Lyme Disease Community
BEYOND ANGRY! Lyme Dr. no longer taking insurance!
About This Community:

This forum is for questions and support regarding What Causes Lyme Disease, Diagnosing Lyme Disease, and Joint Pain. Topics for discussion also include Living with Lyme Disease, Babesia, Bartonella, Rocky Mountain Spotted Fever, Anaplasmosis, other Tick Borne Diseases, Nervous System issues, Prevention, Risk Factors, Skin Disorders, Symptoms and Treatments

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

BEYOND ANGRY! Lyme Dr. no longer taking insurance!

I just got a letter in the mail from my LLMD basically letting me know that he is no longer taking insurance and he will be cancelling all insurance contracts!
His fees now:
Initial Visit: $395
30 min inhouse visit: $195
30 min phone consulation: $150

I am LIVID! It makes me question him as an MD and question my whole treatement plan. What if my other MDs are right and I should not be on long term abx. I am really questioning my whole treatment plan now!!!

Has anyone else gone through this with their Dr???
Related Discussions
7 Comments Post a Comment
Blank
Avatar_f_tn
Very few llmd's take insurance.  Fortunately, mine did.  Some charge even more than that.  I'm not sure if it's because of the insurance company scrutiny or lyme treatment controversies.  I really don't know.  I understand though about you questioning it.  I think we all do this.  
Blank
428506_tn?1296560999
I went into my relationship with my LLMD knowing that he didn't participate in insurance, so my situation is a bit different.  I agree with patsy10 that the rates you mention are consistent.  I also had to pay for most of my testing (everything from Labcorp and Igenex) out of pocket, my insurance only covers Quest labs.  So far, all of my antibiotic prescriptions have been covered (knock on wood!).  

I'm  still drowning in the confusions surrounding Lyme, from testing to diagnosis to treatment to politics,  and I can't offer a neat and concise explanation for why things are the way they are.  I simply continue to navigate the situation as best I can.  

Today is  my three month mark into my antibiotic treatment, and I am getting much better.  So while I am frustrated that I need to pay out of pocket, at least I am seeing progress in my health.  All of my mainstream insured doctors and specialists failed to produce such results, even after extensive testing that must have cost my insurance an arm and a leg (several MRIs, a lumbar puncture, several rounds of blood work...)

Also, though I am still at my reduced work  schedule, at least now I see hope to return full time to my career.  Before treatment, even my part time days were difficult and  often unproductive.  So I also consider the expense a worthwhile investment in my future, since my ability to work is being restored.  Before treatment from my LLMD, I was very fearful of becoming too disabled to work at all.  

So it stinks, and it is frustrating.  But I have come to see it as necessary.  This is just my opinion, I think each person needs to weigh the pros and cons  for themselves.  

Blank
723952_tn?1231861132
I have been uneployed since July due to a 75% layoff. I simply can not find work. I am praying I get good news tomorrow as this is HUGE!

I did talk to the Drs. office today because I have at appt on 3/27 at 11:30am I asked if I was going to be charged and they said no the cancellation process will take at least 90 days.

So I am PRAYING that I am off treatment in 90 days! My progress has been awesome thus far!
Blank
Avatar_f_tn
My LLMD doesn't do insurance either.  It's probably a combination (as others say above) of low reimbursement rates from insurance companies and the hassle of dealing with the paperwork.

Based on my LLMD's hourly rate, I calculated what the cash receipts are (given that I know the office hours and that they are always booked), meaning the hourly rate x the number of hours patients are seen, then subtracted the cost of the very small staff and rental on a very modest office space, and the LLMD ain't getting rich, that's for sure.  And I don't even know what malpractice insurance costs, but I'm sure it's not cheap.

What your doctors are charging are the true costs of their services (my dr is even more expensive than yours because rents and salaries are high here), and if your doctors take insurance, they not only have to hassle with the insurance companies over what is covered and what is not, but the drs also get reimbursed at what is often below the minimum costs of running their practice:  businesses that don't meet their minimum costs are insolvent and therefore gone.

If you have a business that costs you $15 an hour to run, and you charge $20 an hour, you get to keep $5 an hour.  If you contract with a referral service (=insurance company) to send you clients (=patients) and the referral service is only willing to pay you $10 an hour to reimburse you for your services, then you are $5 in the hole every time you take a referral.  Bye bye, referral service.

(Be glad that you have the CHOICE to go to an LLMD; once all the doctors work for the US government, we'll all be stuck with CDC treatment, in other words, 'scrooed'.)

Take a deep breath, and remember that your health is the most important thing you have.  Cut out pizza and movies and new clothes, and get well instead!  And good luck finding a new job: you will!!
Blank
Avatar_f_tn

You may want to consider calling your insurance company and voicing your concerns with them. I honestly don't understand why insurance companies don't have lyme, CFS and fibromyalgia practitioners listed on their websites !? If they did, they would save a TON of money because people would get diagnosed and treated earlier. You wouldn't believe how long it took me to get an accurate diagnosis.

Also... remember Dr. David A. Jernigan has natural herbal-homeopathic formulas that are available without a prescription. I think you'd be surprised at what alternative medicine has to offer. I actually switched from antibiotics to Jernigan's and currently have no desire or need to switch back to antibiotic therapy.

Blank
428506_tn?1296560999
I totally agree with PlatletGal that IF patients of so-called contested diseases (Lyme, CFS, fibro) could get properly diagnosed and offered treatment though standard insured doctors, it would save a TON of money.  Whether or not my insurance company saving money would ever trickle down to the customer, I have no idea.  But in theory, $ would be saved!

As I mention above, the stuff that my insurance DID cover cost way way more than the tests, services, and treatments from my LLMD.  So I see it as being a ridiculous situation, all of those fancy tests and specialists I saw were covered.  Now the relatively simple antibiotics and a doctor who listens to me are the answer, and that needs to come out of my pocket.  

I also see the truth in what JackieCalifornia has to say.  If we didn't have the ability to seek out LLMD's, our options would be limited.  I do like having that choice.    And yes, getting better is the most important thing and I have no regrets at this time about my financial investment in my Lyme treatment.  I only wish I'd done it sooner!

Blank
280418_tn?1306329510
That does stink.  I did hear that there was one in SC that had to stop taking insurance, something about getting his license taken?!  I don't know the full story.  Good luck and take care!
Blank
Post a Comment
To
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
Lyme Disease Community Resources
RSS Expert Activity
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating Control: How to St...
Aug 28 by Roger Gould, M.D.Blank
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
Top Infectious Diseases Answerers
Avatar_f_tn
Blank
JackieCalifornia
1763947_tn?1334058919
Blank
mojogal
Venice, FL
Avatar_f_tn
Blank
Ricobord
CA
Avatar_f_tn
Blank
nutrinut_bob
428506_tn?1296560999
Blank
wonko
Avatar_f_tn
Blank
kathloj
Ottawa