just venting

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just venting

Postby suzeeq » Tue Feb 20, 2007 1:54 pm

Hi All, Just need to vent today. Just found out that after Mar. 31st of this year, I will not be allowed to go to the Lymphedema Clinic that I have been going to since 2004. I receive full treatment there, which includes MLD, measuring and ordering of compression hose or other garments, bandaging etc.. I still have the same employer but they changed their insurance provider to Anthem. Now this clinic is out of network with both of the insurance companies, but previously, I filled out an out of network form and was approved to receive care at this clinic at in network prices. I had asked Anthem to allow me to continue my care at the same clinic at in network prices and they refused. In fairness, I do need to point out that the hospital where I work does now offer MLD done by their physical therapists, and they do bandaging but they do not measure or order hose. Plus they are not certified and charge triple the amount. These facts did not seem to matter to Anthem. I am grateful that I can still get therapy and shouldn't complain, as the hospital that I work at is only 6 minutes from my house, and the clinic is half an hour. I know that alot of you travel hours for care, some have no care available at all, and others can't leave their homes because of lack of mobility. So I know I shouldn't be whining. But I am afraid of this change in care. And I don't know what I am going to do about ordering hose. I have a feeling that Anthem won't be covering the hose or any of the bandages or other garments, so if I have to pay out of pocket, then I can at least order my stuff at the clinic. It is just so frustrating, as you all know. Here is a condition with no cure, no medicines, no reasonable surgery option, and now they take away the only things that help us manage it. Maybe I have jumped the gun. I am going to have to give the hospital a try, at least it will be all paid for. I'll keep you posted. Susan
suzeeq
 
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Postby Daisy » Tue Feb 20, 2007 2:41 pm

Suzeeq
Keep in mind that this might be a good change. As much as you loved the clinic, the hospital might have some different ideas for you. Before the change, be sure to get your info from the clinic, and ask them for ideas on ordering your own stockings and such.

When I went for MLD, I was given a list of supplies and a list of stores, and sent to buy my own. It would have been nice to have been provided w/all the stuff - but it forced me to take care of my own legs. My insurance will only pay for one pair of stockings a year so I used it for my Tribute garment. (tee hee...too cheap to pay $70 for a second pair of hose? How do like these $1800 custom babies) I shop online for support hose - they're cheaper and once you're on the email list there are all sorts of sales.

So... go in with an open mind. Hope for the best -but document everything so you can appeal to the insurance company if necessary. Good luck. Change is never easy.
Daisy
 
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