Guest guest Posted June 7, 2004 Report Share Posted June 7, 2004 Dear Sheryl, We have BCBS of IL through my husband's work and they covered 's Starband at 80% We had the DR. write a medical necessity letter and also 's physical therapist. They didn't give us any trouble and took about two weeks to respond. I wish you luck! Sara & Starband Mishawaka, IN Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2004 Report Share Posted June 7, 2004 Sorry for all of the questions!! The more I read, the more I have! We have BCBS of Illinois. Does anyone have experience with them. I need to call them still, but I want to make sure I ask the right questions. Does anyone have advice on what exactly to ask? Thanks! Sherryl Mommy to Zander Severe Plagio.. waiting on the doctors Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2004 Report Share Posted June 8, 2004 Sara, Can I ask if you have BCBS HMO or PPO? I just got an email from another member with BCBS IL and she said they refuse to pay for any of it, even after a fight. I've seen on another board that HMO covers and PPO doesn't, which is why there is a lawsuit in IL. If you have PPO, I'd like to know so that I can get ours to pay too. Thanks for your reply! Also, did you have his band fitted in IL? Can I ask where? I'm just trying to figure out where we will have to go if our specialist doesn't do bands. Thank you! Sherryl Mommy to Zander~4 Months Severe Plagio Repositioning and waiting on docs... > Dear Sheryl, > We have BCBS of IL through my husband's work and they covered 's Starband > at 80% We had the DR. write a medical necessity letter and also 's > physical therapist. They didn't give us any trouble and took about two weeks to > respond. > > I wish you luck! > > Sara & > Starband > Mishawaka, IN Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2004 Report Share Posted June 8, 2004 Hi Sherryl, I have BCBS OF SC and I know that every plan is different, but one thing I can tell you is to call and call again. if I would have gone to CT, which is where my doctor wrote my first prescription for, without calling first they would not have covered it . My Plan only covers the Starband. Furthermore, there are a lot of places within a 2 hr drive that do the Starband so I had to call again and find which one of those they covered. then call those places and see who had the most experience with doing Starbands. They covered it under Durable Medical Equipment and my plan covers 80% of the band. BCBS on my plan will only spend $5000 a year per person on durable medical equipment so if needs another band they will cover less next time. I also had to call and get pre-determination which was a quick process but different from a pre-certification. I hope this helps, -----Original Message-----From: Sherryl [mailto:nickandgabe@...] Sent: Monday, June 07, 2004 7:34 PMPlagiocephaly Subject: Blue Cross Blue ShieldSorry for all of the questions!! The more I read, the more I have!We have BCBS of Illinois. Does anyone have experience with them. I need to call them still, but I want to make sure I ask the right questions. Does anyone have advice on what exactly to ask?Thanks!SherrylMommy to ZanderSevere Plagio..waiting on the doctorsFor more plagio info Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2004 Report Share Posted June 8, 2004 Hi, I wanted to add to my earlier post that I am PPO. My sister works for BCBS of Ga and she told my that for some reason BCBS will usually cover the Starband but not the DOC without you fighting it. Go figure, probably because it is cheaper. Thanks, -----Original Message-----From: Sherryl [mailto:nickandgabe@...] Sent: Tuesday, June 08, 2004 9:24 AMPlagiocephaly Subject: Re: Blue Cross Blue ShieldSara,Can I ask if you have BCBS HMO or PPO? I just got an email from another member with BCBS IL and she said they refuse to pay for any of it, even after a fight.I've seen on another board that HMO covers and PPO doesn't, which is why there is a lawsuit in IL. If you have PPO, I'd like to know so that I can get ours to pay too. Thanks for your reply!Also, did you have his band fitted in IL? Can I ask where? I'm just trying to figure out where we will have to go if our specialist doesn't do bands. Thank you!SherrylMommy to Zander~4 MonthsSevere PlagioRepositioning and waiting on docs...> Dear Sheryl,> We have BCBS of IL through my husband's work and they covered 's Starband > at 80% We had the DR. write a medical necessity letter and also 's > physical therapist. They didn't give us any trouble and took about two weeks to > respond.> > I wish you luck!> > Sara & > Starband> Mishawaka, INFor more plagio info Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2010 Report Share Posted January 27, 2010 : be sure to check with your doctor and see if Remicade has a patient assistance program. Since both Enbrel and Humira have them, I'd assume that Remicade does too. You might also want to check and see if your state has insurance available for people who are otherwise uninsurable. Here in IL, we have it, though it does cost more than the usual insurance policy. Finally, since none of us can predict what will happen with the health care bill that Congress has spent most of last year working on, I'd drop my Congressman/Senator a note or an e-mail to let them know about what's just happened to you. It stinks and if the Republicans and Democrats can't at least get together on basic issues like this that are just so terribly unfair, God help us all - we are truly in trouble!!!!! You hear horror stories about stuff like this happening and I'm just sorry to see that they are really true! It's more than unfair. Joanna Hoelscher Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2010 Report Share Posted January 27, 2010 Have you talked to your doctors office to see if they have any information on getting you help to pay for this now that you've lost your insurance. Just about every biologic out there has some kind of assistance program for those who don't have insurance. Celeste Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2010 Report Share Posted January 28, 2010 Hi, have you looked into the financial assistance the drug manufacturers offer? Call or go online most drug companies offer some sort of financial assistance. lori sandolo <antlo2003@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2010 Report Share Posted January 28, 2010 , You need to try to get in on a group insurance plan. I don¹t know what kind of Work you and your husband do, but the best solution it to try to find A professional association that has to do with your profession and join So you can hop onto a group plan. A group plan, won¹t be so quick to cancel Them because they usually have an agreement that they can¹t do that or The association will go shopping for another insurance company. kristina adams <mac@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2010 Report Share Posted January 28, 2010 I'd be interested in hearing where all of you are from who are having major BC/BS problems. As I understand it, there are six or seven " umbrella companies " who own the various state BC/BS programs but I've never had a problem with them .. . . . .. . . so I'm wondering if it's the same parent company that's causing all the problems. Reading all these recent posts certainly makes me more and more concerned about getting some kind of " health insurance " reform, which is - from what I hear - what they're now calling it in D.C. Joanna Hoelscher Quote Link to comment Share on other sites More sharing options...
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