This Is MS Multiple Sclerosis Knowledge & Support Community

Just found out that BCBS is no longer covering CCSVI treatments. Wonder why that is the case?

We're discussing it over in this thread:
www.thisisms.com/ftopic-16437-15-days0-orderasc-.html

And newlywed4ever posted a link to the document itself from BCBS outlining its reasons for classifying it as investigational.

(never mind, I see you found the other thread on your own )

I just heard the news and I have BCBS. I had previously been told I would be covered when I looked into it. I had concerns that the U.S. insurance companies would start denying this as they realize it has not gone through the FDA approvals.

Is there anything we with BCBS can do?

My family can probably afford one treatment out of pocket, but if I restenose we could no way afford repeat treatments without insurance!

What is the link the BCBS's policy and when did it go into effect?

Thank you.

If you have symptoms of a dvt in a vein they will correct it.....Don't even speak of MS. That is my two cents worth.

BooBear wrote:Just found out that BCBS is no longer covering CCSVI treatments. Wonder why that is the case?

I would not be surprised. Insurance companies do business, so if they do not gain anything from it and the results of the treatment are not proven yet, then why would they do? In Europe, most of us insurance companies do not cover CCSVI operations.

I am just wondering why insurance companies do not exert more power on clinics to come out with proofs on the effectiveness of their treatment. This is a very comfortable situation for CCSVI clinics, they make big bucks as demand for treatment is so high and they do not have to do any compliance to any standards and they do not have to have any documentation on efficacy, etc.

BooBear wrote:Just found out that BCBS is no longer covering CCSVI treatments. Wonder why that is the case?

BooBear,

I am trying to find out if it is all 39 independant BCBS companies. Do you know if it is?

Below is a list of all the independant BCBS companies.

http://www.bcbs.com/coverage/find/plan/

So far I have only read here on TIMS that Empire BCBS is not covering it. Empire is strictly in the state of New York.

I see you are in Chicago, do you have BCBS of Illinois? If so, do you know of anyone else with CCSVI that has been denied coverage for the angioplasty to treat it?

WeWillBeatMS

http://www.ocregister.com/news/patients ... veins.html

While most patients pay cash, Arata said a few health plans will cover the angioplasty. All of the health insurers contacted by The Register said they do not cover the procedure. Anthem Blue Cross, the largest for-profit insurer in California, describes the procedure for MS patients as "investigational and not medically necessary."

All of the health insurers contacted said they do not cover the procedure?

Cece--Does that mean UHC does not cover it now, either?

What rotten but expected news.

I wonder how many people will have their jugular veins close up because lots of private health insurance companies are now denying the procedure. I also wonder what, if anything, the various CCSVI associations are doing to help with this growing problem???

It might be that when asked by a newspaper if they cover venoplasty for the indication MS, the insurers say no. But in practice, the insurers say yes when the IR bills for the procedure, since insurers have traditionally covered any blockage over 50%, and it is an awfully fine line to make that an insurer will pay for a non-CCSVI-related thrombosed jugular to be cleared but not pay for an equally blocked jugular to be cleared when it is a valve malformation doing the blocking.

I did not mean to alarm, I don't think this article meant much of anything. To the best of my knowledge, UHC is still covering the procedure. Medicare and BCBS are the two that are not, and even that is not across the board, but depending on one's state. (For Medicare, it might be across the board. I have not heard anyone post about having the procedure successfully covered by Medicare for some time now.)

I really hope my jugulars stay open. The possibility of insurance not covering this is worrisome.