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Old 09-28-2005, 05:41 AM   #1
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How do people pay for IV antibiotics, PICC Line, Nursing, etc- very worried!!!

Hi all.

I might have posed this before, but I was wondering, for those of you on IV antibiotics, how do you pay for it? Does insurance cover it?? I was told to go on Medicaid, but unfortunately, I don't qualify due to my husband's income- we would have to spend down our entire income and not even be able to pay our rent. My insurance company will not pay for IV unless you meet this ridiculous criteria!

I was told that I will most likely need IV due to long standing illness and neuro/psych symptoms. I was also told IV was $230 a DAY!!! How the heck can ANYONE afford that??? Not to mention the expenses of having the PICC line inserted, possible nursing care. My husband is working, but we certainly don't have thousands of dollars to spend or borrow for that matter.

So, does your insurance company pay for all your IV or do you have some out of pocket expenses, but manageable? I am very upset because I have heard alot of people getting well on IV's and they might be out of my reach financially. I already have a systemic yeast problem, even before going on the doxy, due to a suppressed immune system. The orals are making it worse, no matter how much probiotics and antifungal meds I take and diet I follow!!! (I heard the IV's still cause yeast, but are a BIT easier since they bypass the stomach).

Someone from one of my support groups said I will have to fight the insurance company and appeal and eventually they will pay= that could take months or even a year. Right now, if my insurance company DOES pay, it is only for 4 weeks and no more!!

Thanks for any info!!! I am very scared I wont get the help I need due to finances, or lack there of!!! ;-(

-Nancy

 
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Old 09-28-2005, 06:16 AM   #2
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Re: How do people pay for IV antibiotics, PICC Line, Nursing, etc- very worried!!!

Dear Nancy,

The picc-line is expensive but your doctor probably won't go that route unless your insurance agrees to it. I did 6 weeks and the doctor re-applied for more and it was granted because I was making progress. Unfortunately I had to quit because of the liver enzymes rocketing. It ended up costing me about $302/week after insurance. My husband is retired and this is killing us especially since I didn't recover because we had to quit too soon. I will be paying the doctor about $300/month for the next year and a half because we started in October and went into a new year so I got hit with 2 deductibles. This is a consideration. I know what your insurance says but maybe the doctor has a way around this. Thank goodness mine is patient with the payments and I could probably pay even less/month but I hate it hanging over my head. My husband retired and is working at Home Depot 3 days a week to pay for my medical care and insurance because nobody wants me and he is on medicare. Working there is a far cry from the high tech job he used to work believe me and the pay stinks. The proverbial rock and a hard place. I am just hoping we don't spend all our savings on getting me better. We definitely had other plans for retirement.

Maureen

 
Old 09-28-2005, 08:12 AM   #3
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Re: How do people pay for IV antibiotics, PICC Line, Nursing, etc- very worried!!!

Hi Nancy...sorry to hear about the problem with your insurance coverage. i know every company is different in costs and coverage for ivs. i was very lucky to have one that pretty much covers 80% of all costs and even more concerning the actual meds themselves...ive had 2 rounds of 5-6 week ivs (rocephin and then primaxin) and the actual bill the insurance has paid off is about 9,500. i have to pay the remaining 600. but to not have insurance i would never have been able to go the iv route. i know at first my ins said that they would not pay for iv, but we asked them under what criteria it would be covered and then told my dr what they were and he met them and worked directly with my insurance to make sure they would pay for it. i sure hope you can find a resouliton for your own ins dilema....keep fighting and you will get there. i am glad you have a support group to go to for help, i cannt imagine how awesome that must be to be able to go to and see them in person for help and advice. good luck and youll be in my prayers.

shanna
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"Be joyful in hope, patient in affliction, and faithful in prayer." - Romans 12:12

 
Old 09-28-2005, 04:13 PM   #4
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Re: How do people pay for IV antibiotics, PICC Line, Nursing, etc- very worried!!!

Nancy:

Have you tried getting in touch with the pharmaceutical companies regarding their patient programs that Ticker has posted so often about?

 
Old 09-28-2005, 04:17 PM   #5
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Re: How do people pay for IV antibiotics, PICC Line, Nursing, etc- very worried!!!

haven't contacted roche yet (rocephin company- not sure how to spell), but contacted several and i don't qualify for any either because my household income is too high or I have other insurance. You have to be making a million a year to afford 230 dollars a day!!!

 
Old 09-28-2005, 05:09 PM   #6
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Re: How do people pay for IV antibiotics, PICC Line, Nursing, etc- very worried!!!

Nancy

I posted some info previously about ins and how I have worked it using an in network Dr to request the IV instead of my LLMD who is not in network (she doesn't take ins at all) I didn't want to repeat all that info if you already read it. My ins co approved 3mnths of IV at first request. Unfortunately I had an infection in the line (they think?) and ended up in the hospital and 4 weeks was the end of that. Disappointing as I have chronic neuro and I was seeing some small improvements at 4 wks. After clearing the infection now I am back to oral abx for lyme.

