the insurance reaching it first. This is a lingo I am in unchartered waters with. Also, someone mentioned allerfy tests and coming out of their pocket BCBS won't cover that? If that is the case I am up a creek without a paddle bc I have to go for that and I sure don't have this kind of money. Take care all sharon <psychoratzilla@...> wrote: I have not heard anything about a $3,000.00 deductable. I would imagine that it would be depending on what kind of coverage you have. I will look into it. It is alot of money but I cannot imagine going back to not breathing again and steroids. Was the $3000.00 deductible change enclosed in a letter you received when they said they were not allowing it to be covered under pharmacy? Sharon In , K K <grneyyedlady@...> wrote: > > That is how my BCBS works at the moment. Did they > explain to you that their " medical " has a $3,000.00 > deductable?!!! Once the 3k has been met, then the > Xolair is covered at 100%. > > I used to self inject. Did it for two years, it > wasn't that bad, actually. PLUS it saved me $$ on > gas! LOL!! Luckily my allergist, who is totally > awesome, is oly 7 miles from my house, so I don't > really have that far to go. > > --- sharon <psychoratzilla@...> wrote: > > > I received a letter yesterday from BCBS saying > > xolair in Jan.08 > > wouldn't be covered under pharmacy but would be > > covered under medical. > > I called today and found out that it only meant that > > a person wouldn't > > be able to receive it on their own from the pharmacy > > or self inject. My > > medicine always went to the doctors anyway, where I > > would recieve the > > shots . I can't imagine life without it... Sharon > > > > > > > > __________________________________________________________ ______________ > Be a better sports nut! Let your teams follow you > with Mobile. Try it now. http://mobile./sports;_ylt=At9_qDKvtAbMuh1G1SQtBI7ntAcJ > --------------------------------- Be a better sports nut! Let your teams follow you with Mobile. Try it now. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 15, 2007 Report Share Posted November 15, 2007 It sounds like the $3.000.00 is a deductible which possibly means other things could be applied to the deductible besides the xolair. Sharon In , B G <meencantador@...> wrote: > > I'd like more info because at the open enrollment session I was told the $3000 had to come out of my pocket first, it was not the insurance reaching it first. > > This is a lingo I am in unchartered waters with. > > Also, someone mentioned allerfy tests and coming out of their pocket BCBS won't cover that? > > If that is the case I am up a creek without a paddle bc I have to go for that and I sure don't have this kind of money. > > Take care all > > > > sharon <psychoratzilla@...> wrote: > I have not heard anything about a $3,000.00 deductable. I would > imagine that it would be depending on what kind of coverage you have. > I will look into it. It is alot of money but I cannot imagine going > back to not breathing again and steroids. Was the $3000.00 > deductible change enclosed in a letter you received when they said > they were not allowing it to be covered under pharmacy? Sharon > > In , K K <grneyyedlady@> wrote: > > > > That is how my BCBS works at the moment. Did they > > explain to you that their " medical " has a $3,000.00 > > deductable?!!! Once the 3k has been met, then the > > Xolair is covered at 100%. > > > > I used to self inject. Did it for two years, it > > wasn't that bad, actually. PLUS it saved me $$ on > > gas! LOL!! Luckily my allergist, who is totally > > awesome, is oly 7 miles from my house, so I don't > > really have that far to go. > > > > --- sharon <psychoratzilla@> wrote: > > > > > I received a letter yesterday from BCBS saying > > > xolair in Jan.08 > > > wouldn't be covered under pharmacy but would be > > > covered under medical. > > > I called today and found out that it only meant that > > > a person wouldn't > > > be able to receive it on their own from the pharmacy > > > or self inject. My > > > medicine always went to the doctors anyway, where I > > > would recieve the > > > shots . I can't imagine life without it... Sharon > > > > > > > > > > > > > > > __________________________________________________________ > ______________ > > Be a better sports nut! Let your teams follow you > > with Mobile. Try it now. > http://mobile./sports;_ylt=At9_qDKvtAbMuh1G1SQtBI7ntAcJ > > > > > > > > > --------------------------------- > Be a better sports nut! Let your teams follow you with Mobile. Try it now. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2007 Report Share Posted November 16, 2007 yes, the $3k is a deductible. once that has been met then Xolair is covered at 100%. ( i did say earlier, but you may have missed that bit.) --- sharon <psychoratzilla@...> wrote: > It sounds like the $3.000.00 is a deductible which > possibly means > other things could be applied to the deductible > besides the xolair. > Sharon > > In , B G > <meencantador@...> wrote: > > > > I'd like more info because at the open enrollment > session I was > told the $3000 had to come out of my pocket first, > it was not the > insurance reaching it first. > > > > This is a lingo I am in unchartered waters with. > > > > > Also, someone mentioned allerfy tests and coming > out of their > pocket BCBS won't cover that? > > > > If that is the case I am up a creek without a > paddle bc I have to > go for that and I sure don't have this kind of > money. > > > > Take care all > > > > > > > > sharon <psychoratzilla@...