Guest guest Posted April 17, 2009 Report Share Posted April 17, 2009 > > Does anybody carry insurance? Where's a good place to start looking? > Maggie > HiMaggie, I'm actually a commercial insurance agent. I recommend making your agent do the footwork. You would like for them to do the comparison shopping for you; commercial insurance is really complicated. It is imperative to have an agent you trust -- this is not something I would do myself, say, by Internet. If your agent is not asking you tons of specific questions when you do the application, you may want to comparison shop, yourself... every commercial policy is different and is tailored from the ground up for the client. Heck, if you're in California, let me know and I'll help you. Here are some guidelines I am personally considering: General liability: You will want adequate products/completed operations coverage so that if there is ever a lawsuit brought by someone claiming to be harmed by your products, you are protected. You will want adequate coverage for personal and advertising injury, in case you accidentally infringe someone's copyright or ads and are sued. You will want tenants liability coverage in case you or your products cause damage to the building you are in (say, through a fire). You may also want to raise your medical payments limit from the default. Property: If you want coverage for your inventory, equipment, or other property in your lab (including computers) you should discuss this with your agent. Be very specific. Be aware that this coverage will, in part, drive your premium, so it is up to you. While you are looking at this limit, be aware of your deductible... raising your deductible lowers your premium, but also lowers your coverage if there is ever a claim. E & O (professional liability): You may also want professional liability insurance to cover your business operations, but it will be rather costly. I am personally going to skip it. Workers' compensation: In the U.S., you MUST maintain workers' compensation insurance if you have employees. Theoretically even volunteer employees must be insured. If you have family members working for you and they are not part owners of your business, they are also supposed to be insured. Penalties can be heavy if you don't insure your employees. Please let me know if you have questions, but understand that my knowledge is limited to California codes. Hope this helps! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 17, 2009 Report Share Posted April 17, 2009 Does anybody carry insurance? Where's a good place to start looking? Maggie *************************************************** Hi Maggie, Check out IBN (Indie Beauty Network). If you get a membership you can get insurance through them. I did it and saved beaucoup bucks over the insurance I had before. I think this is because it is written as a group policy for IBN, rather than an individual policy. But coverage limits are still applied to your own policy (endorsement?) I have never had a claim, so I can't speak to their claim handling capacity, but so far, they have been responsive to my requests for documents that I have requested. Patty Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2009 Report Share Posted April 18, 2009 > Heck, if you're in California, let me know and I'll help you. > > General liability > Property > E & O (professional liability) > Workers' compensation Thank you so much for your detailed answers to all of the above issues and more! I am, in fact in CA so perhaps we could contact eachother offline. My email is mmahboubian@.... Thanks again for your response! Maggie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2009 Report Share Posted April 18, 2009 > > > > Does anybody carry insurance? Where's a good place to start looking? > Maggie > > > *************************************************** > > Hi Maggie, > > Check out IBN (Indie Beauty Network). If you get a membership you can get insurance through them. I did it and saved beaucoup bucks over the insurance I had before. I think this is because it is written as a group policy for IBN, rather than an individual policy. But coverage limits are still applied to your own policy (endorsement?) > > I have never had a claim, so I can't speak to their claim handling capacity, but so far, they have been responsive to my requests for documents that I have requested. > > Patty Thanks so much Patty for your info on IBN. I remember reading about them and it seems like a good place to start. I will definitely research their membership and insurance options! Best, Maggie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2009 Report Share Posted April 18, 2009 I incorporated Mermade so that if we got sued they could only take our inventory and business account. this was our belief anyway.... Katlyn Breene Mermade Magickal Arts (since 1984) katmermade@... http://www.mermadearts.com/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 2009 Report Share Posted April 19, 2009 > I incorporated Mermade so that if we got sued they could only take our > inventory and business account. this was our belief anyway.... > > Katlyn Breene > Mermade Magickal Arts (since 1984) > katmermade@... > http://www.mermadearts.com/ I incorporated my architectural practice for that reason, but I also got " E & O " (errors and omissions) insurance in case I got sued. Supposedly the insurance would cover the amount in a potential law suit. Otherwise, it would have to come out of my pocket! I imagine it's the same situation if you're selling a product. Maggie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 What state are you in ????? I know some states have Special Children's Healthcare... It helps cover anything medical expensives that are left over from private or state insurance.... Its a differnt program then your state insurance and is usualy run through your local Health Dept. not the DHS office.... I would check with them to start because even if they couldn't help they could point you in the right direction  From: carievercelli <itsallaboutkreed@...> Subject: Insurance Date: Sunday, April 18, 2010, 4:25 PM  I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 IVIG is covered at 100% in all 50 states through medicaid in hospital. Have you considered switching to SCIG? You would no longer need private nursing and its very easy to get approval for SCIG when coming from IV. Some states actually mandate SCIG over IV due to cost savings from what I have heard. I know dd's IVIG was costing $4k mo at the hospital and that was before we doubled the dose. When we switched to SCIG at home the cost dropped to $1200 mo which is just the cost of the drug, Nufactor includes everything else with it. ________________________________ From: carievercelli <itsallaboutkreed@...