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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???
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.
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.
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!!
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.
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!
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