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Does Insurance Cover Lyme Disease Testing

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Evaluation Of Peripheral Neuropathy

Lyme Disease Disability Insurance Benefit Claim Tips

Wormser and colleagues noted that in older studies, a chronic distal symmetric sensory neuropathy was reported as a relatively common manifestation of late Lyme disease in the United States. However, the original papers describing this entity had notable inconsistencies and certain inexplicable findings, such as reports that this condition developed in patients despite prior antibiotic treatment known to be highly effective for other manifestations of Lyme disease. More recent literature suggested that this entity is seen rarely, if at all. The authors concluded that a chronic distal symmetric sensory neuropathy as a manifestation of late Lyme disease in North America should be regarded as controversial, and in need of rigorous validation studies before acceptance as a documented clinical entity.

The Need For Insurance Coverage For Lyme

The topic for my law journal article came from hearing stories of other patients struggling to receive insurance coverage, as well as my own personal experience. If patients are not able to pay for their medical treatment because public or private insurance does not cover it, they will likely not get better.

I wanted to provide federal legislators with strong scientific evidence, a background on the controversies associated with the illness and a concrete way to improve the lives of patients who are currently suffering.

My goal was to build on the work of local activists who have achieved incredible results passing legislation in some states, by expanding coverage on the national level.

Insurance coverage is especially critical in states with perceived lower incidence rates because it may not be a priority for those states legislators. My proposal is based on other federal insurance laws including the Federal Parity Law and the Womens Health and Cancer Rights Act.

Since Lyme disease patients live in every state in the U.S., federal legislation will provide insurance coverage for patients no matter where they live.

Jennifer Barrett will graduate from law school this spring.

What Is The Treatment For Lyme Disease

Lyme disease can be treated and cured in all the stages. 14 to 21 days course of oral antibiotics are commonly used to treat the disease in its early stages. The medications used are doxycycline , and cefuroxime and amoxicillin

The later stage of Lyme disease that involves the central nervous system is treated with intravenous antibiotics for a course of 14 to 28 days. Sometimes, these intravenous antibiotics can cause various side effects that include a lower white blood cell count, diarrhea, colonization, or other infection.

Some people might experience symptoms such as joint pain and muscle weakness even after the treatment. This condition is known as post-Lyme disease syndrome and the cause of this syndrome is not known to date. In this case, treating with antibiotics is also ineffective.

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What Does An At

Once ordered, an at-home Lyme disease test kit is delivered to your home, where you can collect the sample privately and comfortably. The kit will include the instructions, the sample collector, and the box to return the sample.

Once the results are ready, you will receive them in your email or through the company’s online portal, or they will be sent to your doctors office.

Testing For Lyme Disease At Home

About Lyme Disease

People can find many at-home Lyme disease tests online.

They typically come with instructions, and most companies require individuals to collect their samples at home and mail it to a lab for testing. The lab then issues the results, and a person can access them via email or through a companys online portal.

People may also be able to speak with a companys medical team to discuss their results and, if applicable, any next steps.

MNT chooses at-home tests that meet the following criteria where possible:

  • Laboratories: Where possible, MNT will choose companies that process test samples in

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Government Assistance For Lyme Disease

While there arent many government assistance programs that help offset Lyme disease costs, filing for disability can make life easier while you receive treatment. Applying for Lyme disease disability benefits can be tricky, but the website lists the benefit programs from every state with information on how to apply.

Why Lyme Disease Isnt Covered By Insurance

Ok, wellI should state that Lyme disease IS covered by insurance. Just not past 28 days of treatment. Why? The medical community is completely divided as to believing or not believing that chronic Lyme exists. Lyme is a political disease. Money. No one is really doing the research in finding a faster or better cure, and every time some one comes up with research about the disease, it is swept under the rug and often ignored.

I suggested you to watch the movie, Under Our Skin, free on Hulu, but I bet you didnt , did you? Dont lie to me! Either way, it is a very informative movie and I highly recommend it. *Cough*Watch the Damn Movie* Cough* This movie really gets into the politics of why long-term Lyme treatment is not covered by insurance, as well as share the stories of some people struggling with this disease.

The IDSA, is made up of a group of people and amongst them, many had a connection to insurance companies among other corporations and wrote a list of guidelines that the CDC has to abide by. Most of these people had a benefit to them, even when evidence was smacking them right in the face. ITS ALL ABOUT MONEY PEOPLE! These people benefited by making up this set of rules, and were paid heavily for doing so.

This has left a lot of people out there sick and unable to get the treatment they need. Its sad.

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Do I Need A Lyme Disease Test

Your doctor will consider whether your symptoms and risk factors suggest Lyme disease when deciding whether you need a Lyme test. Laboratory tests can support a clinical diagnosis, but should not be used on their own to confirm or rule out a current Lyme disease diagnosis.

Your doctor may also do tests to see if other conditions with similar or overlapping symptoms for example, thyroid disease, autoimmune disease, or other tick-borne diseases could be causing your symptoms. If you have been traveling, your doctor might test you for species of Borrelia that cause Lyme disease in other parts of the world.

