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IVIG has again been denied. My Dx: CIDP.
Insurance Co. now states reason for denial is that IVIG is not FDA approved, and not "indicated" for my condition. I thought it was. But after having this conversation w/ Rep. from Humana, did a little research. one article cites only 6 "approved" conditions for IVIG & CIDp was not one. CIDP was addressed in this article. seems the issue (basis for insurance co. denial ) is FDA "approved" vs potential benefits, off label use of IVIG for the many conditons listed, inc. CIDP http://www.emedicine.com/med/topic3546.htm I'd been getting IVIG for few years. I'm "dually insured" --Medicare primary w/ Medicaid supplement . IVIG was covered by state medical assistance but since Medicare Pt. D, it's been denied. Intend to appeal-again; Rep tried to help and re-appeal but was unable. said my DR & I will have to try again . I'm waiting to hear back from his office to see what/if we can do anything. At last apt. DR said IVIG is the treatmt I need but how to get (besides paying out of pocket for this expensive treatmt; cost of just drug is $3000-- so not an option for me) I"ve gotten much worse since not getting IVIG..... I know folks in this forum do get IVIG; some have addressed issues w/ insurance . Does anyone have any suggestions, insight in what can be done? perhaps changing my insurance providor ??? I do have this option & Humana does seem a company that has had numerous complaints. Or will other Insurance providors also deny for same reason-- that IVIG is Not FDA approved, for my condition. What are conditions/Dx which others are getting IVIG [paid by insurance] ARe there better insurance co. , that will approve & pay for IVIG?? Suggestions, help in getting IVIG again, appreciated.... ps. .thought I was Posting this as New Thread, but it's here in this one RE: CIDP & related issues. if there's a better place or way to re-post please advise. or if someone more adept could re-post for me?? connections problems w/ PC have resulted in losing posts, as well as other problems [mainly the neuro issues] w/ writing & posting. I'm needing any/all help can get in this matter. THANKS. |
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