> Sent: Sun, April 18, 2010 1:25:18 PM Subject: Insurance I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. ------------------------------------ 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 April 18, 2010 Report Share Posted April 18, 2010 Yes you do, all states do, you just have to know where to look:) http://www.azdhs.gov/phs/ocshcn/crs/crs_az.htm ________________________________ From: Carie <itsallaboutkreed@...> Sent: Sun, April 18, 2010 2:01:19 PM Subject: RE: Insurance Arizona, we do not have what you are talking about. _____ From: [mailto: ] On Behalf Of aymee Sent: Sunday, April 18, 2010 1:31 PM Subject: Re: Insurance What state are you in ????? I know some states have Special Children's Healthcare... It helps cover anything medical expensives that are left over from private or state insurance.... Its a differnt program then your state insurance and is usualy run through your local Health Dept. not the DHS office.... I would check with them to start because even if they couldn't help they could point you in the right direction From: carievercelli <itsallaboutkreed@ <mailto:itsallaboutkreed%40cox.net> cox.net> Subject: Insurance groups (DOT) <mailto:%40> com Date: Sunday, April 18, 2010, 4:25 PM I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 As we learned EVERY state writes its own rules. There are state laws that write the rules regarding how the Federal funds are implemented. We at this time only have Medicaid in WA state and we do fine. It just takes a little more work to get a state care manager to reduce risk. I would also encourage you to contact IDF and see if someone there can help you. I thought that if my son was on SSI that he would have insurance ( medicare or Medicaid) but there are 3 states do not give kids Medicaid even if they are on SSI. We moved back to WA state because my son could not get ANY insurance in Oklahoma even on SSI. Also if you are on Medicaid they cannot charge you co-pays for anything if it is something that Medicaid does pay even if your primary does not pay for it. It is complex but personally I see some relief in the future especially for our kids.(September) BARBIE ________________________________ From: Madden <bluetaelon@...> Sent: Sun, April 18, 2010 1:33:35 PM Subject: Re: Insurance IVIG is covered at 100% in all 50 states through medicaid in hospital. Have you considered switching to SCIG? You would no longer need private nursing and its very easy to get approval for SCIG when coming from IV. Some states actually mandate SCIG over IV due to cost savings from what I have heard. I know dd's IVIG was costing $4k mo at the hospital and that was before we doubled the dose. When we switched to SCIG at home the cost dropped to $1200 mo which is just the cost of the drug, Nufactor includes everything else with it. ____________ _________ _________ __ From: carievercelli <itsallaboutkreed@ cox.net> groups (DOT) com Sent: Sun, April 18, 2010 1:25:18 PM Subject: Insurance I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. ------------ --------- --------- ------ 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 -unsubscribe@ groups. To search group archives go to: http://groups. / group// messages Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 Arizona, we do not have what you are talking about. _____ From: [mailto: ] On Behalf Of aymee Sent: Sunday, April 18, 2010 1:31 PM Subject: Re: Insurance What state are you in ????? I know some states have Special Children's Healthcare... It helps cover anything medical expensives that are left over from private or state insurance.... Its a differnt program then your state insurance and is usualy run through your local Health Dept. not the DHS office.... I would check with them to start because even if they couldn't help they could point you in the right direction From: carievercelli <itsallaboutkreed@ <mailto:itsallaboutkreed%40cox.net> cox.net> Subject: Insurance groups (DOT) <mailto:%40> com Date: Sunday, April 18, 2010, 4:25 PM I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 Actually SOME states do and it looks like the good news is that Arizonia does have a program. EVERY state is different. I went to EVERY possible agency,legislator(state and Federal) ,DHS, Health Care Authority in OK and was told to leave the state or my son would die. They do not have ANY program for kids in my sons situation. He is on SS but there is NO health insurance for him since he has a pre-existing condition. My only income is SSDI so I am NOT wealthy. I am working with the NPAF national Patient Advocacy Foundation to see why some of the National programs that are law for kids are not being implemented in states like Oklahoma. It is a HUGE hole in the system. My son could have died if I stayed in OK and there are 3 other states that have similar laws. BARBIE ________________________________ From: Madden <bluetaelon@...> Sent: Sun, April 18, 2010 1:54:23 PM Subject: Re: Insurance Yes you do, all states do, you just have to know where to look:) http://www.azdhs. gov/phs/ocshcn/ crs/crs_az. htm ____________ _________ _________ __ From: Carie <itsallaboutkreed@ cox.net> groups (DOT) com Sent: Sun, April 18, 2010 2:01:19 PM Subject: RE: Insurance Arizona, we do not have what you are talking about. _____ From: groups (DOT) com [mailto:groups (DOT) com] On Behalf Of aymee Sent: Sunday, April 18, 2010 1:31 PM groups (DOT) com Subject: Re: Insurance What state are you in ????? I know some states have Special Children's Healthcare.. . It helps cover anything medical expensives that are left over from private or state insurance... . Its a differnt program then your state insurance and is usualy run through your local Health Dept. not the DHS office.... I would check with them to start because even if they couldn't help they could point you in the right direction From: carievercelli <itsallaboutkreed@ <mailto:itsallabout kreed%40cox. net> cox.net> Subject: Insurance groups (DOT) <mailto:% 40groups. com> com Date: Sunday, April 18, 2010, 4:25 PM I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 My child has autism and is nonverbal. I have considered SCIG, but do not know if I could manage it with him. This is a child that is incredibly strong and fights any thing being done to him He won't allow bandages on him, and has instantly removed his stitches on his own. I really do worry about if SCIG is for us. Also I really would hate to