Common Variable Immunodeficiency Support Group
Common variable immunodeficiency (CVID) is a group of 20-30 primary immunodeficiencies (PIDs) which have a common set of symptoms but with different underlying causes. CVID's underlying causes are different, but the result of these are that the body doesn't produce sufficient antibodies in response to exposure to pathogens.
I have autoimmune illnesses, low platelets, migraines...other issues and for the last approximately three years many many sinus infections and several cases of bronchitis. I'm on SSI, but have Blue Cross as my primary insurance and because of the SSI, have Medicare as my secondary health insurance policy.
About ten to 12 months ago, my immunologist told me to take the pneumonia shot so she could get a better understanding if I have CVID. I seem to have a subclass deficiency.
These last several months I have been washing my hands like crazy and avoiding sick people and my rate of infection has decreased somewhat, but not completely and I got a bad infection just recently which brought me back to this doctor and now I WILL do the challenge.
I suspect since my total IGG is normal and I have a subclass deficiency, there might be some confusion about whether I need IGIV, but of course, this shot will help answer many questions.
In two years my husband will retire. The Blue Cross insurance policy through his employment has been very good and I will have the option, for a fee of keeping it. BUT, because I'm on Disability, at that point things would reverse and I would have Medicare as my primary and BC as my secondary.
If I wasn't on Disability, I would just have BC alone and it would be primary.
Questions:
1. If I start IVIG with BC as primary and it switches to secondary, won't that be a big problem?
2. How common is it for Medicare to cover IVIG?
3. Might it be better for me to wait and start any tx when my insurance changes? (After my husband retires)
4. How common is it to receive tx and coverage for tx for a subclass deficiency?
Well, that was a lot of questions. If you can answer any of these questions regarding insurance coverage it would be appreciated. Thank you.
About ten to 12 months ago, my immunologist told me to take the pneumonia shot so she could get a better understanding if I have CVID. I seem to have a subclass deficiency.
These last several months I have been washing my hands like crazy and avoiding sick people and my rate of infection has decreased somewhat, but not completely and I got a bad infection just recently which brought me back to this doctor and now I WILL do the challenge.
I suspect since my total IGG is normal and I have a subclass deficiency, there might be some confusion about whether I need IGIV, but of course, this shot will help answer many questions.
In two years my husband will retire. The Blue Cross insurance policy through his employment has been very good and I will have the option, for a fee of keeping it. BUT, because I'm on Disability, at that point things would reverse and I would have Medicare as my primary and BC as my secondary.
If I wasn't on Disability, I would just have BC alone and it would be primary.
Questions:
1. If I start IVIG with BC as primary and it switches to secondary, won't that be a big problem?
2. How common is it for Medicare to cover IVIG?
3. Might it be better for me to wait and start any tx when my insurance changes? (After my husband retires)
4. How common is it to receive tx and coverage for tx for a subclass deficiency?
Well, that was a lot of questions. If you can answer any of these questions regarding insurance coverage it would be appreciated. Thank you.
I'm on SS Disability for back, neck & shoulder injuries and was diagnosed with CVID as well, 5 years ago. I was also previously medically retired from my job and had a Anthem-Blue Cross policy through my pension for a number of years prior to SSI.
Upon receiving SSI benefits, it was mandatory to go with Medicare as my primary, with Anthem BC as a secondary. Although I was concerned about this initially, I am quite fond of how it now works - especially with the subsequent CVID diagnosis. BTW, I thought the arrangement of Medicare becoming primary when you receive SSI was applicable to everyone but maybe it depends on who provides your private insurance.
Actually from what I know, Medicare is a lot more liberal about approving IVIG treatments than any private insurer is. I've heard horror stories about BC & IVIG denials in some Midwest states (I'm in CA - with fairly strong consumer protections). I would think you'd be better off with Medicare as your primary - at least when it comes down to IVIG approval. The only caveat might be is if they view a sub class deficiency differently from CVID. Also, Medicare may give more weight to what your MD prescribes vs. a private insurer's chart of yes or no.
Sorry I couldn't be a little more definitive but this has been my experience only, and I know a lot of these situations vary from company to company. Good luck...Rick
I wanted to let you know there are some WONDERFUL resources for insurance questions. The Immune Deficiency Foundation has an insurance specialist who can help. www.primaryimmune.org and they have a TON of resources available and peer support volunteers you can talk too.
Additionally the Gammagard Patient Support Program not only has patient advocates that you can speak to and nurses, but they have people who can answer insurance questions as well. And they have free resources and don't require you be on their product. 855-250-5111