The Dr who requested the IV was my in network neurologist. Maybe get one(in network neuro) who is open minded on board with your care. I think you have to basically interview them and find out what they know about Lyme and how they fell about IV as you would like to try it. If #1 is ng go to #2. I pretty much suggest what I want and my neuro usually agrees. My LLMD writes the rx for abx but I let my neuro know what's going on and ask for his imput. I think I remember you saying you had Oxford. I hear they are a progressive co. I have also found that when I have appealed, I have (so far) won. I bet a small percentage of people actually appeal, and they count on that.

My husband laughs because he says they(ins co) don't know who they are dealing with (meaning me). I can be very persistant. It takes alot of energy which we don't always have. Hate to sound cynical but they probabally count on that too.

Best of luck with the ins co and hope you are feeling better soon.

 
Old 09-28-2005, 06:34 PM   #7
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Re: How do people pay for IV antibiotics, PICC Line, Nursing, etc- very worried!!!

Lymegirl & Nancy
After reading your post, had to respond on the insurance. Everyboby read your EOB's and compare to what you are being billed. Lab made a hugh mistake on mine, they said I owed $1500 because I was not covered on my husbands policy. When I checked with ins co, I was told they had never sent it in. Then last week, a second mistake, not sure who made it. Then this week, another approx $600 mistake. This one was by my insurance company. They thought Lab had submitted claim more than once by mistake. Lab actually did the tests more than once at dr request. Lab billed me the difference. Ins admitted it was their mistake this time. This is going to be expensive enought, even if we have insurance, we don't want to pay what we are not suppose to. I thank God that I have insurance. I pray those of you that don't, can get the help you need. Don't give up, look up. Marsha

Last edited by Pearlscale; 09-28-2005 at 06:40 PM.

 
Old 09-29-2005, 04:53 AM   #8
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Re: How do people pay for IV antibiotics, PICC Line, Nursing, etc- very worried!!!

Hey all, I had a terrible time with my insurance company, they didn't want to pay for anything and I was much too sick to argue with them. Those of you who are fighting your insurance companies, I can't imagine how you do it, but I give you lots of credit for taking them on because they are ridiculous to deal with.

I just want to say that I had lyme for 20 years and had serious neurological problems, and I did not have IV but I am really greatly improved. So if you can't get IV meds, please don't give up or think you won't get better. I think IV would be helpful and certainly I'm not against it, but you can get better on oral abx.

As for the drug manufacturer programs, I applied for them and I was not eligible for most. You have to have a very low income to get them, but I did get one from pfizer and it turned out that the "discount" was higher than what I was already paying at the wholesale store that I bought my prescriptions (costco). I was paying $450 a month at coscto for zithromax. I called pfizer and I told them that I hadn't received any money off when using my "pfizer pfriends" card and asked them to quote me a price over the phone to send my prescription directly to them using their program. They quoted me $600. I said, "I can get it cheaper at costco without the discount card!" and they said, "then go to costco." We aren't pfriends any more.

 
Old 09-29-2005, 06:13 AM   #9
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Re: How do people pay for IV antibiotics, PICC Line, Nursing, etc- very worried!!!

Sleeper-

Can I ask, which antibiotics were you on? I was hearing Ketek is good in lieu of oral antibiotics. I am currently on 400mg doxycycline and plaquenil. I was told Biaxin is also very good, but I can;'t tolerate it.

So glad you are doing better. Can I ask, if I may, what neurological problems you were having?

Thanks,
Nancy

 
Old 09-29-2005, 06:17 AM   #10
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Re: How do people pay for IV antibiotics, PICC Line, Nursing, etc- very worried!!!

Also sleeper,

another concern of mine is yeast. I know yeast is a big problem on all antibiotics, but I heard it is a bit easier with the IV since it bypasses the stomach. Even before starting oral abx, I had a systemic yeast infection. My biggest fear is that, if the lyme don't kill me, the antibiotics eventually will even with the best of probiotics and antifungals. ;-(

 
Old 09-29-2005, 06:25 AM   #11
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Re: How do people pay for IV antibiotics, PICC Line, Nursing, etc- very worried!!!

Hi All,
My LLMD has me on Candex (yeast management system) by Pure essence labs. I had to order it on line. So far I have no signs of yeast infection after 2 weeks. Marsha

 
Old 09-30-2005, 06:16 AM   #12
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Re: How do people pay for IV antibiotics, PICC Line, Nursing, etc- very worried!!!

Hi sickandconfused, I can't tolerate biaxin either, it tore through me so bad I lost 25 pounds on it, and I'm a skinny one to begin with so that was very hard on me, I got extremely weak. Right now I take zithromax 500mg, plaquenil 400mg and flagyl (every other week on the flagyl) at 1000mg. It's working very well. I take cholestyramine to clear out the toxins. That's good stuff too.

For yeast, I take ketoconazole and I also use a very high quality probiotic called "healthy trinity" and it works great. I brush my mouth out with straight tea tree oil and keep some tea tree oil in the bathroom next to the toilet to use occasionally. Some of the other women on the board say it's a little too caustic for the private areas, but if I get yeast there, the tea tree oil does the job. I avoid sugar in my diet too, that makes a big difference.

See the other post called "sleeperwoken" for the neurological info. Blessings and good health to you...

 
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