> wrote: > > I have not heard anything about a > $3,000.00 deductable. I > would > > imagine that it would be depending on what kind of > coverage you > have. > > I will look into it. It is alot of money but I > cannot imagine going > > back to not breathing again and steroids. Was the > $3000.00 > > deductible change enclosed in a letter you > received when they said > > they were not allowing it to be covered under > pharmacy? Sharon > > > > In , K K > <grneyyedlady@> wrote: > > > > > > That is how my BCBS works at the moment. Did > they > > > explain to you that their " medical " has a > $3,000.00 > > > deductable?!!! Once the 3k has been met, then > the > > > Xolair is covered at 100%. > > > > > > I used to self inject. Did it for two years, it > > > wasn't that bad, actually. PLUS it saved me $$ > on > > > gas! LOL!! Luckily my allergist, who is totally > > > awesome, is oly 7 miles from my house, so I > don't > > > really have that far to go. > > > > > > --- sharon <psychoratzilla@> wrote: > > > > > > > I received a letter yesterday from BCBS saying > > > > xolair in Jan.08 > > > > wouldn't be covered under pharmacy but would > be > > > > covered under medical. > > > > I called today and found out that it only > meant that > > > > a person wouldn't > > > > be able to receive it on their own from the > pharmacy > > > > or self inject. My > > > > medicine always went to the doctors anyway, > where I > > > > would recieve the > > > > shots . I can't imagine life without it... > Sharon > > > > > > > > > > > > > > > > > > > > > > > __________________________________________________________ > > ______________ > > > Be a better sports nut! Let your teams follow > you > > > with Mobile. Try it now. > > > http://mobile./sports;_ylt=At9_qDKvtAbMuh1G1SQtBI7ntAcJ > > > > > > > > > > > > > > > > > --------------------------------- > > Be a better sports nut! Let your teams follow you > with > Mobile. Try it now. > > > > [Non-text portions of this message have been > removed] > > > > > ________________________________________________________________________________\ ____ Be a better sports nut! Let your teams follow you with Mobile. Try it now. http://mobile./sports;_ylt=At9_qDKvtAbMuh1G1SQtBI7ntAcJ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2007 Report Share Posted November 16, 2007 It would definitely depend on the policy. I have BS/BS Anthem and my Xolair is covered 100% under my medical coverage. My allergy testing was also covered 100%. I do have a yearly deductable of $200 which it's hit or miss how they apply that..........I was not on Xolair this past January so they did not hit that but based on past experience that could be where they apply it this year. In the past years it's been applied to anything from cortisone shots to office visits to durable medical equipment so my guess is they can apply it to anything they want under the medical portion. I find out when I get a bill from someone for an uncovered portion of a bill?? ----- Original Message ---- From: sharon <psychoratzilla@...> Sent: Thursday, November 15, 2007 6:42:28 PM Subject: [ ] Re: xolair/insurance It sounds like the $3.000.00 is a deductible which possibly means other things could be applied to the deductible besides the xolair. Sharon In , B G <meencantador@ ...> wrote: > > I'd like more info because at the open enrollment session I was told the $3000 had to come out of my pocket first, it was not the insurance reaching it first. > > This is a lingo I am in unchartered waters with. > > Also, someone mentioned allerfy tests and coming out of their pocket BCBS won't cover that? > > If that is the case I am up a creek without a paddle bc I have to go for that and I sure don't have this kind of money. > > Take care all > > > > sharon <psychoratzilla@ ...> wrote: > I have not heard anything about a $3,000.00 deductable. I would > imagine that it would be depending on what kind of coverage you have. > I will look into it. It is alot of money but I cannot imagine going > back to not breathing again and steroids. Was the $3000.00 > deductible change enclosed in a letter you received when they said > they were not allowing it to be covered under pharmacy? Sharon > > In , K K <grneyyedlady@ > wrote: > > > > That is how my BCBS works at the moment. Did they > > explain to you that their " medical " has a $3,000.00 > > deductable?! !! Once the 3k has been met, then the > > Xolair is covered at 100%. > > > > I used to self inject. Did it for two years, it > > wasn't that bad, actually. PLUS it saved me $$ on > > gas! LOL!! Luckily my allergist, who is totally > > awesome, is oly 7 miles from my house, so I don't > > really have that far to go. > > > > --- sharon <psychoratzilla@ > wrote: > > > > > I received a letter yesterday from BCBS saying > > > xolair in Jan.08 > > > wouldn't be covered under pharmacy but would be > > > covered under medical. > > > I called today and found out that it only meant that > > > a person wouldn't > > > be able to receive it on their own from the pharmacy > > > or self inject. My > > > medicine always went to the doctors anyway, where I > > > would recieve the > > > shots . I can't imagine life without it... Sharon > > > > > > > > > > > > > > > ____________ _________ _________ _________ _________ _________ _ > ____________ __ > > Be a better sports nut! Let your teams follow you > > with Mobile. Try it now. > http://mobile. / sports;_ylt= At9_qDKvtAbMuh1G 1SQtBI7ntAcJ > > > > > > > > > ------------ --------- --------- --- > Be a better sports nut! Let your teams follow you with Mobile. Try it now. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2007 Report Share Posted November 16, 2007 Mmmmm, this " deductible " and medical vs pharmaceutical are all foreign to me although I have HMOBlue. I make a $45.00 a month copay for Xolair to be delivered to my home. That's it. No going to doctor for shots, no other co-pay and no idea about deductibles or medical or pharmaceutical. Obviously this policy we have is very different from many others. I am still just a teensy bit concerned about any cancellations but haven't heard any rumors. Xolair is still mostly unheard of so it would not be a hot topic of discussion amongst employees. Of course, I find that when I go to other docs who even know what Xolair is (my pulmo gives me the Xolair Rx) they seem to be slightly to overtly put off by it mostly due to $$$. > > > I received a letter yesterday from BCBS saying > > xolair in Jan.08 > > wouldn't be covered under pharmacy but would be > > covered under medical. > > I called today and found out that it only meant that > > a person wouldn't > > be able to receive it on their own from the pharmacy > > or self inject. My > > medicine always went to the doctors anyway, where I > > would recieve the > > shots . I can't imagine life without it... Sharon > > > > > > > > ______________________________________________________________________ ______________ > Be a better sports nut! Let your teams follow you > with Mobile. Try it now. http://mobile./sports;_ylt=At9_qDKvtAbMuh1G1SQtBI7ntAcJ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2007 Report Share Posted November 16, 2007 --- B G <meencantador@...> wrote: *snip* > Also, someone mentioned allerfy tests and coming > out of their pocket BCBS won't cover that? > > If that is the case I am up a creek without a > paddle bc I have to go for that and I sure don't > have this kind of money. That was me (Nan). Because I refuse to enroll in a HMO, the BC/BS policy my hubby gets does not cover office visits and allergists PERIOD. I guess allergists are in the same group as tooth fairy as far as they are concerned. I'm on SSDI so I think Medicare might throw a few bones to the allergy testing bill, but I have to look into that. The HMO covers everything, but you never ever see the same doctor and there is only one hospital that is used. Also getting Xolair is next to impossible. The HMO considers it too much money, when prednisone can handle the job just as well. Stupid bean counters! Nan " I love deadlines. I love the whooshing noise they make as they go by. " ~ ~ ________________________________________________________________________________\ ____ Get easy, one-click access to your favorites. Make your homepage. http://www./r/hs Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2007 Report Share Posted November 16, 2007 " The HMO considers it too much money, when prednisone can > handle the job just as well. " > Evidently they do NOT care about the other major expenses that years of evil candy can produce. My insurance had to pay for 2 cervical fusions in my neck, cataract surgeries and my diabetes care because of that nasty stuff. Also, it gets us asthmatics off of a lot of other expensive medications. They also save money by keeping hospitalizations down due to asthma. Thank GOD for xolair. I don't have to be on evil candy anymore and have stopped a few other expensive asthma meds; things that have saved my insurance a lot of buckaroos. $$$$$$$ In 2003 when I first started xolair I dreaded the response from my insurance. I was shocked when they had no problems covering it at all because of the money they would save in the long run. Just my experience, Doug Group founder Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2007 Report Share Posted November 16, 2007 that is EXACTLY what my HMO said about Xolair. BUT...I had an allergic reaction to something, went into anaphalactic shock and then suffered respitory failure at the end of 2004. Then again in May of 2005. Both times they got stuck with a $40K hospital bill. Their minds quiclkly changed. Because, not to long after I recovered I had my first Xolair injection and I haven't looked back since!!! ;-) --- uca79iii <bme1979@...> wrote: > " The HMO considers it too much money, when > prednisone can > > handle the job just as well. " > > > > Evidently they do NOT care about the other major > expenses that years > of evil candy can produce. My insurance had to pay > for 2 cervical > fusions in my neck, cataract surgeries and my > diabetes care because of > that nasty stuff. Also, it gets us asthmatics off of > a lot of other > expensive medications. They also save money by > keeping > hospitalizations down due to asthma. > > Thank GOD for xolair. I don't have to be on evil > candy anymore and > have stopped a few other expensive asthma meds; > things that have saved > my insurance a lot of buckaroos. $$$$$$$ > > In 2003 when I first started xolair I dreaded the > response from my > insurance. I was shocked when they had no problems > covering it at all > because of the money they would save in the long > run. > > Just my experience, > > Doug > Group founder > > ________________________________________________________________________________\ ____ Be a better pen pal. Text or chat with friends inside . See