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How do you deal when insurance won't cover treatment?

Insurance cover treatment ibs Dietician new symptoms pain management

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#1 tbonimaroni

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Posted 10 May 2017 - 02:42 PM

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Hi I'm new to the forum. I recently took a turn for the worse so I joined the forum for advice and support. It seems now that my bowels are rejecting all foods, including water. I'm in pain from the time I wake, with up,with D, to the time I go to bed. I tried to see a dietician to manage my diet bc I have no idea what to eat now but my insurance won't cover it. I was wondering how people deal when this happens. How do I get my insurance to pay?
I am starting to starve myself and have suicidal thoughts and tendencies. I am bi-polar and have suffered from depression in the past.
I stopped eating all red meat and fried foods; most veggies; and dairy; but the foods I still do eat hurt me too. I am taking Levsin and Viberzi. I just started Viberzi again 2 days ago after my pharmacy messed up and didn't give it to me so my doc had to re-prescribe it. My husband keeps telling me to go back to the doctor bc he thinks "something else" has to be going on but my doc insists it's ibs.

#2 highlandhilman

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Posted 10 May 2017 - 03:34 PM

I'm not familiar with insurance coverage in the states - do you get benefits through work? If so, would they cover a dietitian, or mental health specialist, etc, if your doctor provided a note saying you require it for medical reasons? Does your insurance cover naturpathy, functional medicine, osteopathy, or Chinese medicine?

 

Have you tried any supplements, such as probiotics or digestive enzymes? What kind of relief are the Levsin and Viberzi providing?

 

IBS is a very broad diagnosis, known as an 'elimination diagnosis' - that is, if they can't find anything else wrong, they slap the label "IBS" on you simply because they don't have a better one. It probably is more than just IBS simply because of the nature of the diagnostic process.

 

Do you have a medical phone line you can call? In my area we have "811" - a nurse is able to answer and provide us with some help. You may want to call them, or a suicide/mental health hotline. They may be able to connect you with some support services that exist outside your GP and insurance, but that you (hopefully) may not have to pay for out of pocket.



#3 Rboe

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Posted 10 May 2017 - 03:36 PM

Has the doctor run tests? Blood work and a colonoscopy? If not, get a new doctor. You want to be sure it is ibs. The symptoms are consistent with IBS but also with IBD so good to know for sure.

Otherwise there are diets designed for IBS. You can research them yourself and try them out. Some good diets to research and try are the low FODMAP diet (http://www.med.monas.../gastro/fodmap/) the Candida diet with anti-fungals, and the SCD diet. (.http://www.breakingtheviciouscycle.info/home/) Some people have also reported success with a ketosis diet.

The diets take time to work. I usually recommend the FODMAP diet first. Also, on some diets, escpecially the Candida diet and even SCD, you may actually feel worse when you start it. It is the bad bacteria dieing off. But once that subsides, you feel better.

I tried the low FODMAP first. It decreased my symptoms a bit but eventually they came back. I never got to the point where I could try to add foods back in to see if they would bother me. However, I still think it is a good diet to try because many other people have found it works very well for them and it is less restrictive than some of the other diets.

I then saw a naturopath who did food intolerance testing. Eliminating those foods made no difference (but I am currently still avoiding them.). Next they put me on a Candida diet with anti-fungals and I improved 60-70%.

Now I am following the SCD (the Specific Carbohydrate Diet). I am in the early stages so I am actually only eating meat and a handful of vegetables, however it has improved me another 20-25% I would say. It is amazing that most days now I go to bed and think "wow, I did not have to stop to find a bathroom and my stomach did not hurt all day."

#4 tbonimaroni

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Posted 10 May 2017 - 09:06 PM

Highlandhilman
No my insurance won't cover those things bc ibs is not a real disease. I'm going to try probiotics. It seems that everything I eat causes me pain. I'm down to one meal a day usually chicken or fish and steamed veggies and rice or potatoes. I'm trying to follow the low FODMAP diet but I don't have a complete diet plan so I don't really get it. I'm keeping a food diary.
I'm not sure about a line I can call, my insurance has one I think and I'm sure there's a mental health one. I can try it. I didn't think of that, thanks.

#5 tbonimaroni

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Posted 10 May 2017 - 09:19 PM

Rboe
Thanks for the links.
I'm totally thinking of switching doctors bc the sudden change in symptoms is severe and I feel ignored. I get a colonoscopy every 5 years bc my mother had a colon cancer scare but I'm not due for a couple years. My doc ordered a routine blood test when I went in for my checkup and used that to tell me I had no infection or anything else when I visited him a second time about the abdominal distress. No other tests.
I'm trying to follow the low FODMAP diet but I don't have a complete list of the diet or anything I'm just running blind and going from what I read on articles and stuff. I'm down to eating just a few veggies and fruits and fish, chicken, turkey, rice, and potatoes. Those foods still make me hurt as soon as I start eating. I'm also going to start taking probiotics as it is recommended by many on this forum. Again thanks for the links they will help.

#6 highlandhilman

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Posted 11 May 2017 - 09:59 AM

If you're struggling with the fodmap diet you can try this app here: https://play.google....maplookup&hl=en. All you do is search for the food you want, and it will tell you if it's high or low fodmap. I've found it really helpful in following a low fodmap diet.

 

Another thing you could try is making homemade low-fodmap chicken/beef/turkey broth - don't use the store-bought broth! I've found it to be very soothing and filling - I've been drinking it for 8 months, about 1 cup with every meal, I have noticed a difference in my abdominal pain, though it did take some time and patience before I noticed a change. Now it's just a regular habit. It's full of nutrients that can help your gut lining to heal.

 

Another thing to try is amino acids - L-glutamine in particular. L-glutamine is very beneficial for your gut lining and is crucial in repairing gut damage - you need to take a very high dose to notice any difference, though - anywhere from 10-40gm/day. I recommend L-glutamine in powdered form so it's more affordable, if you find you can tolerate it of course. As with anything, start small and slowly build yourself up so you don't shock your system! Start with 1-2gm/day and slowly work the dosage up to something you find works for you.


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#7 APR

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Posted 22 May 2017 - 03:03 AM

Highlandhilman
No my insurance won't cover those things bc ibs is not a real disease. 

That is garbage.  IBS is real and there is criterion for diagnosing it.  If possible, you should appeal insurance rejection of claims or [with an HMO] refusal to let you see a dietician or a specialist.

 

Some insurance policies just won't cover seeing a dietician.  Depending on whether you get insurance through work, are on Medicaid, or get your own insurance policy [either on or off the health exchange], you should consider switching insurance policies next year [though with Republican efforts to repeal the ACA, everything is up in the air for next year].

 

In some situations, it actually ends up saving money paying more for a PPO, rather than an HMO, where your GP [and basically the insurance company] has to refer you to a specialist, dietician, etc.

 

These private for profit insurance companies are interested in maximizing profits, not your well being.  In some cases, you really have to fight them to get them to pay a claim.  Also, your policy may or may not cover a prescription medication.  Many insurance companies require pre-approval before they'll cover expensive medications (I had to wait 10 days to get pre-approval for Amitiza, an ibs medication).  It's a problem.


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