Insurance

Immune Deficiency Foundation - Peer Contact for GA

December 14, 2002

Thanks, Virginia! I am breathing easier today...you guys are all so nice to

respond. I have done some serious scrubbing-- toilets, tubs, floors...and I

feel less stressed .... hadn't been home in weeks to do it! Well...I was home

between doctor runs...but you all know how it goes.

I am hoping that our docs will set it up as a doc visit/clinic visit...then

we'll only pay the co-pay. We will be at the hospital on Dec 31st ad our HEM is

going to meet us at the ENT appt so we can all talk. They always want to know

when the boys have appts at the hospital and they come down to talk to the docs

with us. HOW cool is that? She takes time even when she isn;t getting paid to

visit us!

Pattie

Actually our insurance pays for all of Jonathons IVIG. They treat it as an

outpatient treatment. That is private insurance though and I am not sure

how it will work for you

Viriginia

December 14, 2002

did not respond to the Hep B vaccination---we found out recently b/c during

his bone marrow biopsy the doc poked himself with the needle and they had to run

the tests. We knew about his responses and lack of responses to the PPV.....

My concern is that it won't help either or ph..... although all three

docs involved think it would, but the HEM wants to wait to see what the ENT can

do.

Do any of you know what else they can do besides all of the allergy meds and

nasal sprays? We've tried them all.....

Pattie

Actually it provides passive antibodies and not necessarily IgG directly. It

infuses the antibodies

into the system already made per say. It can replace antibody deficiency but

will not always supplement low IgG counts.

This is why many immunologists will hold off on infusing low IgG unless there is

no response to the pneumococcal

vaccination also.

December 14, 2002

Ursala,

How does your family manage that much of a copay each month, plus the doctor

office bills and the drug bills? I've got 3 weeks to redo the family budget

for at least $150 more per month, and likely more, of medical expenses.

I just keep chanting: but my God will supply all my needs..... Hurry up,

God! I'm getting scared again!

Pam

wife to (15 years)

mother to , 9, Hannah, 6, Rebekah, 3, and Leah, 1

Re: insurance

We pay 10%. She gets 15 gms every 4 weeks. At $190 per gram it comes to

$2850. This comes to a $285 copay each month.

The brand is chosen by the doctor. Different brands contain different

amounts of IgA and can cause or prevent

reactions. Some are more known for causing reactions than others. IVIG

covers b-cell function but does nothing for the

t-cell counts. Actually it provides passive antibodies and not necessarily

IgG directly. It infuses the antibodies

into the system already made per say. It can replace antibody deficiency

but will not always supplement low IgG counts.

This is why many immunologists will hold off on infusing low IgG unless

there is no response to the pneumococcal

vaccination also.

Ursula Holleman

Macey's mom (7 yr. old with CVID, asthma, sinus disease, GERD, Diabetes

Insipidus, colonic inertia)

Immune Deficiency Foundation - Peer Contact for GA

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

December 14, 2002

Oh, guys, please pray about our insurance issues! We may have to pay 20% as

an outpatient or go back to the inpatient infusion clinic with the

hematologists. You remember the hem we deal with who give high doses and

doesn't want to infuse until 6 weeks? We would have to go back to him to

pay less but then we would get poorer care. I've got calls in to our case

manager and the insurance policy writer to negotiate/clarify the situation.

Pam

wife to (15 years)

mother to , 9, Hannah, 6, Rebekah, 3, and Leah, 1

Re: insurance

Thanks, Virginia! I am breathing easier today...you guys are all so nice to

respond. I have done some serious scrubbing-- toilets, tubs, floors...and I

feel less stressed .... hadn't been home in weeks to do it! Well...I was

home between doctor runs...but you all know how it goes.

I am hoping that our docs will set it up as a doc visit/clinic visit...then

we'll only pay the co-pay. We will be at the hospital on Dec 31st ad our

HEM is going to meet us at the ENT appt so we can all talk. They always want

to know when the boys have appts at the hospital and they come down to talk

to the docs with us. HOW cool is that? She takes time even when she isn;t

getting paid to visit us!

Pattie

Actually our insurance pays for all of Jonathons IVIG. They treat it as an

outpatient treatment. That is private insurance though and I am not sure

how it will work for you

Viriginia

December 14, 2002

Pam, remember to talk money to the case manager. Outline the costs of

in-patient care as opposed to home care or ask her to tell you what the

difference is. Don't bring up a bunch of " personal " issues like he's happier

at home or even that you feel he gets better care. Do bring up that he will

be exposed to less germs at home and therefore could save them a lot in

hospital bills and ER down the road. I don't know whether it will work - but

it will come near working than being emotional or whiney -- hey, it's works

with Moms!!!! Once I learned to talk in their language, I began seeing more

consideration.

Whatever you do, keep looking for a solution to keep away from the previous

doctor. That was life-threateningly dangerous.

Hope that helps and I am praying for you to get all that worked out soon.

In His service,

Dale

Pam Mork wrote:

>

> Oh, guys, please pray about our insurance issues! We may have to pay 20% as

> an outpatient or go back to the inpatient infusion clinic with the

> hematologists. You remember the hem we deal with who give high doses and

> doesn't want to infuse until 6 weeks? We would have to go back to him to

> pay less but then we would get poorer care. I've got calls in to our case

> manager and the insurance policy writer to negotiate/clarify the situation.

>

> Pam

> wife to (15 years)

> mother to , 9, Hannah, 6, Rebekah, 3, and Leah, 1

>

> Re: insurance

>

> Thanks, Virginia! I am breathing easier today...you guys are all so nice to

> respond. I have done some serious scrubbing-- toilets, tubs, floors...and I

> feel less stressed .... hadn't been home in weeks to do it! Well...I was

> home between doctor runs...but you all know how it goes.

