Insurance Issues

Insurance Issues

Remember- there are usually deadlines for filing complaints and responding to inquires so please do not delay. 

First Thing To Do-  Appeal the decision immediately!    
Write to the insurer!  A "Sample Letter" is located below.  Feel free to adjust it to relate to your own circumstances.  

Very Important-  Contact your Attorney General as soon as possible and file a complaint.  They need to know about your insurance issues to be able to help you and budget the necessary funds and resources to address the ongoing insurance problems we are having.  They have been very helpful to those who have taken this step and have resolved many if not all issues for patients.  

To Find Your Attorney Generalclick here.
Additional Steps-  File a complaint with the your state's Insurance Commissioner.  For their contact information, click here.  

To note:  
A legal transcript involving a Lyme disease case in court included testimony by an insurance executive.  He admitted insurers sometimes flag Lyme cases and have been known to deny patients claims initially to save money, but they usually will pay the claim if an appeal is filed. 

NEVER let it drop when you are denied- that is what they expect you to do.  Fight for your rights! Make it easier on yourself by getting help from the above agencies.  Good luck!

Additional Information

Be sure to mention you are being treated according to the International Lyme and Associated Diseases Society's (ILADS) Lyme Disease Guidelines.  They can be found here.  Remind the insurer that the Infectious Diseases Society of America's (IDSA) guidelines were published in 2006 and have since been removed from the National Guidelines Clearinghouse because they had not been updated in over 5 years (the normal requirement) and they fail to meet the standards set forth by the IOM for medical guidelines.  More information here.

Contact Patient Advocate Foundation (PAF)- provides effective 
mediation and arbitration services to patients to remove obstacles 
to healthcare including medical debt crisis, insurance access issues 
and employment issues for patients with chronic, debilitating and 
life-threatening illnesses. They assist patients with- 

Information provided by Lucy Barnes-

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