Guest guest Posted May 29, 2002 Report Share Posted May 29, 2002 , Where do you do the IVIG? At home or at the hospital? Would a hospital allow you to bring the meds to be administered? Great job on not giving up and finding a way to make it happen!! le 12 Selective antibody def., IVIG every 3 weeks last 5 years, 7 surgeries before being diagnosed. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 29, 2002 Report Share Posted May 29, 2002 's IVIG is done at home with a pediatric home health nurse. It's my understanding that the medication will be delivered directly to me several days before infusion. I think as long as you can obtain the medication before his therapy, you can have it either delivered to the hospital or bring it yourself as long as you have the script. I'm far from an expert but I would definitely go for the cheapest route and make a few phone calls to be sure. God Bless, Re: insurance > , > Where do you do the IVIG? At home or at the hospital? > Would a hospital allow you to bring the meds to be administered? > Great job on not giving up and finding a way to make it happen!! > le > 12 Selective antibody def., IVIG every 3 weeks last 5 years, 7 surgeries > before being diagnosed. > > > This forum is open to parents and caregivers of children diagnosed with a Primary Immune Deficiency. Opinions or medical advice stated here are the sole responsibility of the poster and should not be taken as professional advice. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 1, 2002 Report Share Posted September 1, 2002 Dear Diane Yippee!!!! I'm so glad that you were able to get the good care that you needed for Kody. Martha (mom to Chrissy) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 1, 2002 Report Share Posted September 1, 2002 Thanks Martha! Believe me, we were jumping up and down and screaming when we heard the news....too bad we were driving....LOL It is especially a blessing now that it is strongly suspected that my 15 year old daughter and myself have some type of immune deficiency as well. Arika would get the children's special health care insurance same as Kody, but all my bills would come out of my pocket. I guess from what the nurses said at the hospital yesterday that BCBS barely pays what medicare pays. That was the problem. Diane, Mom to Kody Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 24, 2002 Report Share Posted November 24, 2002 , Is there any way you can get your insurance company to authorize coverage of the upcoming infusion since it is just a couple of days away? Here is what I just went through... My employer informed me on a Friday afternoon that our insurance would change the following Tuesday. Of course, my son's home healthcare agency isn't a provider of the new insurance company. I requested the new company to authorize a " continuation of care " since there was no way a new nurse could be found with an in-network provider in the 2 days we had until his next scheduled infusion. I also asked for a case manager so I could explain that we are dealing with a chronically ill child who is difficult to access for infusions and has had the same nurse for 5 years... except when there has been a substitute, and those infusions were nightmares. I faxed the information to them in the a.m., and by the afternoon the case manager told me they would authorize a continuation with our current home healthcare agency for 4 months which would give us an adequate amount of time to get things figured out. Good luck. I'm sorry you have to go through this. Kathy, mom to Isaac, 11, CVID Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 25, 2002 Report Share Posted November 25, 2002 I did ask for an exception but was told no. I also have asked numerous times for a case manager and again was told no. I feel like a fish swimming up stream. Talk about frustration. Re: insurance > > >> > > ---------------------------------------------------------------------~-> > > This forum is open to parents and caregivers of children diagnosed with a Primary Immune Deficiency. Opinions or medical advice stated here are the sole responsibility of the poster and should not be taken as professional advice. > > To unsubscribe -unsubscribegroups (DOT) > To search group archives go to: /messages > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2002 Report Share Posted December 12, 2002 which brings me to my next question--- do most of y'alls (excuse my southern accent y'all :>) insurances cover IVIG as a prescription or what? i.e. do you pay a drug co-pay or do you pay 20% I need to find this out. Also-- how do they figure out which brand to use? Is there much of a difference? I've looked at a few sites and they say they haven't noted a difference... just wondering. I know that they have been thinking of IVIG for for a long time, but you all know how it is when a child has so many health issues...you research the one you are dealing with at the time... Sorry about all the questions! Hope no one minds.....if you get tired, just click delete when you see my name in the from section! :-) Pattie Well, we got the news about the new insurance policies at my dh's job. Insurance itself goes up $50/month. Copays for doctor visits are the same, but copays for drugs are up a LOT. The drugs Rebekah is on will go up between $5 and $30 each! Plus, with Hannah's allergies, it looks like we might be spending as much as $150-$175 per month on drug copays. I'm still waiting on news about whether gammaguard and IV antibiotics are covered fully. OUCH! I know that word doesn't cover the financial pinch, but I'll say it agan: OUCH!!! Pam Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 13, 2002 Report Share Posted December 13, 2002 We do it as a Drs office visit and we only pay for a copay. BARBIE Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 13, 2002 Report Share Posted December 13, 2002 Pattie, Since Kody's only had his IVIG in the hospital, I don't know about home infusions, but it is covered under our insurance as a hospital admittance. With our insurance hospital admittances are 100% covered after our deductable is met (we usually meet the family deductible in the first two months of hte year). Which means that the IVIG perscription is also covered under the hospital admittance. Now, whatever the insurance doesn't pay, Kody s second insurance does pay because it is Children's Special Health Care Services insurance. My experience with home health care for other antibiotics are that they are covered 100% too. You should call your insurance company and ask. Here is a tip: with our insurance company because Kody needs so much medically he is assigned a caseworker, who is also an RN. She has visited us in the hospital before. Anyway, when you call, ask if your case has a particular case worker and ask to speak with them. Not only do they have all the information you need, but they usually will work with you better than the person that just answers the phone! Please feel free to visit my website for parents of children with multiple special needs : www.geocities.com/schmidtzoo/SNAK.index.html -- Re: insurance which brings me to my next question--- do most of y'alls (excuse my southern accent y'all :>) insurances cover IVIG as a prescription or what? i.e. do you pay a drug co-pay or do you pay 20% I need to find this out. Also-- how do they figure out which brand to use? Is there much of a difference? I've looked at a few sites and they say they haven't noted a difference... just wondering. I know that they have been thinking of IVIG for for a long time, but you all know how it is when a child has so many health issues...you research the one you are dealing with at the time... Sorry about all the questions! Hope no one minds.....if you get tired, just click delete when you see my name in the from section! :-) Pattie Well, we got the news about the new insurance policies at my dh's job. Insurance itself goes up $50/month. Copays for doctor visits are the same, but copays for drugs are up a LOT. The drugs Rebekah is on will go up between $5 and $30 each! Plus, with Hannah's allergies, it looks like we might be spending as much as $150-$175 per month on drug copays. I'm still waiting on news about whether gammaguard and IV antibiotics are covered fully. OUCH! I know that word doesn't cover the financial pinch, but I'll say it agan: OUCH!!! Pam Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 13, 2002 Report Share Posted December 13, 2002 Thanks for the info, Diane. Pattie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 13, 2002 Report Share Posted December 13, 2002 Well, it looks like we will be paying 20% on each treatment with a cap on payments for IVIG at $1000 starting next year. It was completely covered this year. Ouch. Oh, yeah. One more thing: the $1000 cap does NOT include dr office copays or drug copays. There is no limit to those expenses. Double ouch! Pam wife to (15 years) mother to , 9, Hannah, 6, Rebekah, 3, and Leah, 1 Re: insurance We do it as a Drs office visit and we only pay for a copay. BARBIE Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 13, 2002 Report Share Posted December 13, 2002 Actually our insurance pays for all of Jonathons IVIG. They treat it as an outpatient treatment. That is private insurance though and I am not sure how it will work for you Viriginia >From: " Pattie Curran " <paxchristi@...> >Reply- >< > >Subject: Re: insurance >Date: Thu, 12 Dec 2002 23:58:51 -0500 > >which brings me to my next question--- do most of y'alls (excuse my >southern accent y'all :>) insurances cover IVIG as a prescription or >what? i.e. do you pay a drug co-pay or do you pay 20% > >I need to find this out. > >Also-- how do they figure out which brand to use? Is there much of a >difference? I've looked at a few sites and they say they haven't noted a >difference... just wondering. > >I know that they have been thinking of IVIG for for a long time, but >you all know how it is when a child has so many health issues...you >research the one you are dealing with at the time... > >Sorry about all the questions! Hope no one minds.....if you get tired, >just click delete when you see my name in the from section! > >:-) >Pattie > >Well, we got the news about the new insurance policies at my dh's job. >Insurance itself goes up $50/month. Copays for doctor visits are the same, >but copays for drugs are up a LOT. The drugs Rebekah is on will go up >between $5 and $30 each! Plus, with Hannah's allergies, it looks like we >might be spending as much as $150-$175 per month on drug copays. I'm still >waiting on news about whether gammaguard and IV antibiotics are covered >fully. OUCH! I know that word doesn't cover the financial pinch, but I'll >say it agan: OUCH!!! > >Pam > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 