| Author | Post |
|---|
Adkgal
Member
|
Posted: Sat Aug 23rd, 2008 01:58 |
|
| MY doctor will not perticipaste and told me today my insurce would not cover treatment is there any truth to this?
____________________
klj
|
Dr Trevor Marshall
Research Team
|
Posted: Sat Aug 23rd, 2008 04:52 |
|
Adkgal,
An advocate will be along soon and point you to the info you will need to give your physician and the insurer.
|
Julia
Advocate (on leave)
|
Posted: Sat Aug 23rd, 2008 20:17 |
|
Hi Adkgal,
Maybe it's time to find another doctor 
How To Obtain Insurance Benefit for Full Dose of Benicar
A member with sarcoidosis had a similar question answered by Meg: In the USA, insurance coverage varies widely. In general, the D METABOLITES TESTS are covered without question when using the codes listed.
If you have medication coverage, most insurers will cover the cost of 40mg of Benicar per day unless they require that you first try a less expensive antihypertensive. Commonly, insurers will initially refuse to pay the increased cost of the MP required dosage of Benicar 40mg every six to eight hours.
All insurers have an appeal process for claims that are denied. In the case of Benicar, you need to find out the insurers appeal process. This sometimes only requires a phone call from the doctors office verifying that s/he has determined only Benicar will do and that you need the higher dosage of Benicar-no other explanation required. Sometimes a form needs to be filled out, signed by the doc and faxed back to the insurer to obtain an 'override' on the usual dosage. This override is usually good for one year.
Some insurers make this appeal process as difficult as possible (long waits on the phone, clueless sales reps, referrals to the wrong department, misinformation, lost faxed forms, etc.) so it may take some persistence.
Most insurers do not cover medications considered experimental so it is important not to use that term. It is unnecessary to explain to your insurer why your doctor has ordered a higher dose of Benicar. That is your doctor's responsibility. Some insurers have decided that the Marshall Protocol is experimental so it is best not to mention the MP. The doctor should simply point out that s/he is licensed to practice medicine and in his/her best judgement, this is the dose of Benicar that is required to help you recover from sarcoidosis.
It is worth fighting for your full insurance benefit because Benicar is a fairly expensive medication. Hopefully, your doctor would be eager to battle an insurer who would try to tell him/her how to practice medicine. Although the MP is considerably cheaper than the standard method of treating sarcoidosis because no sophisticated testing is required, the logic of this reduction in expense means nothing to an insurer.
Your pharmacist, whether local or mailorder, will refuse to fill the Benicar prescription at the higher dose until they get the okay from your insurer which can pose an unexpected delay. If you get caught short of Benicar, as I did for a routine reorder, ask your doctor for samples to tide you over.
The other medications on the MP, are commonly used antibiotics and should not present a problem in insurance coverage.
Doctor visits are usually covered by insurance with a deductible and co-pay. These visits do not need to be frequent. Many doctors encourage their patients to get routine information and support from our websites. Other routine labwork to monitor organ function is usually covered by insurance.
Suggestions To Get Your Doctor On Board With the MP
Hope this helps. Please ask any further questions here in your own personal thread 
Julia 
____________________
Always consult a physician
Essential Info; FAQ; Julia's story
|
Adkgal
Member
|
Posted: Wed Sep 3rd, 2008 01:24 |
|
| Hi I was justnwondering if Ceilacs diease could be related to e form bacteria?
____________________
klj
|
Rico
Advocate
| Joined: | Wed Oct 17th, 2007 |
| Location: | |
| Posts: | 110 |
| Status: |
Offline
|
|
Posted: Wed Sep 3rd, 2008 02:02 |
|
Is the MP an Applicable Treatment for my Disease
http://tinyurl.com/6ho98u
____________________
Essential Info; FAQ; ABC's of MP; Side Topics; Perspectives
|
Adkgal
Member
|
Posted: Sun Oct 5th, 2008 02:52 |
|
Hi all I'm happy to say that I finally feel like I am making progress. I rencently was excepted into a local teaching hospital Program and when I asked them about the MP they didn't know about it but with the phase 1 in hand they looked at it and said that they knew that the antibotics they talked about were some times used but only when the current treatments fail. So thus Not wanting to I had to I agrred to run a trail of prednizone for a few months and watch it fail but I would love more feed back on articles to give the Dr in Dec. when I go back. I really believe that the MP is the answer I just can't seem to find anyone close to do it with me. Hopfully If I am armed with better articles and documation I can convince the DR that this is the right path. Any help would be greatly appreacted I will not give up on my desire to be healthey
____________________
klj
|
Dr Trevor Marshall
Research Team
|
Posted: Sun Oct 5th, 2008 03:23 |
|
Using prednisone, even for a single month, can do a lot of damage.
This multinational study showed that hip-joints could be destroyed with as little as 60mg of prednisone for one month:
http://www.ncbi.nlm.nih.gov/pubmed/12189457
Ask your University Clinic for a copy of the full-text of that paper from their library, and look at patients 1 and 2 of Table 1 (who both developed failure of their hip joints within one month).
The clinic you are attending knows that steroids are dangerous, and they know that none of the drugs in the MP are dangerous. Once your body has been harmed by the steroids, you will find they still will not allow you to use the MP.
Try working with a Family doctor instead. Our members tell us that family Docs tend to know more, and are more open minded as well.
|
Adkgal
Member
|
Posted: Sun Oct 5th, 2008 03:30 |
|
| Thanks for the information is there anything else I can try?? They say knowlege is power can I show them any more info to get them to listen to me??
____________________
klj
|
Dr Trevor Marshall
Research Team
|
Posted: Sun Oct 5th, 2008 03:38 |
|
Take them the transcripts from the recent conference in Porto.
http://www.marshallprotocol.com/forum39/12376.html
Only Cpt Perez's transcript is finished at this point, but more will come available as the weeks go by.
http://AutoimmunityResearch.org/transcripts/ICA2008_Transcript_TomPerez.pdf
But I really suggest focusing on Family Docs, especially Internists. They tend to be quicker to recognize therapies that work. University Clinics have too much inertia, and too much cash flow, to adapt to change.
Last edited on Sun Oct 5th, 2008 03:40 by Dr Trevor Marshall
|
Current time is 03:53 | |
|