take a chance on using anything other then Gammagard because he has zero reaction from it, and my Dr. won't approve using Gammagard for SCIG since it is not FDA approved. _____ From: [mailto: ] On Behalf Of Madden Sent: Sunday, April 18, 2010 1:34 PM Subject: Re: Insurance IVIG is covered at 100% in all 50 states through medicaid in hospital. Have you considered switching to SCIG? You would no longer need private nursing and its very easy to get approval for SCIG when coming from IV. Some states actually mandate SCIG over IV due to cost savings from what I have heard. I know dd's IVIG was costing $4k mo at the hospital and that was before we doubled the dose. When we switched to SCIG at home the cost dropped to $1200 mo which is just the cost of the drug, Nufactor includes everything else with it. ________________________________ From: carievercelli <itsallaboutkreed@ <mailto:itsallaboutkreed%40cox.net> cox.net> groups (DOT) <mailto:%40> com Sent: Sun, April 18, 2010 1:25:18 PM Subject: Insurance I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. ------------------------------------ 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: http://groups. </messages> /group//messages Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 We have familes with autism who do SCIG, perhaps they will weigh in:) We did Gammagard for IV then switched to Gamunex for SCIG without a problem which many people use. I " think " Viva is the only SCIG thats FDA approved but thats pretty recent, people have been using other products for decades without a problem. ________________________________ From: Carie <itsallaboutkreed@...> Sent: Sun, April 18, 2010 2:06:09 PM Subject: RE: Insurance My child has autism and is nonverbal. I have considered SCIG, but do not know if I could manage it with him. This is a child that is incredibly strong and fights any thing being done to him He won't allow bandages on him, and has instantly removed his stitches on his own. I really do worry about if SCIG is for us. Also I really would hate to take a chance on using anything other then Gammagard because he has zero reaction from it, and my Dr. won't approve using Gammagard for SCIG since it is not FDA approved. _____ From: [mailto: ] On Behalf Of Madden Sent: Sunday, April 18, 2010 1:34 PM Subject: Re: Insurance IVIG is covered at 100% in all 50 states through medicaid in hospital. Have you considered switching to SCIG? You would no longer need private nursing and its very easy to get approval for SCIG when coming from IV. Some states actually mandate SCIG over IV due to cost savings from what I have heard. I know dd's IVIG was costing $4k mo at the hospital and that was before we doubled the dose. When we switched to SCIG at home the cost dropped to $1200 mo which is just the cost of the drug, Nufactor includes everything else with it. ________________________________ From: carievercelli <itsallaboutkreed@ <mailto:itsallaboutkreed%40cox.net> cox.net> groups (DOT) <mailto:%40> com Sent: Sun, April 18, 2010 1:25:18 PM Subject: Insurance I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. ------------------------------------ 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: http://groups. </messages> /group//messages Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 We use Gammagard SD SubQ. I can see your hesitation and it may not work. My son has emotional issues too. We did it at night with a mild sedative. (Benadryl) I would wait until he went to sleep and put some emla on and do it. It only takes a little over an hour. But.... as he got older(12) it became a bigger issue and we had to work out another plan. He is 14 now and is willing to do it but my son is high functioning. Oh we also use only 2 sites. He was suppose to use 4 but refused. We use 30cc per site with NO problems. It hardly turns red now after 4 years. BARBIE ________________________________ From: Carie <itsallaboutkreed@...> Sent: Sun, April 18, 2010 2:06:09 PM Subject: RE: Insurance My child has autism and is nonverbal. I have considered SCIG, but do not know if I could manage it with him. This is a child that is incredibly strong and fights any thing being done to him He won't allow bandages on him, and has instantly removed his stitches on his own. I really do worry about if SCIG is for us. Also I really would hate to take a chance on using anything other then Gammagard because he has zero reaction from it, and my Dr. won't approve using Gammagard for SCIG since it is not FDA approved. _____ From: groups (DOT) com [mailto:groups (DOT) com] On Behalf Of Madden Sent: Sunday, April 18, 2010 1:34 PM groups (DOT) com Subject: Re: Insurance IVIG is covered at 100% in all 50 states through medicaid in hospital. Have you considered switching to SCIG? You would no longer need private nursing and its very easy to get approval for SCIG when coming from IV. Some states actually mandate SCIG over IV due to cost savings from what I have heard. I know dd's IVIG was costing $4k mo at the hospital and that was before we doubled the dose. When we switched to SCIG at home the cost dropped to $1200 mo which is just the cost of the drug, Nufactor includes everything else with it. ____________ _________ _________ __ From: carievercelli <itsallaboutkreed@ <mailto:itsallabout kreed%40cox. net> cox.net> groups (DOT) <mailto:% 40groups. com> com Sent: Sun, April 18, 2010 1:25:18 PM Subject: Insurance I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. ------------ --------- --------- ------ 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 -unsubscribe@ groups. To search group archives go to: http://groups. <http://groups. / group// messages> /group/ /messagesY ahoo! Groups Links Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 Actually since it is state government the rules in are in writing if you can get the RIGHT people to talk to . I would call the state Department of Health ( or contact the people that showed you) ask them to do a review of what your choices include for his specific services. Like Pre-authorizing and see what it would cost you to be on it or not. It will take your time but at least you will know what your options are. I would keep calling to talk to someone that is willing to help you figure this out. There are some GREAT people working for the state but also some burned out souls. I am not talking about talking to the local dshs office but actually a nurse. BARBIE ________________________________ From: Carie <itsallaboutkreed@...