Health Insurance Coverage for Lyme Treatment in Minnesota - Patient information

Health Insurance Coverage for Lyme Disease in Disability - Lyme advocate Barbara Arnold explains some of the factors involved when a Lyme patient files for SSDI.

Applying for social security disability

Lyme disease impairment questionnaire, (submit with your claim) by Ethel Schaen, social security disability attorney.

Strategy for appealing a denial of social security disability, by Ethel Schaen, social security disability attorney.

Disability.gov is a comprehensive Federal website of disability-related government resources.

Medicare Programs

Presciption Hope can help you obtain any of about 1500 brand name prescription medications

If you have been denied insurance . . .

We urge you to contact Commerce Commissioner Mike Rothman, and send/email a copy of the letter to your state representative and senator. Concisely tell your story and ask that he remind insurance companies of their obligations to treat Lyme patients under Minnesota Statute 62A.265. The more patients he hears from, the stronger his mandate will be to advocate on our behalf.

Commissioner Mike Rothman 85 7th Place East, Suite 500, St. Paul, MN 55101  651-296-4026

commerce.commissioner@state.mn.us  651-296-4026

Lymedisease.org recommends . . .



The CDC says:

Surveillance case definitions establish uniform criteria for disease reporting and should not be used as:* the sole criteria for establishing clinical diagnoses;* determining the standard of care necessary for a particular patient;* setting guidelines for quality assurance, or providing standards for reimbursement.

Yet, doctors are inappropriately using CDC surveillance criteria to diagnose, and insurance companies are using the criteria to deny reimbursement, thus patients are not getting diagnosed and treated.

The following letter was sent from Representative John Ward to Dept. of Commerce Commissioner Mike Rothman.

If you have been denied insurance reimbursement for treatment of Lyme disease, we encourage you to write a letter to the commissioner and send a copy to your state representative and senator!

Commissioner Mike Rothman -MN Department of Commerce   

85 7th Place East, Ste 500

St. Paul, MN 55101

Dear Commissioner Rothman:

I wanted to take this opportunity to highlight the fact that several constituents have contacted me recently to share their concerns about the fact that their health insurance providers have denied coverage for IV antibiotics to treat Lyme disease. In addition, Brenda Peltier, president of the Minnesota Lyme Association, reached out to me to bring to light the fact that their members are noticing more insurance denials as well. They are organizing an effort to send letters to insurance companies to remind them of their obligations in Minnesota Statutes 62A.265 (Coverage for Lyme Disease):Subdivision 1.Required coverage.

Every health plan, including a plan providing the coverage specified in section 62A.011, subdivision 3, clause (10), must cover treatment for diagnosed Lyme disease.Subd. 2.Special restrictions prohibited.

No health plan included in subdivision 1 may impose a special deductible, co-payment, waiting period, or other special restriction on treatment for Lyme disease that the health plan does not apply to nonpreventive treatment in general.

The number of Lyme disease cases has been increasing dramatically since the 1990s. You may not be aware of the fact that my district is ground-zero for Lyme disease and other tick-borne illnesses in Minnesota. In fact, almost 12 percent of all Lyme disease cases in Minnesota were reported in Crow Wing County. Cass County also ranks among the highest for incidence of Lyme disease, representing 5 percent of all reported cases. That is why I have worked diligently to combat Lyme disease in Minnesota with further efforts for prevention, and legislation, enacted in 2010, allowing physicians to more aggressively treat Lyme disease patients.

Today I am asking for your help. Although I am aware that the Minnesota Department of Commerce does not have jurisdiction over self-insured plans, I hope that you will act on behalf of Lyme patients in Minnesota and ensure that the insurance plans under your control meet their obligations to cover the treatment methods the patient and doctor determine is best for them. Oftentimes, multiple treatment methods are needed to attack this crippling disease and the most beneficial healing method should be determined by medical professionals, not insurance companies.

Thank you in advance for your time and attention to this serious matter. I look forward to receiving a response from you. If you have any questions, or if your policy staff feels that additional legislative action is needed, please don't hesitate to contact me at (651) 296-4333.

Sincerely,

John Ward                                

State Representative