13, 2002 Report Share Posted December 13, 2002 We pay 10%. She gets 15 gms every 4 weeks. At $190 per gram it comes to $2850. This comes to a $285 copay each month. The brand is chosen by the doctor. Different brands contain different amounts of IgA and can cause or prevent reactions. Some are more known for causing reactions than others. IVIG covers b-cell function but does nothing for the t-cell counts. Actually it provides passive antibodies and not necessarily IgG directly. It infuses the antibodies into the system already made per say. It can replace antibody deficiency but will not always supplement low IgG counts. This is why many immunologists will hold off on infusing low IgG unless there is no response to the pneumococcal vaccination also. Ursula Holleman Macey's mom (7 yr. old with CVID, asthma, sinus disease, GERD, Diabetes Insipidus, colonic inertia) http://members.cox.net/maceyh Immune Deficiency Foundation - Peer Contact for GA http://www.primaryimmune.org / Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 14, 2002 Report Share Posted December 14, 2002 Thanks, Virginia! I am breathing easier today...you guys are all so nice to respond. I have done some serious scrubbing-- toilets, tubs, floors...and I feel less stressed .... hadn't been home in weeks to do it! Well...I was home between doctor runs...but you all know how it goes. I am hoping that our docs will set it up as a doc visit/clinic visit...then we'll only pay the co-pay. We will be at the hospital on Dec 31st ad our HEM is going to meet us at the ENT appt so we can all talk. They always want to know when the boys have appts at the hospital and they come down to talk to the docs with us. HOW cool is that? She takes time even when she isn;t getting paid to visit us! Pattie Actually our insurance pays for all of Jonathons IVIG. They treat it as an outpatient treatment. That is private insurance though and I am not sure how it will work for you Viriginia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 14, 2002 Report Share Posted December 14, 2002 did not respond to the Hep B vaccination---we found out recently b/c during his bone marrow biopsy the doc poked himself with the needle and they had to run the tests. We knew about his responses and lack of responses to the PPV..... My concern is that it won't help either or ph..... although all three docs involved think it would, but the HEM wants to wait to see what the ENT can do. Do any of you know what else they can do besides all of the allergy meds and nasal sprays? We've tried them all..... Pattie Actually it provides passive antibodies and not necessarily IgG directly. It infuses the antibodies into the system already made per say. It can replace antibody deficiency but will not always supplement low IgG counts. This is why many immunologists will hold off on infusing low IgG unless there is no response to the pneumococcal vaccination also. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 14, 2002 Report Share Posted December 14, 2002 Ursala, How does your family manage that much of a copay each month, plus the doctor office bills and the drug bills? I've got 3 weeks to redo the family budget for at least $150 more per month, and likely more, of medical expenses. I just keep chanting: but my God will supply all my needs..... Hurry up, God! I'm getting scared again! Pam wife to (15 years) mother to , 9, Hannah, 6, Rebekah, 3, and Leah, 1 Re: insurance We pay 10%. She gets 15 gms every 4 weeks. At $190 per gram it comes to $2850. This comes to a $285 copay each month. The brand is chosen by the doctor. Different brands contain different amounts of IgA and can cause or prevent reactions. Some are more known for causing reactions than others. IVIG covers b-cell function but does nothing for the t-cell counts. Actually it provides passive antibodies and not necessarily IgG directly. It infuses the antibodies into the system already made per say. It can replace antibody deficiency but will not always supplement low IgG counts. This is why many immunologists will hold off on infusing low IgG unless there is no response to the pneumococcal vaccination also. Ursula Holleman Macey's mom (7 yr. old with CVID, asthma, sinus disease, GERD, Diabetes Insipidus, colonic inertia) http://members.cox.net/maceyh Immune Deficiency Foundation - Peer Contact for GA http://www.primaryimmune.org / This forum is open to parents and caregivers of children diagnosed with a Primary Immune Deficiency. Opinions or medical advice stated here are the sole responsibility of the poster and should not be taken as professional advice. To unsubscribe -unsubscribegroups (DOT) To search group archives go to: /messages Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 14, 2002 Report Share Posted December 14, 2002 Oh, guys, please pray about our insurance issues! We may have to pay 20% as an outpatient or go back to the inpatient infusion clinic with the hematologists. You remember the hem we deal with who give high doses and doesn't want to infuse until 6 weeks? We would have to go back to him to pay less but then we would get poorer care. I've got calls in to our case manager and the insurance policy writer to negotiate/clarify the situation. Pam wife to (15 years) mother to , 9, Hannah, 6, Rebekah, 3, and Leah, 1 Re: insurance Thanks, Virginia! I am breathing easier today...you guys are all so nice to respond. I have