If you think you may have Lyme disease, but your doctor hasnt considered it or has ruled it out before testing you for it, heres how you can start a conversation: Give your doctor a list of Lyme disease symptoms and risk factors , and ask them if, given your own symptoms and risk factors, Lyme disease could be a possible cause and whether you should be tested.

In some cases, a Lyme test may not be helpful. Using todays tests it is difficult to distinguish between current and previous infections, so if you were previously diagnosed with Lyme disease and may have been re-infected, your doctor should make the diagnosis based on your symptoms and risk factors.

Tick Testing

Where Are Deer Ticks Found In Canada

The Real Deal: Limited Insurance Coverage for Lyme Disease

These areas include southern British Columbia, southeastern and south-central Manitoba, southern, eastern and northwestern Ontario, southern Quebec, southern New Brunswick and Grand Manan Island, and parts of Nova Scotia. The Public Health Agency of Canada has a map that shows the known areas of risk.

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Touched By Lyme: The Thorny Question Of Insurance Coverage For Lyme

People suffering from persistent Lyme disease typically make a lot of unpleasant discoveries early on. For instance, how many different places your body can hurt. And how exhausting even simple exercise can be.

But the pain and exhaustion isnt just physical. Its also financial. Turns out, your regular doctor probably cant help youand your health insurance likely wont pay for anybody who can.

The topic is frequently discussed in Lyme patient support groups, whether online or in-person.

But the issue of lack of insurance coverage for Lyme disease treatment is rarely mentioned in the mainstream news media.

Therefore, I was pleasantly surprised to see the following headline and article in Business Insider, an online news publication with a worldwide readership.

Reporter Heather Schlitz presents a pretty accurate picture of how Lyme patients get little to no support from their health insurance companies.

Profiling a patient from Northern California, she notes: Over three years, she estimates she paid around $100,000 for antibiotics and other medications, an amount that drained her and her husbands savings account and retirement funds, but that managed to rein in the avalanche of symptoms.

Schlitz explains that insurance companies often refuse to cover the costs of treatment because of the Infectious Diseases Society of Americas stance on the subject. She writes:

Schlitz continues:

Urine Ospa Protein Evaluation

The authors do note that PCR analysis of urinary Borrelia, or urinary Borrelia culture was not done, because of the very low sensitivity of these tests in human urine. Consequently, a weakness of this study is that a true positive diagnosis of LB could only be based on the CDC clinical criteria , and the development of a later positive serology in patients who underwent therapy at the time of the clinical diagnosis of LB. Despite this weakness, the strong correlation of urinary OspA with treatment response may offer a new class of information to assist the treating physician to determine whether a first round of therapy is successful in primary cutaneous early stage LB. In a population of patients being under surveillance for persistent or recurrent LB, the percentage of positive urinary OspA patients is in keeping with previous studies on patients estimated to actually have LB in endemic areas. It is impossible to know if urinary OspA, assuming that is indicative of Borrelia burgdorferi infection, is caused by a recurrent or new infection. Thus, urinary OspA measurements may provide additional information to assist the clinical workup of patients under investigation of disseminated later stages of LB.

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How Will My Lyme Disease Diagnosis Affect My Health Insurance

Have you ever checked for ticks after going for a hike or walking through tall grass? If so, youre probably familiar with the risks of Lyme disease the most common vector-borne illness in the United States. Every year, over 30,000 people in America will contract Lyme disease from tick bites, and the Centers for Disease Control estimates that the actual number is probably much higher, around 476,000. So, is Lyme disease covered by health insurance?

The effects of Lyme disease can differ in severity for those who contract it, depending on a variety of factors like age and preexisting conditions. If youve received a Lyme disease diagnosis, you might be wondering how it will affect your health insurance and what treatment will be covered by your provider. Read on to find out!

Question 12 Where Can I Find Information On Additional Tests For Tick

453 best images about Lyme 411: Awareness on Pinterest

Click here for a list of additional tests for tick-borne infectious diseases at Quest.


  • Lyme Disease. Centers for Disease Control and Prevention. Reviewed December 16, 2019. Accessed June 15, 2020.
  • Centers for Disease Control and Prevention. Tickborne Diseases of the United States: A Reference Manual for Healthcare Providers. 5th ed. US Department of Health and Human Services 2018. Accessed June 15, 2020.
  • Mead P, Petersen J, Hinckley A. Updated CDC recommendation for serologic diagnosis of Lyme disease. MMWR Morb Mortal Wkly Rep. 2019 68:703. doi:10.15585/mmwr.mm6832a4
  • Zeus ELISA Borrelia VIsE1/pepC10 IgG/IgM Test System. Package insert. Zeus Scientific Inc 2019.
  • Wormser GP, Dattwyler RJ, Shapiro ED, et al. The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2006 43:10891134. doi:10.1086/508667
  • Waddell LA, Greig J, Mascarenhas M, et al. The accuracy of diagnostic tests for Lyme disease in humans, a systematic review and meta-analysis of North American research. PLoS One. 2016 11: e0168613. doi:10.1371/journal.pone.0168613
  • Kalish RA, Kaplan RF, Taylor E, et al. Evaluation of study patients with Lyme disease, 1020-year follow-up. J Infect Dis. 2001 183:453-460. doi:10.1086/318082
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    Going From Doctor To Doctor

    I went from doctor to doctor trying to find the cause of my symptoms. Every time I went to the ER, they gave me a pregnancy test and discharged me. One ER doctor refused to give me a Lyme test. Another refused to believe my positive Lyme test and instead told me that I was attention-seeking and psychosomatic.