how. http://overview.mail./ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 17, 2007 Report Share Posted November 17, 2007 Our insurance only covers allergists at 50% and same for allergy testing. Not sure if they pay anything for allergy shots or if that's at 50 percent too. The allergist (about 3+ years ago) really ripped me off running tests that were not covered and not telling me specifically that he was running tests not covered. At the time I was in a physician's IPA (sort've an insurance subgroup of doctors that contract with HMOBlue) that was really in the business of denying healthcare. They did a really good job of denial too. A year ago there didn't seem to be any difficulty getting reimbursement for IgE tests but that was with a pulmonologist. At least I was never billed for anything but my visit to a specialist is $45.00 period. No other charges for tests. Sooooo, I think these subgroups are really the royal rip offs. HMOBlue (sort've a subset of BCBS) likes to push for them too. Allergy shots not only did not work (40+ years ago) - they actually seemed to cause more trouble. That is one area where I somewhat grudgingly agree that allergists are up there w/voodoo. Prednisone is a killer - a wolf wrapped in sheep's skin. Interestingly, the pulmo didn't have too much trouble getting the Xolair for me. It took maybe 3 or 4 weeks to get it approved but I was one of their early patients going on it and self injecting so my case was their 3rd " trial balloon. " I think also that having a doc at a medical school who is a pulmo might be better .... The real problem was getting a nurse to " train " me on how to inject - not an insurance issue - just a flipped out nursing system in part due to FDA reaction. Interesting that shortly after I got on Xolair and got a nasty cold w/bronchitis (what else ?!?!) my IgE shot up to over 1200 ... as I got better it went down to 600 something. It was 409 3 years ago. So, although Genentech gets squirrely about testing IgE while on Xolair I can see that the IgE IS influenced by other things going on in the body. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2007 Report Share Posted November 18, 2007 Gotta defend allergists and allergy shots here. " That [allergy shots] is one area where I somewhat grudgingly agree that allergists are up there w/voodoo. " While it sounds like they were not effective for you (although it's important to recognize that allergy shots have improved a great deal in the 40 years since you had them), there is an enormous body of scientific evidence over a long period of time showing that allergy shots are often very effective, definitely not voodoo. Some folks have severe enough allergies that they have impressive allergic reactions to even very low doses of allergy shots in which case they " cause more trouble " but this is by far the exception rather than the rule. Also, by the way, you really can't blame your allergist who you felt " really ripped me off running tests that were not covered and not telling me specifically that he was running tests not covered. " There is no way a doc can be expected keep track of what is and isn't covered by the many insurance companies around; it is your responsibity to ask questions and check with your insurance company ahead of time if you are not clear about whether something will be covered. - Fran --- In , " instdesgn1 " <instdesgn1@...> wrote: > > Our insurance only covers allergists at 50% and same for allergy > testing. Not sure if they pay anything for allergy shots or if > that's at 50 percent too. The allergist (about 3+ years ago) really > ripped me off running tests that were not covered and not telling me > specifically that he was running tests not covered. At the time I > was in a physician's IPA (sort've an insurance subgroup of doctors > that contract with HMOBlue) that was really in the business of > denying healthcare. They did a really good job of denial too. > > A year ago there didn't seem to be any difficulty getting > reimbursement for IgE tests but that was with a pulmonologist. At > least I was never billed for anything but my visit to a specialist is > $45.00 period. No other charges for tests. Sooooo, I think these > subgroups are really the royal rip offs. HMOBlue (sort've a subset > of BCBS) likes to push for them too. > > Allergy shots not only did not work (40+ years ago) - they actually > seemed to cause more trouble. That is one area where I somewhat > grudgingly agree that allergists are up there w/voodoo. Prednisone > is a killer - a wolf wrapped in sheep's skin. > > Interestingly, the pulmo didn't have too much trouble getting the > Xolair for me. It took maybe 3 or 4 weeks to get it approved but I > was one of their early patients going on it and self injecting so my > case was their 3rd " trial balloon. " I think also that having a doc > at a medical school who is a pulmo might be better .... The real > problem was getting a nurse to " train " me on how to inject - not an > insurance issue - just a flipped out nursing system in part due to > FDA reaction. > > Interesting that shortly after I got on Xolair and got a nasty cold > w/bronchitis (what else ?!?!) my IgE shot up to over 1200 ... as I > got better it went down to 600 something. It was 409 3 years ago. > So, although Genentech gets squirrely about testing IgE while on > Xolair I can see that the IgE IS influenced by other things going on > in the body. > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.