>

> I am hoping that our docs will set it up as a doc visit/clinic visit...then

> we'll only pay the co-pay. We will be at the hospital on Dec 31st ad our

> HEM is going to meet us at the ENT appt so we can all talk. They always want

> to know when the boys have appts at the hospital and they come down to talk

> to the docs with us. HOW cool is that? She takes time even when she isn;t

> getting paid to visit us!

>

> Pattie

>

> Actually our insurance pays for all of Jonathons IVIG. They treat it as an

> outpatient treatment. That is private insurance though and I am not sure

> how it will work for you

>

> Viriginia

>

December 14, 2002

Thanks, that's some good advice. I'm kinda glad that I'm not talking to

them until Monday. I'm still in a rather emotional state (and dh is in

denial about the looming medical bills). That's a really good point about

how cheap home care is and how much safer it is for her. I'm going to make

a list of reasons that should continue home care that are financially

prudent (from their perspective).

And, thanks, for saying that the previous situation was life-threateningly

dangerous. That's what I thought, too, but then I wondered if I was

over-reacting.

Pam

wife to (15 years)

mother to , 9, Hannah, 6, Rebekah, 3, and Leah, 1

Re: insurance

>

> Thanks, Virginia! I am breathing easier today...you guys are all so nice

to

> respond. I have done some serious scrubbing-- toilets, tubs, floors...and

I

> feel less stressed .... hadn't been home in weeks to do it! Well...I was

> home between doctor runs...but you all know how it goes.

>

> I am hoping that our docs will set it up as a doc visit/clinic

visit...then

> we'll only pay the co-pay. We will be at the hospital on Dec 31st ad our

> HEM is going to meet us at the ENT appt so we can all talk. They always

want

> to know when the boys have appts at the hospital and they come down to

talk

> to the docs with us. HOW cool is that? She takes time even when she

isn;t

> getting paid to visit us!

>

> Pattie

>

> Actually our insurance pays for all of Jonathons IVIG. They treat it as

an

> outpatient treatment. That is private insurance though and I am not sure

> how it will work for you

>

> Viriginia

>

December 15, 2002

We have that plus $100 for Les's new meds that they have started him on in an

attempt to keep from needing IVIG. Plus

Macey has about $100 in meds (some not PID related). Doctor copays are $15.

These plus the drug costs must be paid up

front but the copays for the infusions or any other hospital bills are on a

payment plan with the hospital. We pay

about $20 per account (6 outstanding right now) and as long as we're making

payments in good faith they can't send us to

collections. I believe this is a state specific law regarding medical bills.

We're what they term " frequent flyers "

and they know that we've been good for all our bills in the past. Hopefully

next year when I go back to work fulltime

after graduating we will be adding a second health insurance policy and that

should help.

Ursula Holleman

Macey's mom (7 yr. old with CVID, asthma, sinus disease, GERD, Diabetes

Insipidus, colonic inertia)

Immune Deficiency Foundation - Peer Contact for GA

December 15, 2002

OH yeah-- we are frequent fliers, too. What I always get a kick out of are the

people who say, " But don;t you have insurance? " LOL. You know they haven't

had to use their insurance much..... My mom seems to think that 20% isn;t THAT

much.

AYE YI YI

Pattie

December 15, 2002

OH yeah-- we are frequent fliers, too. What I always get a kick out of are the

people who say, " But don;t you have insurance? " LOL. You know they haven't

had to use their insurance much..... My mom seems to think that 20% isn;t THAT

much.

AYE YI YI

Pattie

December 16, 2002

We pay 10%. She gets 15 gms every 4 weeks. At $190 per gram it comes

to

$2850. This comes to a $285 copay each month.

The brand is chosen by the doctor.

Pam,

We have to pay a 20% co pay, 15 grams every three weeks. We do not qualify for

assistance because we are in the middle class........we have tried........my

husband took a new job last year that was 1/2 his salary........long story but

he is much happier.........we applied for Childrens services and they look at

your tax returns for the previous year ........we were doing ok then..........we

also currently have no insurance for meds at the pharmacy. Office visits are

$35

Anyways, we don't stress over what we owe the hospital we pay every month but we

will owe them for along time. They know we are not going anywhere so they are

pretty good with us.

le

Pam Mork <pmork@...> wrote:Ursala,

How does your family manage that much of a copay each month, plus the doctor

office bills and the drug bills? I've got 3 weeks to redo the family budget

for at least $150 more per month, and likely more, of medical expenses.

I just keep chanting: but my God will supply all my needs..... Hurry up,

God! I'm getting scared again!

Pam

wife to (15 years)

mother to , 9, Hannah, 6, Rebekah, 3, and Leah, 1

Re: insurance

We pay 10%. She gets 15 gms every 4 weeks. At $190 per gram it comes to

$2850. This comes to a $285 copay each month.

The brand is chosen by the doctor. Different brands contain different

amounts of IgA and can cause or prevent

reactions. Some are more known for causing reactions than others. IVIG

covers b-cell function but does nothing for the

t-cell counts. Actually it provides passive antibodies and not necessarily

IgG directly. It infuses the antibodies

into the system already made per say. It can replace antibody deficiency

but will not always supplement low IgG counts.

This is why many immunologists will hold off on infusing low IgG unless

there is no response to the pneumococcal

vaccination also.

Ursula Holleman

Macey's mom (7 yr. old with CVID, asthma, sinus disease, GERD, Diabetes

Insipidus, colonic inertia)

Immune Deficiency Foundation - Peer Contact for GA