Hello all,
I have a very specific and serious healthcare issue that I tried researching on my own and asking insurance companies but have not reached anyone that knows about it. I have a condition called Chronic Inflammatory Demyelinating Polyneuropathy that developed after a man fell asleep at the wheel and hit me from behind at 100 mph. Ever since that day I have had shooting, stabbing, stinging, burning, and pin poking nerve pain on every inch of my body. I also have crawling sensations and difficulty urinating. I was only 27 when I was hit, I’m 29 now. I lost my job and my life was destroyed because the pain is so bad. This is also a degenerative disease that is similar to MS. I have seen many specialists and tried every treatment known to man. I finally found a neurologist that got something called IVIG approved by my insurance here in California. I have Medi-Cal, Anthem Blue Cross. I got IVIG approved about a month ago and it seems like it is really helping which is a miracle! However, my attorneys told me the insurance agency settled and I will be getting my personal injury check soon (not a lot, but enough to disqualify me from my insurance). I have also been wanting to move back to Texas to be with my family. I do not qualify for Medicaid in Texas so I would buy a BCBS plan from the marketplace (they only offer HMO’s). I intend to have my new BCBS of Texas insurance begin on March 1 and my Medi-Cal insurance will end on Feb 28th. So I will not have a gap in coverage, however, I am concerned about having a gap in treatment.
QUESTION: For people like me with chronic, degenerative issues, or terminally ill people for that matter, is there some kind of law or policy that prevents them from having a gap in TREATMENT, not coverage, but treatment, because if they do, their condition will get significantly worse?
I thought this was called “Continuity of care” however, BCBS of Texas (my future insurance) told me they have never heard of that term, even though there is a PDF written about it (https://www.bcbstx.com/provider/pdf/sece_preauth.pdf). Medi-Cal (my current insurance) does not know anything about it either. The link I provided does not give an official definition of what “continuity of care” is nor does it explain the procedure well. Also, I’m not sure if it would be Texas or California would be providing the “continuity of care”. You would need a lawyer to interpret it! Which btw, I already contacted healthcare lawyers who had no idea how to help me… even lawyers don’t know! I figure only people with chronic conditions on serious treatment plans who moved across country would know. Can someone help me? I’m lost and I’ve tried everything to find the answer.
Thanks so much!
submitted by /u/lisaclairesummers
[link] [comments]
Hello all, I have a very specific and serious healthcare issue that I tried researching on my own and asking insurance companies but have not reached anyone that knows about it. I have a condition called Chronic Inflammatory Demyelinating Polyneuropathy that developed after a man fell asleep at the wheel and hit me from behind at 100 mph. Ever since that day I have had shooting, stabbing, stinging, burning, and pin poking nerve pain on every inch of my body. I also have crawling sensations and difficulty urinating. I was only 27 when I was hit, I’m 29 now. I lost my job and my life was destroyed because the pain is so bad. This is also a degenerative disease that is similar to MS. I have seen many specialists and tried every treatment known to man. I finally found a neurologist that got something called IVIG approved by my insurance here in California. I have Medi-Cal, Anthem Blue Cross. I got IVIG approved about a month ago and it seems like it is really helping which is a miracle! However, my attorneys told me the insurance agency settled and I will be getting my personal injury check soon (not a lot, but enough to disqualify me from my insurance). I have also been wanting to move back to Texas to be with my family. I do not qualify for Medicaid in Texas so I would buy a BCBS plan from the marketplace (they only offer HMO’s). I intend to have my new BCBS of Texas insurance begin on March 1 and my Medi-Cal insurance will end on Feb 28th. So I will not have a gap in coverage, however, I am concerned about having a gap in treatment. QUESTION: For people like me with chronic, degenerative issues, or terminally ill people for that matter, is there some kind of law or policy that prevents them from having a gap in TREATMENT, not coverage, but treatment, because if they do, their condition will get significantly worse? I thought this was called “Continuity of care” however, BCBS of Texas (my future insurance) told me they have never heard of that term, even though there is a PDF written about it (https://www.bcbstx.com/provider/pdf/sece_preauth.pdf). Medi-Cal (my current insurance) does not know anything about it either. The link I provided does not give an official definition of what “continuity of care” is nor does it explain the procedure well. Also, I’m not sure if it would be Texas or California would be providing the “continuity of care”. You would need a lawyer to interpret it! Which btw, I already contacted healthcare lawyers who had no idea how to help me… even lawyers don’t know! I figure only people with chronic conditions on serious treatment plans who moved across country would know. Can someone help me? I’m lost and I’ve tried everything to find the answer. Thanks so much!
submitted by /u/lisaclairesummers [link] [comments]Read Morer/HealthInsurance