Sep 09, 2007 Filed in:
MedicalI just got a note from SaveMyMedicine.org about the latest way that insurance companies are working to help the drug companies: by refusing to pay for compounded hormones. You'd think they'd be smart enough to see that by covering compounded bioidentical hormones they could be saving themselves drastic amounts of money: Premarin or Prometrium are about $45 a month each and testosterone gel or patches are upwards of $200 a month, while compounded estrogen (usually a combination of estrone, estradiol, and estriol), progesterone, or testosterone each start at around $25 or so a month (they can go a little higher at higher doses). Add the additional costs of higher incidences of breast cancer in women taking Provera and they could really be making out by supporting bioidenticals.
Aetna's going to stop on October 1, while BCBS changed their policy back in May (note that BCBS cites an unscientific 2001 FDA study that even the FDA doesn't support).
As the note I got says: If you are an Aetna or BlueCross BlueShield customer, please contact your employer’s HR department and ask them to petition your health insurance company to reinstate coverage of bioidentical hormones and other compounded medicines. Remind them that healthy employees are productive employees and your health depends on these drugs. Your doctor has decided that compounded medicines such as bioidenticals are the best treatment option for you. Both your employer and your insurer have a responsibility to provide you with the medicines you need at a reasonable cost.Tags: Hormones, Insurance
Nov 14, 2006 Filed in:
MedicalHyperbaric Oxygen Therapy (HBOT) is quite useful for a number of conditions, though the medicare laws have a curious and unusual statement about HBOT: a non-covered conditions list. Most therapies' entries in the medicare laws don't even list covered conditions, so why does this specifically name 22 conditions as being "non-covered"? This is especially interesting because the 22 conditions are all clearly effectively treated by HBOT.
The last issue of Hyperbaric Medicine Today has an interesting article about how this happened. You can go read it yourself at http://www.hbomedtoday.com/PDF/HBOMT_8.pdf The article starts on page 7, you'll have to scroll down to it in the acrobat file yourself. Interesting reading.
If you'd like to read some information about HBOT by physicians who use it, try here. You can read a (relatively) short bibliography of research on HBOT here.
Here is the medicaid list of noncovered conditions:
1. Cutaneous, decubitus, and stasis ulcers
2. Chronic peripheral vascular insufficiency
3. Anaerobic septicemia and infection other than clostridial
4. Skin burns (thermal)
5. Senility
6. Myocardial infarction
7. Cardiogenic shock
8. Sickle cell anemia
9. Acute thermal and chemical pulmonary damage, i.e., smoke inhalation with pulmonary insufficiency
10. Acute or chronic cerebral vascular insufficiency
11. Hepatic necrosis
12. Aerobic septicemia
13. Nonvascular causes of chronic brain syndrome (Pick's disease, Alzheimer's disease, Korsakoff's disease)
14. Tetanus
15. Systemic aerobic infection
16. Organ transplantation.
17. Organ storage.
18. Pulmonary emphysema
19. Exceptional blood loss anemia
20. Multiple Sclerosis
21. Arthritic Diseases
22. Acute cerebral edema
As the author of the "noncovered conditions" list points out, there is no law against using HBOT for these conditions, they are merely off-label uses for HBOT. There are also articles about using HBOT for migraine and Lyme disease (which medicare presumably won't cover either, nor, by extension, would insurance companies). And since I have a special interest in MS, I dug up this page which is the beginning of a discussion on HBOT for MS.
Why do I take this interest in HBOT? I managed to get my hands on a modest chamber and have been looking into using it therapeutically.Tags: Hyperbarics, Insurance, Multiple Sclerosis