    When my CDC-approved blood antibody test came back positive for Lyme, I thought I was finally on the road to recovery. My primary care provider prescribed antibiotics, and after a few weeks of treatment, I felt fantastic. My neck pain was gone, I was no longer dizzy, and I was finally sleeping.

    But when I followed up with an infectious disease doctor, he attributed my positive test results to the fact that I had Lyme when I was younger and attributed my sudden regain of health to the anti-inflammatory agents in antibiotics. He prescribed a test for every infectious disease he could think of and ordered me to stop taking antibiotics.

    But as each test came back negative and my symptoms began to flare, the doctor had second thoughts. He agreed to treat me with IV antibiotics for one month, but only if I got a lumbar puncture.

    At my two-week check-up, the doctor told me that my treatment would be complete after just one month of IV antibiotics, even though I was still slightly dizzy and exhausted. I decided to seek a second opinion.

    Lyme Disease Financial Assistance

    Because the CDC states that Lyme disease can be treated with 30 days of antibiotics, the majority of insurance companies do not recognize chronic Lyme disease as a legitimate illness and will not pay for long-term treatment.

    The cost of Lyme disease treatments can run into the thousands for patients each yearand sometimes each month. This puts people suffering from chronic Lyme disease in a very tough financial position and makes it difficult to pay medical bills. It might even lead to medical bankruptcy. Thankfully, there are still a few ways to pay for Lyme disease treatments without insurance.

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    Cpt Codes Covered If Selection Criteria Are Met:

    0041U Borrelia burgdorferi, antibody detection of 5 recombinant protein groups, by immunoblot, IgM 0042U Borrelia burgdorferi, antibody detection of 12 recombinant protein groups, by immunoblot, IgG 0043U Tick-borne relapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgM 0044U Tick-borne relapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgG 84181 Western Blot, with interpretation and report, blood or other body fluid 84182 Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each 86617 Borrelia burgdorferi confirmatory test 86618 Immunofluorescence, per specimen initial single antibody stain procedure 88350 Immunofluorescence, per specimen each additional single antibody stain procedure 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis initial, up to 1 hour + 96366 each additional hour, + 96367 additional sequential infusion, up to 1 hour + 96368 concurrent infusion 96369 Subcutaneous infusion for therapy or prophylaxis initial, up to 1 hour, including pump set-up and establishment of subcutaneous infusion site + 96370 each additional hour + 96371 additional pump set-up with establishment of new subcutaneous infusion site 99601 Home infusion/specialty drug administration, per visit + 99602 each additional hour

    Health Woes Lead To Self

    Lyme Disease: Medical-Surgical |@LevelUpRN

    Oppenheimer said Freitas, once wildly independent, increasingly depends on him as she struggles with her health. The two met when she was a single mom driving a Madison Metro bus and juggling classes at the UW-Madison. Oppenheimer had overheard her speaking in Portuguese, and he tried to put together a phrase that he could speak in the same language. That led to a first date and in 2011, marriage.

    But these days, Oppenheimer said, his wife is very drained.

    And even friends and family members question whether the symptoms Freitas describes are real.

    “When everybody is saying that it is not Lyme,” Freitas said, “you start to question yourself.”

    She tried a four-week course of doxycycline, the first-line antibiotics therapy for treating Lyme disease, prescribed by another rheumatologist. She began to feel better, with less pain and less brain fog. However, the symptoms returned once she completed the treatment. She even found herself starting to stutter.

    Oppenheimer himself was diagnosed with Lyme disease as a 19-year-old. At the time, he was living less than 50 miles from Lyme, Connecticut, the community for which the disease was named.

    He described an “arrogant unwillingness” by the medical establishment to recognize what he believes are his wifes ongoing symptoms of Lyme disease.

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    Prolonged Intravenous Antibiotics For The Treatment Of Lyme Disease

    Lantos stated that the diagnosis of chronic Lyme disease has been embroiled in controversy for many years. This is exacerbated by the lack of a clinical or microbiologic definition, and the commonality of chronic symptoms in the general population. An accumulating body of evidence suggested that Lyme disease is the appropriate diagnosis for only a minority of patients in whom it is suspected. In prospective studies of Lyme disease, very few patients go on to have a chronic syndrome dominated by subjective complaints. There is no systematic evidence that Borrelia burgdorferi, the etiology of Lyme disease, can be identified in patients with chronic symptoms following treated Lyme disease. Multiple prospective trials have revealed that prolonged courses of antibiotics neither prevent nor alleviate such post-Lyme syndromes. The author concluded that extended courses of IV antibiotics have resulted in severe adverse events , which in light of their lack of efficacy, make them contraindicated.

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