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IV vs oral antibiotics

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Posted 7/26/2014 3:07 PM (GMT 0)
For those of you who are taking abx via IV/picc—and anyone else who might have thoughts:

How was the process of getting insurance coverage for this more expensive delivery of abx?
Did your insurance companies require CDC positive tests?
Did it require extra coaxing or convincing from you/LLMD?
What other conditions (especially GI) did you have or have to prove before it was covered?
Did you have to take oral abx for a period of time first?
Was a long-term program approved or only a short-term?

Any other thoughts?

thanks -
p
Posted 7/26/2014 4:04 PM (GMT 0)
Good morning! My daughter recently completed 6 weeks of IV antibiotics. She had a CDC positive test from Igenex, 2.5 months of oral antibiotics with little to no improvement, and we had no problem getting the IV covered by insurance. Once the doctor decided she needed IV, he called the lab, the lab called insurance and approval was given in one day with no coaxing, arguing, etc needed which surprised me! It was only approved for a short term, 6 weeks. The insurance required that the line be pulled after 6 weeks and my daughter re-evaluated. Her re-evaluation is next Thursday and doctor does think she will need another round of the IV antibiotics. Whether or not the insurance will approve it as easily as they did the first round, remains to be seen.

She was very lucky and had no adverse effects, GI or otherwise, with the IV antibiotics.

I know that the various insurance companies handle things differently. Hope you don't have a problem with yours.

Hope this helps!

Denise
Posted 7/26/2014 4:48 PM (GMT 0)
Thanks so much Denise -

That's great that your daughter didn't have adverse effects—she has enough going on.

I am strongly considering IV since I have so many GI problems that aren't improving much. I started herbal treatment for lyme (CDC positive) only last March and recently introduced more herbal treatment for Bartonella and Babesia in order to get more CDC positive testing results for those co-infections. LLMD thinks I might have other infections as well but they are on back burner for now. I am handling the herbs well but feel ready and willing to try the abx but only via IV and only if it's covered (I am flat broke and not working).

I have read many similar stories to your daughter's, that the first 6 wks was easily approved and approval for additional time was a battle. But I hope you don't have issues.

I'm also curious how my LLMD is going to treat all three co-infections—or if she is. I really want to get this show on the road, but my guess is she'll try to slow down the pace a bit.

thanks -
p
Posted 7/27/2014 3:51 AM (GMT 0)
anyone else???
Posted 7/27/2014 4:50 AM (GMT 0)
I did oral abx for 5 months and only got worse. Started IV's and within weeks started feeling better. Ins company has not questioned anything and is paying. Good luck!
Posted 7/27/2014 1:18 PM (GMT 0)
Good to know pictureofhealth! I don't think my GI can take 5 mos of oral abx so I hope I can convince my LLMD & insurance co. to start w/ IV. Thx -

-p
Posted 7/29/2014 12:34 PM (GMT 0)
Pirouette,

I did IV Rocephin for 13 month followed by 3 months IV Doxy. IV coverage varies greatly from state to state, and with insurance companies. Maybe post your state and insurance company name to get more specific advice.

For example: RI, CT and MA (pending approval this week) all have laws that require insurance companies to cover all Lyme related treatment (within individual policy coverage) for as long as a licensed MD prescribes the treatment.
Posted 7/30/2014 4:44 AM (GMT 0)
Thanks tickbite666 -
good idea.

Covered California / HealthNet PPO

Wow. I did not know that about the required coverage for those states. Great progress. Hopefully, now that lyme & co. is rampant throughout the states the other states will catch up… you know, in about 20 yrs… It sets great precedence, though.

-p
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