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Although I have been an absent participant for some time, I am hoping someone

may still have some words of wisdom for me regarding our current issue with the

insurance company. Today I opened an EOB to discover that has exceeded

her lifetime maximum benefit and according to this EOB alone we owe providers

$6,938 for what insurance no longer covers. Not to mention all of her

appointments and medications she needs. She is presently in PT, she has a

medication for a primary immune deficiency that runs up to $5000 a month, plus

her arthritis meds... she was supposed to see a new rheumy in a week... they

gave us no warning and our EOB's do not track that for us. I am in shock and at

a loss as to how we are going to provide the medical necessities for her. It

seems to me her primary immune deficiency meds should have been charged under

prescription meds like her Enbrel but they charged it under major medical so it

sucked her benefits dry.

turned 20 this week and should have 5 more years on the

insurance...pointless if there are no more benefits to be had.

Desperate for any ideas or suggestions or if any of you with older children have

faced anything like this???

Many thank yous in advance.

mom to (cvid, poly, hashimotos, migraines)

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