anyone in PA w/ Blue Cross insurance??

[sapphire4373]

Hi all, I was wondering if anyone in PA happens to have Blue Cross/ Blue Shield insurance and also had your derm prescribe a UVB panel for home phototherapy?? My derm gave me an RX in May or early June and I cannot find any Durable Medical Providers in this entire state to order me one. The 1 company that was going to get it for me decided that they weren't going to get paid enough so I was told they couldn't do it. And yes before you ask me, I did ask them if I could pay the difference and they told me no. The NPF will be sending me info as I did call them, but I was just wondering if anyone had gone thru this and could possibly tell me of any DME providers in PA that could order me a panel. I want to get off this MTX so bad and I am out of options here with getting a light panel.

Well thanks for any and all replies.
Lisa

[winter]

I am on Medicare and BC/BS and was finally able to get my replacement bulbs paid for but the durable goods is handled in Indianapolis, Indiana. Applying through regular Medicare channels was hopeless. There are places listed in your NPF bulletins and there are quite a few of them. Go on the internet under GOOGLE and see what you can find also. One member of our group was able to take the information we had given her to her doctor and she got lights even though she belongs to an HMO. Just keep on trying. Hopefully NPF will guide you through this better than I have. Good luck.

[Keith]

go to www.photothrx.com they are a provider you can order from yourself as long as you have a prescription

[sapphire4373]

Thanks for the replies, I did the google search and I was also in contact with photo therapeutix, they only offer the full body system and my insurance won't cover anywhere near $5000.00 I also called every DME provider that Blue Cross is under contract with but no one will order them...they have alot of people call about these units but they don't offer the service. Oh well it just looks like Thurs. when I go back to my derm that I can tell him that this option has been exhausted, because I know I am!!! I have been at this for almost 5 months and it is surely not helping my condition and I justgive up. I just can't believe that for once insurance will pay with no problems (they find it medically necessary!!) but the ONE place that would have ordered me one won't do it over $75!!!!!

[tsicard]

Lisa, I am a Blue Cross member only in St Paul MN. I was fortunate to have had a DME provider here in town. However I had origiannly started with the manufacturer and one of the ladies (sorry I don't recall the name) at the order desk was fantastic in her suggestions for getting around the full price ticket of a personal purchase. I was able to get it with the perscription.
Try that first - ask the manufacturer for some suggesstions for your geographic set back. If that is no help, dial up your states Insurance Commissioner. Most importatnly, document your path of research and responses.

[winter]

I also got from the U of M the instructions on how to build a box out of plywood. My sons and my nephew built it for me and I have been able to get the fixtures and light bulbs for it with a prescription from my dermatologist. I had it in the basement when I lived in my house but now that I am in a condominium it needs to be painted. That is another avenue you could pursue. I do not understand BC/BS limiting lights to $75.00. Eight 6 foot bulbs that are required in a light box cost me around $600.00. Is the problem dependent on the type of insurance that you have with them? The bulbs only last so long and then must be replaced again with a doctor's prescription. Psoriasis is forever so we have to keep working on it. Good luck and persistance.

[sapphire4373]

I finally got it!!! It wasn't Blue Cross it was the providers themselves. Money hungry in my opinion. Anyway it is a long story, but if any in PA ever needs to find one let me know!!! Persistence does pay off. I did my 1st treatment today and I still can't believe it is here after all the months of trying!!
Thanks for all the tips from everyone, and like I said let me know if anyone out there has as much trouble as I did. 1 phone call will make your life better.