> Sent: Sun, April 18, 2010 2:18:08 PM Subject: RE: Insurance Yes, that's right they do not charge you for co-pays, but they also will not cover things if your primary insurance could cover it first, so if we had a primary insurance and our home care agency will not take that primary insurance then we are forced to go to a place that does take it, but there is no place that takes our primary insurance that also takes our Medicaid too, so we would be stuck paying the leftover balance or we have to not put him on the primary so that we can use only our Medicaid. Having Medicaid only really limits you. They also tend to deny a lot (at least here) and they say they are impossible to fight. We have been really confused with what is the best thing to do. _____ From: groups (DOT) com [mailto:groups (DOT) com] On Behalf Of Barbara Jimenez Sent: Sunday, April 18, 2010 1:58 PM groups (DOT) com Subject: Re: Insurance As we learned EVERY state writes its own rules. There are state laws that write the rules regarding how the Federal funds are implemented. We at this time only have Medicaid in WA state and we do fine. It just takes a little more work to get a state care manager to reduce risk. I would also encourage you to contact IDF and see if someone there can help you. I thought that if my son was on SSI that he would have insurance ( medicare or Medicaid) but there are 3 states do not give kids Medicaid even if they are on SSI. We moved back to WA state because my son could not get ANY insurance in Oklahoma even on SSI. Also if you are on Medicaid they cannot charge you co-pays for anything if it is something that Medicaid does pay even if your primary does not pay for it. It is complex but personally I see some relief in the future especially for our kids.(September) BARBIE ____________ _________ _________ __ From: Madden <bluetaelon@ att. <mailto:bluetaelon% 40att.net> net> groups (DOT) <mailto:% 40groups. com> com Sent: Sun, April 18, 2010 1:33:35 PM Subject: Re: Insurance IVIG is covered at 100% in all 50 states through medicaid in hospital. Have you considered switching to SCIG? You would no longer need private nursing and its very easy to get approval for SCIG when coming from IV. Some states actually mandate SCIG over IV due to cost savings from what I have heard. I know dd's IVIG was costing $4k mo at the hospital and that was before we doubled the dose. When we switched to SCIG at home the cost dropped to $1200 mo which is just the cost of the drug, Nufactor includes everything else with it. ____________ _________ _________ __ From: carievercelli <itsallaboutkreed@ cox.net> groups (DOT) com Sent: Sun, April 18, 2010 1:25:18 PM Subject: Insurance I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. ------------ --------- --------- ------ 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 -unsubscribe@ groups. To search group archives go to: http://groups. / group// messages Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 Really? Here they cover MORE then the crappy HMO they make everyone get. dd just qualified for SSI and I'm moving her to straight Medi-cal (medicaid) because it covers more then the HMO. ________________________________ From: Carie <itsallaboutkreed@...> Sent: Sun, April 18, 2010 2:18:08 PM Subject: RE: Insurance Yes, that's right they do not charge you for co-pays, but they also will not cover things if your primary insurance could cover it first, so if we had a primary insurance and our home care agency will not take that primary insurance then we are forced to go to a place that does take it, but there is no place that takes our primary insurance that also takes our Medicaid too, so we would be stuck paying the leftover balance or we have to not put him on the primary so that we can use only our Medicaid. Having Medicaid only really limits you. They also tend to deny a lot (at least here) and they say they are impossible to fight. We have been really confused with what is the best thing to do. _____ From: [mailto: ] On Behalf Of Barbara Jimenez Sent: Sunday, April 18, 2010 1:58 PM Subject: Re: Insurance As we learned EVERY state writes its own rules. There are state laws that write the rules regarding how the Federal funds are implemented. We at this time only have Medicaid in WA state and we do fine. It just takes a little more work to get a state care manager to reduce risk. I would also encourage you to contact IDF and see if someone there can help you. I thought that if my son was on SSI that he would have insurance ( medicare or Medicaid) but there are 3 states do not give kids Medicaid even if they are on SSI. We moved back to WA state because my son could not get ANY insurance in Oklahoma even on SSI. Also if you are on Medicaid they cannot charge you co-pays for anything if it is something that Medicaid does pay even if your primary does not pay for it. It is complex but personally I see some relief in the future especially for our kids.(September) BARBIE ________________________________ From: Madden <bluetaelonatt (DOT) <mailto:bluetaelon%40att.net> net> groups (DOT) <mailto:%40> com Sent: Sun, April 18, 2010 1:33:35 PM Subject: Re: Insurance IVIG is covered at 100% in all 50 states through medicaid in hospital. Have you considered switching to SCIG? You would no longer need private nursing and its very easy to get approval for SCIG when coming from IV. Some states actually mandate SCIG over IV due to cost savings from what I have heard. I know dd's IVIG was costing $4k mo at the hospital and that was before we doubled the dose. When we switched to SCIG at home the cost dropped to $1200 mo which is just the cost of the drug, Nufactor includes everything else with it. ____________ _________ _________ __ From: carievercelli <itsallaboutkreed@ cox.net> groups (DOT) com Sent: Sun, April 18, 2010 1:25:18 PM Subject: Insurance I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. ------------ --------- --------- ------ 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 -unsubscribe@ groups. To search group archives go to: http://groups. / group// messages Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 He could talk to our OK immunologist or even our current one or even call IDF. It is being used all over the country. We were not given an option to use Vivaglobin since my son had no IgA. It has been used in Europe for over 25 years sub Q. BARBIE ________________________________ From: Carie <itsallaboutkreed@...