done some serious scrubbing-- toilets, tubs, floors...and I feel less stressed .... hadn't been home in weeks to do it! Well...I was home between doctor runs...but you all know how it goes. I am hoping that our docs will set it up as a doc visit/clinic visit...then we'll only pay the co-pay. We will be at the hospital on Dec 31st ad our HEM is going to meet us at the ENT appt so we can all talk. They always want to know when the boys have appts at the hospital and they come down to talk to the docs with us. HOW cool is that? She takes time even when she isn;t getting paid to visit us! Pattie Actually our insurance pays for all of Jonathons IVIG. They treat it as an outpatient treatment. That is private insurance though and I am not sure how it will work for you Viriginia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 14, 2002 Report Share Posted December 14, 2002 Pam, remember to talk money to the case manager. Outline the costs of in-patient care as opposed to home care or ask her to tell you what the difference is. Don't bring up a bunch of " personal " issues like he's happier at home or even that you feel he gets better care. Do bring up that he will be exposed to less germs at home and therefore could save them a lot in hospital bills and ER down the road. I don't know whether it will work - but it will come near working than being emotional or whiney -- hey, it's works with Moms!!!! Once I learned to talk in their language, I began seeing more consideration. Whatever you do, keep looking for a solution to keep away from the previous doctor. That was life-threateningly dangerous. Hope that helps and I am praying for you to get all that worked out soon. In His service, Dale Pam Mork wrote: > > Oh, guys, please pray about our insurance issues! We may have to pay 20% as > an outpatient or go back to the inpatient infusion clinic with the > hematologists. You remember the hem we deal with who give high doses and > doesn't want to infuse until 6 weeks? We would have to go back to him to > pay less but then we would get poorer care. I've got calls in to our case > manager and the insurance policy writer to negotiate/clarify the situation. > > Pam > wife to (15 years) > mother to , 9, Hannah, 6, Rebekah, 3, and Leah, 1 > > Re: insurance > > Thanks, Virginia! I am breathing easier today...you guys are all so nice to > respond. I have done some serious scrubbing-- toilets, tubs, floors...and I > feel less stressed .... hadn't been home in weeks to do it! Well...I was > home between doctor runs...but you all know how it goes. > > I am hoping that our docs will set it up as a doc visit/clinic visit...then > we'll only pay the co-pay. We will be at the hospital on Dec 31st ad our > HEM is going to meet us at the ENT appt so we can all talk. They always want > to know when the boys have appts at the hospital and they come down to talk > to the docs with us. HOW cool is that? She takes time even when she isn;t > getting paid to visit us! > > Pattie > > Actually our insurance pays for all of Jonathons IVIG. They treat it as an > outpatient treatment. That is private insurance though and I am not sure > how it will work for you > > Viriginia > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 14, 2002 Report Share Posted December 14, 2002 Thanks, that's some good advice. I'm kinda glad that I'm not talking to them until Monday. I'm still in a rather emotional state (and dh is in denial about the looming medical bills). That's a really good point about how cheap home care is and how much safer it is for her. I'm going to make a list of reasons that should continue home care that are financially prudent (from their perspective). And, thanks, for saying that the previous situation was life-threateningly dangerous. That's what I thought, too, but then I wondered if I was over-reacting. Pam wife to (15 years) mother to , 9, Hannah, 6, Rebekah, 3, and Leah, 1 Re: insurance > > Thanks, Virginia! I am breathing easier today...you guys are all so nice to > respond. I have done some serious scrubbing-- toilets, tubs, floors...and I > feel less stressed .... hadn't been home in weeks to do it! Well...I was > home between doctor runs...but you all know how it goes. > > I am hoping that our docs will set it up as a doc visit/clinic visit...then > we'll only pay the co-pay. We will be at the hospital on Dec 31st ad our > HEM is going to meet us at the ENT appt so we can all talk. They always want > to know when the boys have appts at the hospital and they come down to talk > to the docs with us. HOW cool is that? She takes time even when she isn;t > getting paid to visit us! > > Pattie > > Actually our insurance pays for all of Jonathons IVIG. They treat it as an > outpatient treatment. That is private insurance though and I am not sure > how it will work for you > > Viriginia > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 15, 2002 Report Share Posted December 15, 2002 We have that plus $100 for Les's new meds that they have started him on in an attempt to keep from needing IVIG. Plus Macey has about $100 in meds (some not PID related). Doctor copays are $15. These plus the drug costs must be paid up front but the copays for the infusions or any other hospital bills are on a payment plan with the hospital. We pay about $20 per account (6 outstanding right now) and as long as we're making payments in good faith they can't send