Insurance in USA: So per my doctor it... - British Liver Trust

British Liver Trust

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Insurance in USA

Lara86 profile image
9 Replies

So per my doctor it took her hours of paperwork and fighting with my insurance, BC/BC Horizon to get my CT scan. The reason was because 3 years ago I had a CT of my adrenals while testing for something else and they showed fatty liver. At the time this was barely mentioned to me it was more ur less just noted in passing and I was told I had no adrenal tumors. Fast forward 3 years to me gaining 10 lbs in 3 months with no change in lifestyle. All the weight in my abdomin. Now my doctor panics. And the insurance fights her. After the ultrasound and paperwork etc I get the CT scan. Liver fibrosis. Small benign nodule on lung.

She puts me on diet meds and Metformin. I've been on the same diet med in the past with no results however, combined with Metformin I'm finally having much needed success. Needed to help remove fat from liver! However insurance won't pay for continued use of diet med. Introduction dose was free (kinda like a street drug dealer). Welcome to America!

I work for the state. My plan is supposed to be really good and too generous and public employees don't deserve it etc, etc. And here I am.

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Lara86 profile image
Lara86
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9 Replies

Hi laura,

I am in USA too, and out insurance is very difficult. so bad that we are treated that way. Can I ask what medication you need that the insurance won't pay for? Have you gotten a diagnosis from your doctor yet? Seem like your post they really haven't said much about what's going on. I can maybe give you some suggestion on medications.

dckimberly profile image
dckimberly in reply to

Are you a doctor Sophia? You can’t advise people on medication, or shouldn’t without a medical degree plus medical background and testing. Someone please correct me if I’m wrong.

in reply to dckimberly

Kimberly,

If you read the post, she is stating her insurance won't pay for her diet medication. In no way am I giving her medical advice. I do know places that will pay when insurance won't pay depending on your diagnoses. So next time when you decide to go on the attack, READ and Stop trying to get others involved in your lack of ability to READ.

dckimberly profile image
dckimberly in reply to

Maybe YOU should have read my post about bring so I’ll and often unable to communicate.

You are a very rude person. But I will not go on some diatribe with you. I have been a supportive member of this site for a few years. If I misread you it certainly was not what you decideded I understood.

And as far as reading goes, I try and read every day. Alas my HE right now makes it difficult to to comprehend everything. Not that you would understand that, at all.

Have a splendid self righteous day.

Goodbye.

By the way, this group is for liver disease, at least it 2as the last time I checked.thus all the post titles

in reply to dckimberly

I am not a rude person, was just trying to support someone that insurance won't pay for her medication. If you having a hard time communicating maybe you should be careful with your words. I know this is about liver issues because I am a caregiver for my father-in-law and yes he has liver issues. I just wanted to help...and by no way was I trying to give medical advice but if I can help someone get medication that they can't afford, I see nothing wrong with trying to help. you have a blessed day and I hope things get better for you.

dckimberly profile image
dckimberly

The US could care less. It’s not the doctors. It’s insurance and big pharmacy. They gave me like 6 months and I was not eligible for transplant. I came to the UK to be with my partner at the end. I went to the doctor here for my palliative meds, and he sent me to the specialist team for liver tx at Addenbrookes hospital. I told them don’t worry, I know I’m not eligible. He said we’ll see about that. And all the sudden I had 3 days of testing and was told I was going on the list. It was barely three months and I got my tx. I was also marked to be one of the first 500 to get the very expensive Hep C drug. The home office didn’t want to give me an answer in a timely manner so the doctors said too bad and put me on it. I was also past my visa date but the doctors said I could not leave the country prior to transplant due to massive ascites, and then after because of hepatic enchalopothy. My first tx is not working, but not because of what the US doctors said. It’s because they did not know the liver given to me had portal hypertension.

So I’m back on the list waiting. I’ve been really sick the last six months, but because of the superior medicine here, not only am I alive, but I’ve seen both my grandchildren born.

I’m sorry I’m not around much anymore, but I do read posts. I just have HE so much, I can’t talk, think, remember etc. it just seems like yesterday it was June.

But I’m still here.

I’m becoming a citizen also. This last election in the US really has hurt the nation. But I love England and I’m so so grateful.

Cheering everyone on!

Kimberly

mncold profile image
mncold

Hi Lara86,

It could be the insurance is fighting because they don't cover diet meds for some reason. Have you or your doctor started an appeal to get the decsision reversed?

Insurance can be a beast, especially during a treatment.

Good luck and, please, keep us informed.

Mary

Lara86 profile image
Lara86

Yes, I was able to get it. And supposedly it is safe for my liver. I'm not thrilled with being on diet meds the rest of my life. I was in this same med before and it didn't work but now I'm in diabetic meds as well. I think the diabetic med is really what helped. I believe that will be for life, or at least until I retire. Unfortunately, sitting behind a desk 40 hours a week makes it hard to get adequate exercise,especially during winter. I'm hoping the weight loss will make exercise more comfortable, it's made me feel more ambitious especially with the approach of spring weather.

I will be seeing a top liver specialist in about a month and I'm hoping for some better insight. I appreciate any advice on diet and health tips, vitamins but not weird stuff. I'm just trying to eat whole foods, nothing processed which isn't easy in the usa. I'm trying to keep positive until the specialist at least.

Hello everyone

Just to say please can all users respect the right of other members to present their individual health experiences, regardless of whether or not they are in agreement, and express any disagreements politely and with compassion for all those involved.

Participation in this community should always be with respect, honesty and in the spirit of supporting and learning from fellow users.

Thank you

British Liver Trust team

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