WOW to Ignorance ~ Insurance Companies 101

An acquantance of mine called me recently upset that her health insurance company was denying approval for her to receive more then 4 weeks of intravenous antibiotic for Chronic Lyme Disease. She had finally, after 6 years!!!, been diagnosed with Lyme. Bare in mind, this lady went from being a mid-30's, very athletic professional, to being wheelchair bound in the matter of 4 years. I don't know about you but it's still astonishing that doctors actually questioned whether there was really anything wrong with her because tests seemed "fine". Even her 3 year old daughter knew there was something wrong when she told her "Go doctor mommy. Doctor fix you".

Back on track......I asked her to forward me her insurance policy so I could read the small print.

Policy states:

"Insurance Company" will reimburse for the use of intravenous ceftriaxone, cefotaxime, or penicillin G (for up to four weeks) for the treatment of chronic or recurrent Lyme disease. Prior authorization is required for outpatient, office-based, and home infusion services provided to members enrolled in our HMO, POS, and PPO products.

"Insurance Company" does not reimburse for the use of parenteral antibiotics beyond four weeks, as there is no evidence indicating that such use is beneficial in the treatment of chronic or recurrent Lyme disease. We also do not reimburse for parenteral (IV or IM) imipenem-cilastatin, ceftazidime, cefuroxime, vancomycin, bicillin, or ampicillin for the treatment of early or late disseminated stages of Lyme disease, as there is no proven role for the use of these agents. It is recommended that use of these antibiotics be avoided, too, as prolonged use may encourage community-based resistance.

I have changed the name to "Insurance Company" as my battle is not again this particular company but all health insurance companies I have come across. It's their overall lack of knowledge. Their amazing ability to deny the existance of an epidemic that is effecting millions of people around the globe. How is it that our government can spend billions of dollars on swine flu vaccinations (almost half which have expired and were never used) yet this epidemic of lyme is being overlooked?

How is it that people are paying tens of thousands of dollars a year, out of pocket, in order to receive the treatment they NEED in order to save their lives?

MANY people are SUFFERING from Lyme. MANY people are FINANCIALLY DEVASTATED from Lyme. MANY people have become DEBILATED from lyme. MANY people have DIED from Lyme.........