> Sent: Sun, April 18, 2010 2:21:24 PM Subject: RE: Insurance How do you get your Doctor to agree to use Gammgard for SCIG if it is not FDA approved? I have asked and he didn't even seem to know it was an option? Does he contact someone? _____ From: groups (DOT) com [mailto:groups (DOT) com] On Behalf Of Madden Sent: Sunday, April 18, 2010 2:07 PM groups (DOT) com Subject: Re: Insurance We have familes with autism who do SCIG, perhaps they will weigh in:) We did Gammagard for IV then switched to Gamunex for SCIG without a problem which many people use. I " think " Viva is the only SCIG thats FDA approved but thats pretty recent, people have been using other products for decades without a problem. ____________ _________ _________ __ From: Carie <itsallaboutkreed@ <mailto:itsallabout kreed%40cox. net> cox.net> groups (DOT) <mailto:% 40groups. com> com Sent: Sun, April 18, 2010 2:06:09 PM Subject: RE: Insurance My child has autism and is nonverbal. I have considered SCIG, but do not know if I could manage it with him. This is a child that is incredibly strong and fights any thing being done to him He won't allow bandages on him, and has instantly removed his stitches on his own. I really do worry about if SCIG is for us. Also I really would hate to take a chance on using anything other then Gammagard because he has zero reaction from it, and my Dr. won't approve using Gammagard for SCIG since it is not FDA approved. _____ From: groups (DOT) <mailto:% 40groups. com> com [mailto:@ groups. <mailto:% 40groups. com> com] On Behalf Of Madden Sent: Sunday, April 18, 2010 1:34 PM groups (DOT) <mailto:% 40groups. com> com Subject: Re: Insurance IVIG is covered at 100% in all 50 states through medicaid in hospital. Have you considered switching to SCIG? You would no longer need private nursing and its very easy to get approval for SCIG when coming from IV. Some states actually mandate SCIG over IV due to cost savings from what I have heard. I know dd's IVIG was costing $4k mo at the hospital and that was before we doubled the dose. When we switched to SCIG at home the cost dropped to $1200 mo which is just the cost of the drug, Nufactor includes everything else with it. ____________ _________ _________ __ From: carievercelli <itsallaboutkreed@ <mailto:itsallabout kreed%40cox. net> cox.net> groups (DOT) <mailto:% 40groups. com> com Sent: Sun, April 18, 2010 1:25:18 PM Subject: Insurance I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. ------------ --------- --------- ------ 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 -unsubscribe@ groups. To search group archives go to: http://groups. <http://groups. <http://groups. / group// messages> /group/ /messagesY ahoo> /group/ /messagesY ahoo! Groups Links Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 Quick google search " Gammagard scig " shows Gammagard can be and is used for SCIG:) ________________________________ From: Carie <itsallaboutkreed@...> Sent: Sun, April 18, 2010 2:23:54 PM Subject: RE: Insurance I would really be open to this option, but only if I could use Gammagard like I have been using. I would really need someone to help me that knows what they are doing, and our home nurse of 3 years just left due to medical issues for himself, so my new nurse does not know how my child well enough to help me. _____ From: [mailto: ] On Behalf Of Barbara Jimenez Sent: Sunday, April 18, 2010 2:08 PM Subject: Re: Insurance We use Gammagard SD SubQ. I can see your hesitation and it may not work. My son has emotional issues too. We did it at night with a mild sedative. (Benadryl) I would wait until he went to sleep and put some emla on and do it. It only takes a little over an hour. But.... as he got older(12) it became a bigger issue and we had to work out another plan. He is 14 now and is willing to do it but my son is high functioning. Oh we also use only 2 sites. He was suppose to use 4 but refused. We use 30cc per site with NO problems. It hardly turns red now after 4 years. BARBIE ________________________________ From: Carie <itsallaboutkreed@ <mailto:itsallaboutkreed%40cox.net> cox.net> groups (DOT) <mailto:%40> com Sent: Sun, April 18, 2010 2:06:09 PM Subject: RE: Insurance My child has autism and is nonverbal. I have considered SCIG, but do not know if I could manage it with him. This is a child that is incredibly strong and fights any thing being done to him He won't allow bandages on him, and has instantly removed his stitches on his own. I really do worry about if SCIG is for us. Also I really would hate to take a chance on using anything other then Gammagard because he has zero reaction from it, and my Dr. won't approve using Gammagard for SCIG since it is not FDA approved. _____ From: groups (DOT) com [mailto:groups (DOT) com] On Behalf Of Madden Sent: Sunday, April 18, 2010 1:34 PM groups (DOT) com Subject: Re: Insurance IVIG is covered at 100% in all 50 states through medicaid in hospital. Have you considered switching to SCIG? You would no longer need private nursing and its very easy to get approval for SCIG when coming from IV. Some states actually mandate SCIG over IV due to cost savings from what I have heard. I know dd's IVIG was costing $4k mo at the hospital and that was before we doubled the dose. When we switched to SCIG at home the cost dropped to $1200 mo which is just the cost of the drug, Nufactor includes everything else with it. ____________ _________ _________ __ From: carievercelli <itsallaboutkreed@ <mailto:itsallabout kreed%40cox. net> cox.net> groups (DOT) <mailto:% 40groups. com> com Sent: Sun, April 18, 2010 1:25:18 PM Subject: Insurance I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. ------------ --------- --------- ------ 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 -unsubscribe@ groups. To search group archives go to: http://groups. <http://groups. / group// messages> /group/ /messagesY ahoo! Groups Links Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 Quick google search " Gammagard scig " shows Gammagard can be and is used for SCIG:) ________________________________ From: Carie <itsallaboutkreed@...