us to collections. I believe this is a state specific law regarding medical bills. We're what they term " frequent flyers " and they know that we've been good for all our bills in the past. Hopefully next year when I go back to work fulltime after graduating we will be adding a second health insurance policy and that should help. Ursula Holleman Macey's mom (7 yr. old with CVID, asthma, sinus disease, GERD, Diabetes Insipidus, colonic inertia) http://members.cox.net/maceyh Immune Deficiency Foundation - Peer Contact for GA http://www.primaryimmune.org / Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 15, 2002 Report Share Posted December 15, 2002 OH yeah-- we are frequent fliers, too. What I always get a kick out of are the people who say, " But don;t you have insurance? " LOL. You know they haven't had to use their insurance much..... My mom seems to think that 20% isn;t THAT much. AYE YI YI Pattie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 15, 2002 Report Share Posted December 15, 2002 OH yeah-- we are frequent fliers, too. What I always get a kick out of are the people who say, " But don;t you have insurance? " LOL. You know they haven't had to use their insurance much..... My mom seems to think that 20% isn;t THAT much. AYE YI YI Pattie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2002 Report Share Posted December 16, 2002 We pay 10%. She gets 15 gms every 4 weeks. At $190 per gram it comes to $2850. This comes to a $285 copay each month. The brand is chosen by the doctor. Pam, We have to pay a 20% co pay, 15 grams every three weeks. We do not qualify for assistance because we are in the middle class........we have tried........my husband took a new job last year that was 1/2 his salary........long story but he is much happier.........we applied for Childrens services and they look at your tax returns for the previous year ........we were doing ok then..........we also currently have no insurance for meds at the pharmacy. Office visits are $35 Anyways, we don't stress over what we owe the hospital we pay every month but we will owe them for along time. They know we are not going anywhere so they are pretty good with us. le Pam Mork <pmork@...> wrote:Ursala, How does your family manage that much of a copay each month, plus the doctor office bills and the drug bills? I've got 3 weeks to redo the family budget for at least $150 more per month, and likely more, of medical expenses. I just keep chanting: but my God will supply all my needs..... Hurry up, God! I'm getting scared again! Pam wife to (15 years) mother to , 9, Hannah, 6, Rebekah, 3, and Leah, 1 Re: insurance We pay 10%. She gets 15 gms every 4 weeks. At $190 per gram it comes to $2850. This comes to a $285 copay each month. The brand is chosen by the doctor. Different brands contain different amounts of IgA and can cause or prevent reactions. Some are more known for causing reactions than others. IVIG covers b-cell function but does nothing for the t-cell counts. Actually it provides passive antibodies and not necessarily IgG directly. It infuses the antibodies into the system already made per say. It can replace antibody deficiency but will not always supplement low IgG counts. This is why many immunologists will hold off on infusing low IgG unless there is no response to the pneumococcal vaccination also. Ursula Holleman Macey's mom (7 yr. old with CVID, asthma, sinus disease, GERD, Diabetes Insipidus, colonic inertia) http://members.cox.net/maceyh Immune Deficiency Foundation - Peer Contact for GA http://www.primaryimmune.org / This forum is open to parents and caregivers of children diagnosed with a Primary Immune Deficiency. Opinions or medical advice stated here are the sole responsibility of the poster and should not be taken as professional advice. To unsubscribe -unsubscribegroups (DOT) To search group archives go to: /messages Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2002 Report Share Posted December 16, 2002 How about some good news on the insurance front!?! My employer has a small category called " home health care " and they forgot to include it when they changed to an 80/20 split for all other in-patient or out-patient care. So, we are still 100% covered for IVIG. We still have no answers about thinks like bloodwork, IM rocephin, etc. but I feel a LOT less stressed today about money. THANK YOU ALL for your prayers and suggestions. The insurance company was so glad to keep us at home that the issue of going back to the infusion clinic was never even a serious consideration! Pam wife to (15 years) mother to , 9, Hannah, 6, Rebekah, 3, and Leah, 1 How does your family manage that much of a copay each month, plus the doctor office bills and the drug bills? I've got 3 weeks to redo the family budget for at least $150 more per month, and likely more, of medical expenses. I just keep chanting: but my God will supply all my needs..... Hurry up, God! I'm getting scared again! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2003 Report Share Posted February 1, 2003 In a message dated 01/31/2003 5:14:26 AM Pacific Standard Time, pnqt@... writes: > Looking for product liability insurance. Please advise if you have insurer > you're happy with. > Look at website www.rli.com. I am happy with them. Rose Quote Link to comment Share on other sites More sharing options...
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