Insurance Coverage question for Lance

[M&M]

Hi Lance, Bonnie said you are the one with some answers for me hopefully. I have CIGNA of New Hampshire and CIGNA of Connecticut - CIGNA of New Hampshire is a state employee insurance plan. I am a state employee - unfortunately a CIGNA rep came in my hospital room and told me I not only didn't qualify for cardiac rehab - but my insurance would not pay for a home INR monitor !!! Well, thank you !!

I was wondering - if it was determined medically necessary from my EP doc - do you know if my insurance would then pay?

I called my husband's insurance CIGNA of Connecticut and they said they would pay all but $300.00 - yes, I've heard this before - I said - maybe I should get that pre-authorized as you've claimed things like this in the past only you wouldn't reimburse me as you previously claimed.

I see my EP doc next week and I hope to get things started for a home testing kit.

Any suggestions as to how to start the process - paperwork ?? Or is it better to let my EP take care of everything?

Thank You So Much for any assistance you can provide.

Best Wishes
Runner
Marilyn, Dick and Judy - I like to give all the 'hardware' in my body a name - that way we keep everything straight as to 'who's' doing what. I don't go to the hospital anymore for my medical needs - no I go to the hardware store..

 

[Ross]

Hey screwball, do you know what machine you might be interested in? Coaguchek, Protime, or INRatio? We can get the paper work over the web. To get a faster response from Lance, I'd suggest calling QAS as he's not on here all the time.

Protime 1-800-298-4515 http://www.hometestmed.com/images/docs/QAS-GettingStarted-ProTime-Packet.pdf

Coaguchek 1-800.563.5801 http://www.coumadintest.com/docs/CoaguChek-GetStartPacket.pdf

Hemosense INRatio 1-800-563-5680 http://www.ptinratio.com/docs/QAS-INRatio-GetStart-Packet.pdf

 

[M&M]

Choices !!!!

Choices !!!!

Oh Please Ross its much to early in the morning to be asking me so many questions. I haven't finished my first cup of tea and now you want me to make a decision on which brand !!! I thought there would be - one brand - fits all.. All I want is the one that doesn't hurt when it takes my blood?

I see my doctor on Wedesday and I'll ask him if there's one particular model he trusts more than the others.. Now that sounds like a wise decision - considering how early it is...

Thank You Ross for the tip. Your so smart.

Runner
Marilyn, Dick and Judy !!!!

 

[Ross]

If your Doctor is anything like the other 99.9% of them, he'll say he doesn't have a clue as to what your talking about. For some reason, they don't want people knowing about it. Just don't be surprised if this is what you hear.

No, I'm not smart. If I were smart, I'd stop trying to fix everything that breaks myself. Every darn time I try to save money by doing it myself, it costs me more. GRRRRRRRRRRRRR

 

[M&M]

Thanks Ross

Thanks Ross

But Ross, everytime you fix something - just think of all that knowledge your gaining. Not eveyone can 'fix' things even if it does cost more money in the beginning - The next time - It won't cost as much - because you'll know how to fix it without the expensive 'learning' curve - But I have a suggestion - I think 'high' schools have woodworking shops and in our town every high school student has to put in 40 hours of community service time before they can graduate. Perhaps a woodworking student would love to be of assistance to any house project you might need help with. Call your local high school and see if they have this program.. Its a wonderful program and helps many.

Take Care and Thank You For Your Help
Runner

 

[catwoman]

Runner:

An insurance company not paying for cardiac rehab????

I didn't go through rehab and wish I had. I believe I would have gone through recuperation much faster and bounced back with fewer problems. Guess your insurer's rep who visited you had never had OHS, had he/she?

I also wonder if the same rep knew what you were talking about on the home-testing unit?
Far fewer people take Coumadin for mechanical valves than for all other reasons, no doubt. Some of them take it for limited periods of time -- 3, 6 or 12 months -- not for the rest of their lives. And have to take extra readings when going on various medications to see what the effect the new med will have on the INR, or before having dentals or before & after certain invasive procedures (colonoscopies, etc.).

Have you examined your coverage and then checked with someone else from your insurer? Go up the food chain.
Do get authorization from the insurer first. Will expedite things.

 

[M&M]

Hi Marsha, I know what you mean - cardiac rehab denied for 'open heart surgery' patient !!! Now there's a good publicity ad if I ever saw one... I thought it was ludicrous when she told me 'no rehab is not covered'- but of course I could have paid for it myself -and later when I got home I did speak to one cardiac rehab spokesperson - I told her what I was doing for execise and she didn't think I could get much more out of rehab than what I was already doing on my own. So I saved the money.

But.... when I had my heart attack - in 1992 - once again my insurance denied coverage for cardiac rehab - I asked WHY - back then I had blue cross/blue shield !!! and she told me - my heart attack wasn't 'big' enough to qualify for rehab !!! Can you believe it - I could have used it back then - as I was way out of shape and even though I worked full time - I had a family and a mortgage and I really had no money to spare. So, I ended up just working out with some local ladies doing aerobics - 3 times a week - and along with running on my own - it all really helped to get me back in shape.

I see my EP doc this week and if I remember correctly he had offered to help me get a home test before my surgery - but, if he can't I hope he can direct me to someone in the hospital who can help me with this. Along with any input you all have.. I did speak to my husband's insurance and they thought all but $300.00 would be covered under his plan - but to be sure - they said get it pre-authorized..

See Ya
Runner

 

[QAS Lance]

Runner

Runner

Hello Runner,

I think we should give this a shot, but I will need the necessary
paperwork. (Thanks for the links Ross). Please call me when you
get a chance to go over some greater details. Thanks!

Lance, QAS
800-298-4515 ext 2865

 

[M&M]

Thanks Lance

Thanks Lance

Hi Lance, Sorry, I took so long to get back to you and I want to Thank you for your offer of help - I saw my cardio and talked with my coumadin clinic and they're already on top of trying to get me a machine at home. Since they've already filled out the application I'll wait and see how I make out with them at this point. But, I want to thank you for your offer and I may take you up on it at a later date..

Best Wishes
Runner