> Sent: Sun, April 18, 2010 2:23:54 PM Subject: RE: Insurance I would really be open to this option, but only if I could use Gammagard like I have been using. I would really need someone to help me that knows what they are doing, and our home nurse of 3 years just left due to medical issues for himself, so my new nurse does not know how my child well enough to help me. _____ From: [mailto: ] On Behalf Of Barbara Jimenez Sent: Sunday, April 18, 2010 2:08 PM Subject: Re: Insurance We use Gammagard SD SubQ. I can see your hesitation and it may not work. My son has emotional issues too. We did it at night with a mild sedative. (Benadryl) I would wait until he went to sleep and put some emla on and do it. It only takes a little over an hour. But.... as he got older(12) it became a bigger issue and we had to work out another plan. He is 14 now and is willing to do it but my son is high functioning. Oh we also use only 2 sites. He was suppose to use 4 but refused. We use 30cc per site with NO problems. It hardly turns red now after 4 years. BARBIE ________________________________ From: Carie <itsallaboutkreed@ <mailto:itsallaboutkreed%40cox.net> cox.net> groups (DOT) <mailto:%40> com Sent: Sun, April 18, 2010 2:06:09 PM Subject: RE: Insurance My child has autism and is nonverbal. I have considered SCIG, but do not know if I could manage it with him. This is a child that is incredibly strong and fights any thing being done to him He won't allow bandages on him, and has instantly removed his stitches on his own. I really do worry about if SCIG is for us. Also I really would hate to take a chance on using anything other then Gammagard because he has zero reaction from it, and my Dr. won't approve using Gammagard for SCIG since it is not FDA approved. _____ From: groups (DOT) com [mailto:groups (DOT) com] On Behalf Of Madden Sent: Sunday, April 18, 2010 1:34 PM groups (DOT) com Subject: Re: Insurance IVIG is covered at 100% in all 50 states through medicaid in hospital. Have you considered switching to SCIG? You would no longer need private nursing and its very easy to get approval for SCIG when coming from IV. Some states actually mandate SCIG over IV due to cost savings from what I have heard. I know dd's IVIG was costing $4k mo at the hospital and that was before we doubled the dose. When we switched to SCIG at home the cost dropped to $1200 mo which is just the cost of the drug, Nufactor includes everything else with it. ____________ _________ _________ __ From: carievercelli <itsallaboutkreed@ <mailto:itsallabout kreed%40cox. net> cox.net> groups (DOT) <mailto:% 40groups. com> com Sent: Sun, April 18, 2010 1:25:18 PM Subject: Insurance I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. ------------ --------- --------- ------ 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 -unsubscribe@ groups. To search group archives go to: http://groups. <http://groups. / group// messages> /group/ /messagesY ahoo! Groups Links Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 Yes, that's right they do not charge you for co-pays, but they also will not cover things if your primary insurance could cover it first, so if we had a primary insurance and our home care agency will not take that primary insurance then we are forced to go to a place that does take it, but there is no place that takes our primary insurance that also takes our Medicaid too, so we would be stuck paying the leftover balance or we have to not put him on the primary so that we can use only our Medicaid. Having Medicaid only really limits you. They also tend to deny a lot (at least here) and they say they are impossible to fight. We have been really confused with what is the best thing to do. _____ From: [mailto: ] On Behalf Of Barbara Jimenez Sent: Sunday, April 18, 2010 1:58 PM Subject: Re: Insurance As we learned EVERY state writes its own rules. There are state laws that write the rules regarding how the Federal funds are implemented. We at this time only have Medicaid in WA state and we do fine. It just takes a little more work to get a state care manager to reduce risk. I would also encourage you to contact IDF and see if someone there can help you. I thought that if my son was on SSI that he would have insurance ( medicare or Medicaid) but there are 3 states do not give kids Medicaid even if they are on SSI. We moved back to WA state because my son could not get ANY insurance in Oklahoma even on SSI. Also if you are on Medicaid they cannot charge you co-pays for anything if it is something that Medicaid does pay even if your primary does not pay for it. It is complex but personally I see some relief in the future especially for our kids.(September) BARBIE ________________________________ From: Madden <bluetaelonatt (DOT) <mailto:bluetaelon%40att.net> net> groups (DOT) <mailto:%40> com Sent: Sun, April 18, 2010 1:33:35 PM Subject: Re: Insurance IVIG is covered at 100% in all 50 states through medicaid in hospital. Have you considered switching to SCIG? You would no longer need private nursing and its very easy to get approval for SCIG when coming from IV. Some states actually mandate SCIG over IV due to cost savings from what I have heard. I know dd's IVIG was costing $4k mo at the hospital and that was before we doubled the dose. When we switched to SCIG at home the cost dropped to $1200 mo which is just the cost of the drug, Nufactor includes everything else with it. ____________ _________ _________ __ From: carievercelli <itsallaboutkreed@ cox.net> groups (DOT) com Sent: Sun, April 18, 2010 1:25:18 PM Subject: Insurance I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. ------------ --------- --------- ------ 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 -unsubscribe@ groups. To search group archives go to: http://groups. / group// messages Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 Are you sure about that, Carie? Our primary insurance (BCBS) doesn't pay for ANY of our home nursing but Medicaid (secondary) does. It could be different in different states (we're in Indiana) but in our case it has nothing to do with whether or not the insurance is accepted at the agency because BCBS wouldn't pay for it period. Have you talked directly with the nursing agency because I would think they are the ones that would be most familiar (we have discovered that the Medicaid people don't really know anything)? Is this for nursing for home IVIG or other home nursing because maybe that's the difference, too - we have both. Personally, I love still having the BCBS as primary because when we need to travel for care or have any other big expenses, I don't deal with the Medicaid bureaucratic red tape as you mentioned. By the beginning of March every year, we have met our out of pocket max so Medicaid only pays for our nursing and our pharmacy co-pays - BCBS pays at 100% of medical once we've reached the OOP max. Good luck with your decision and good for you for checking out all benefits and repercussions before making the decision! Mom to 4, 3 with mito From: [mailto: ] On Behalf Of Carie Sent: Sunday, April 18, 2010 5:18 PM Subject: RE: Insurance Yes, that's right they do not charge you for co-pays, but they also will not cover things if your primary insurance could cover it first, so if we had a primary insurance and our home care agency will not take that primary insurance then we are forced to go to a place that does take it, but there is no place that takes our primary insurance that also takes our Medicaid too, so we would be stuck paying the leftover balance or we have to not put him on the primary so that we can use only our Medicaid. Having Medicaid only really limits you. They also tend to deny a lot (at least here) and they say they are impossible to fight. We have been really confused with what is the best thing to do. _____ From: <mailto:%40> [mailto: <mailto:%40> ] On Behalf Of Barbara Jimenez Sent: Sunday, April 18, 2010 1:58 PM <mailto:%40> Subject: Re: Insurance As we learned EVERY state writes its own rules. There are state laws that write the rules regarding how the Federal funds are implemented. We at this time only have Medicaid in WA state and we do fine. It just takes a little more work to get a state care manager to reduce risk. I would also encourage you to contact IDF and see if someone there can help you. I thought that if my son was on SSI that he would have insurance ( medicare or Medicaid) but there are 3 states do not give kids Medicaid even if they are on SSI. We moved back to WA state because my son could not get ANY insurance in Oklahoma even on SSI. Also if you are on Medicaid they cannot charge you co-pays for anything if it is something that Medicaid does pay even if your primary does not pay for it. It is complex but personally I see some relief in the future especially for our kids.(September) BARBIE ________________________________ From: Madden <bluetaelonatt (DOT) <mailto:bluetaelon%40att.net> net> groups (DOT) <mailto:%40> com Sent: Sun, April 18, 2010 1:33:35 PM Subject: Re: Insurance IVIG is covered at 100% in all 50 states through medicaid in hospital. Have you considered switching to SCIG? You would no longer need private nursing and its very easy to get approval for SCIG when coming from IV. Some states actually mandate SCIG over IV due to cost savings from what I have heard. I know dd's IVIG was costing $4k mo at the hospital and that was before we doubled the dose. When we switched to SCIG at home the cost dropped to $1200 mo which is just the cost of the drug, Nufactor includes everything else with it. ____________ _________ _________ __ From: carievercelli <itsallaboutkreed@ cox.net> groups (DOT) com Sent: Sun, April 18, 2010 1:25:18 PM Subject: Insurance I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. ------------ --------- --------- ------ 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 -unsubscribe@ groups. To search group archives go to: http://groups. / group// messages Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 Are you sure about that, Carie? Our primary insurance (BCBS) doesn't pay for ANY of our home nursing but Medicaid (secondary) does. It could be different in different states (we're in Indiana) but in our case it has nothing to do with whether or not the insurance is accepted at the agency because BCBS wouldn't pay for it period. Have you talked directly with the nursing agency because I would think they are the ones that would be most familiar (we have discovered that the Medicaid people don't really know anything)? Is this for nursing for home IVIG or other home nursing because maybe that's the difference, too - we have both. Personally, I love still having the BCBS as primary because when we need to travel for care or have any other big expenses, I don't deal with the Medicaid bureaucratic red tape as you mentioned. By the beginning of March every year, we have met our out of pocket max so Medicaid only pays for our nursing and our pharmacy co-pays - BCBS pays at 100% of medical once we've reached the OOP max. Good luck with your decision and good for you for checking out all benefits and repercussions before making the decision! Mom to 4, 3 with mito From: [mailto: ] On Behalf Of Carie Sent: Sunday, April 18, 2010 5:18 PM Subject: RE: Insurance Yes, that's right they do not charge you for co-pays, but they also will not cover things if your primary insurance could cover it first, so if we had a primary insurance and our home care agency will not take that primary insurance then we are forced to go to a place that does take it, but there is no place that takes our primary insurance that also takes our Medicaid too, so we would be stuck paying the leftover balance or we have to not put him on the primary so that we can use only our Medicaid. Having Medicaid only really limits you. They also tend to deny a lot (at least here) and they say they are impossible to fight. We have been really confused with what is the best thing to do. _____ From: <mailto:%40> [mailto: <mailto:%40> ] On Behalf Of Barbara Jimenez Sent: Sunday, April 18, 2010 1:58 PM <mailto:%40> Subject: Re: Insurance As we learned EVERY state writes its own rules. There are state laws that write the rules regarding how the Federal funds are implemented. We at this time only have Medicaid in WA state and we do fine. It just takes a little more work to get a state care manager to reduce risk. I would also encourage you to contact IDF and see if someone there can help you. I thought that if my son was on SSI that he would have insurance ( medicare or Medicaid) but there are 3 states do not give kids Medicaid even if they are on SSI. We moved back to WA state because my son could not get ANY insurance in Oklahoma even on SSI. Also if you are on Medicaid they cannot charge you co-pays for anything if it is something that Medicaid does pay even if your primary does not pay for it. It is complex but personally I see some relief in the future especially for our kids.(September) BARBIE ________________________________ From: Madden <bluetaelonatt (DOT) <mailto:bluetaelon%40att.net> net> groups (DOT) <mailto:%40> com Sent: Sun, April 18, 2010 1:33:35 PM Subject: Re: Insurance IVIG is covered at 100% in all 50 states through medicaid in hospital. Have you considered switching to SCIG? You would no longer need private nursing and its very easy to get approval for SCIG when coming from IV. Some states actually mandate SCIG over IV due to cost savings from what I have heard. I know dd's IVIG was costing $4k mo at the hospital and that was before we doubled the dose. When we switched to SCIG at home the cost dropped to $1200 mo which is just the cost of the drug, Nufactor includes everything else with it. ____________ _________ _________ __ From: carievercelli <itsallaboutkreed@ cox.net> groups (DOT) com Sent: Sun, April 18, 2010 1:25:18 PM Subject: Insurance I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. ------------ --------- --------- ------ 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 -unsubscribe@ groups. To search group archives go to: http://groups. / group// messages Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 Yes, they do have a CRS program. Does anyone know what this means in terms of IVIG? _____ From: [mailto: ] On Behalf Of Barbara Jimenez Sent: Sunday, April 18, 2010 2:03 PM Subject: Re: Insurance Actually SOME states do and it looks like the good news is that Arizonia does have a program. EVERY state is different. I went to EVERY possible agency,legislator(state and Federal) ,DHS, Health Care Authority in OK and was told to leave the state or my son would die. They do not have ANY program for kids in my sons situation. He is on SS but there is NO health insurance for him since he has a pre-existing condition. My only income is SSDI so I am NOT wealthy. I am working with the NPAF national Patient Advocacy Foundation to see why some of the National programs that are law for kids are not being implemented in states like Oklahoma. It is a HUGE hole in the system. My son could have died if I stayed in OK and there are 3 other states that have similar laws. BARBIE ________________________________ From: Madden <bluetaelonatt (DOT) <mailto:bluetaelon%40att.net> net> groups (DOT) <mailto:%40> com Sent: Sun, April 18, 2010 1:54:23 PM Subject: Re: Insurance Yes you do, all states do, you just have to know where to look:) http://www.azdhs. gov/phs/ocshcn/ crs/crs_az. htm ____________ _________ _________ __ From: Carie <itsallaboutkreed@ cox.net> groups (DOT) com Sent: Sun, April 18, 2010 2:01:19 PM Subject: RE: Insurance Arizona, we do not have what you are talking about. _____ From: groups (DOT) com [mailto:groups (DOT) com] On Behalf Of aymee Sent: Sunday, April 18, 2010 1:31 PM groups (DOT) com Subject: Re: Insurance What state are you in ????? I know some states have Special Children's Healthcare.. . It helps cover anything medical expensives that are left over from private or state insurance... . Its a differnt program then your state insurance and is usualy run through your local Health Dept. not the DHS office.... I would check with them to start because even if they couldn't help they could point you in the right direction From: carievercelli <itsallaboutkreed@ <mailto:itsallabout kreed%40cox. net> cox.net> Subject: Insurance groups (DOT) <mailto:% 40groups. com> com Date: Sunday, April 18, 2010, 4:25 PM I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2010 Report Share Posted April 18, 2010 How do you get your Doctor to agree to use Gammgard for SCIG if it is not FDA approved? I have asked and he didn't even seem to know it was an option? Does he contact someone? _____ From: [mailto: ] On Behalf Of Madden Sent: Sunday, April 18, 2010 2:07 PM Subject: Re: Insurance We have familes with autism who do SCIG, perhaps they will weigh in:) We did Gammagard for IV then switched to Gamunex for SCIG without a problem which many people use. I " think " Viva is the only SCIG thats FDA approved but thats pretty recent, people have been using other products for decades without a problem. ________________________________ From: Carie <itsallaboutkreed@ <mailto:itsallaboutkreed%40cox.net> cox.net> groups (DOT) <mailto:%40> com Sent: Sun, April 18, 2010 2:06:09 PM Subject: RE: Insurance My child has autism and is nonverbal. I have considered SCIG, but do not know if I could manage it with him. This is a child that is incredibly strong and fights any thing being done to him He won't allow bandages on him, and has instantly removed his stitches on his own. I really do worry about if SCIG is for us. Also I really would hate to take a chance on using anything other then Gammagard because he has zero reaction from it, and my Dr. won't approve using Gammagard for SCIG since it is not FDA approved. _____ From: groups (DOT) <mailto:%40> com [mailto:groups (DOT) <mailto:%40> com] On Behalf Of Madden Sent: Sunday, April 18, 2010 1:34 PM groups (DOT) <mailto:%40> com Subject: Re: Insurance IVIG is covered at 100% in all 50 states through medicaid in hospital. Have you considered switching to SCIG? You would no longer need private nursing and its very easy to get approval for SCIG when coming from IV. Some states actually mandate SCIG over IV due to cost savings from what I have heard. I know dd's IVIG was costing $4k mo at the hospital and that was before we doubled the dose. When we switched to SCIG at home the cost dropped to $1200 mo which is just the cost of the drug, Nufactor includes everything else with it. ________________________________ From: carievercelli <itsallaboutkreed@ <mailto:itsallaboutkreed%40cox.net> cox.net> groups (DOT) <mailto:%40> com Sent: Sun, April 18, 2010 1:25:18 PM Subject: Insurance I do not know what to do. We lose our cobra insurance in a couple of weeks, and will be left with only our state insurance. We have an opportunity through my husbands work to get new insurance, but no home care angency's take both the new insurance and my secondary state insurance. If I don't put him on our new insurance then I can use our current home agency of 3 years, but it is a scary thought to only have medicaid for him, and not two insurances for him like we have always had. If we put him on our new insurance then it will be considered our primary insurance and not one home care agency takes it and also our secondary insurance so we would be forced to cover the rest. Did all that make sense? We get IVIG every month and could never afford to pay the rest anyway. I just do not know what to do. I am assuming that the hospitals take both insurances, but we used to do our infusions at the hospital and it was nightmarish! My son has a metabolic disorder also, and is nonverbal with autism, and he refuses to eat when we go to the hospital and his blood sugar drops and they also can never get his vein (he is a hard stick), and it takes 8 hours compared to 1 1/2 when we do it at home. It really is very stressful for him to not have it at home. They also will not guarentee he will get his brand of IVIG that he needs, and he has had severe reactions to other brands, so this is not even an option for us. Any ideas? We have to make a decision by the end of the month. Thanks Carie mom to Kreed 12 CVID, SCAD, hypothyroidism, epilepsy, colitis, gastritis, autism, possible NIPBL, and mito. ------------------------------------ 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: http://groups. <http://groups. </messages> /group//messages> /group//messages Quote Link to comment Share on other sites More sharing options...
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