Thank you, United Healthcare

This post is in reference to THIS post, where I explained that my health insurance, United Healthcare, decided not to cover my echocardiogram (to see if my heart had an abnormalty that was giving me headaches), after they had initially said they would cover it.

My awesome neurologist, Dr. Matthews at the NC Comprehensive Headache Clinic, who I'm not seeing right now because I'm seeing a new neuro at UNC Healthcare, submitted an appeal for me with all of my health records. In addition, I submitted my own appeal to United Healthcare.

Today I received a letter from United Healthcare saying that after reviewing the appeal, they decided they WILL cover the echocardiogram. WOOT!

I just wanted to say thank you, United Healthcare. You guys have been covering a lot of my bills lately, from my sleep study, prescriptions, etc. and I'm blessed to have health insurance so that I can continue to fight my headaches.

Also, I wanted to let patients reading this know that if this happens to you, SUBMIT AN APPEAL. Submit three if you have to. It's worth the try!!!

:o)

Why My unnamed health insurance Sucks

Late last year I had an echocardiogram...see this post for details.

My health insurance sent me a letter before the test, and I realize now looking back that the wording is tricky. For example:

"Based on the information reviewed, we are pleased to inform you that coverage is available."

Is available, yes. Just not for me - at least not the full amount. It goes on to say:

"All covered services are subject to screening for allowable charges. The final allowable charge(s) will be determinted when the bill is submitted and will be based on the actual service(s) provided."

Ok, so this is my bad. Obviously I have no way of defending myself. But their way of doing things is ridiculous! What is the point of checking to see if something is covered if they're not going to give you a straight answer until after you have it done?

So the letter I received last week said that certain parts of the test weren't covered:

"Our clinical staff reviewed the submitted documentation and determined that CPT codes..." (a bunch of numbers) "...have not been proven effective for the documented clinical circumstances surrounding this service. The service requested is considered an experimental or unproven treatment due to lack of evidence of randomized controlled trials demonstrating safety and efficacy in peer-reviewed medical literature."

I can't even begin to speculate what that means and why they aren't covering a standard echocardiogram, which tons of headache patients have done.

I want to appeal it, but I've appealed things before and I think I'd be wasting my time. I'll decide once I get the bill from my doctor. Right now, the bill was $1000something, but the insurance covered all but $600something. My mom and hubby told me to wait until I get a bill because my doc might not bill me for as much since insurance didn't cover it. This whole system is just stupid.

I'm sure $600 bucks is pocket change compared to others who have been screwed by insurance companies or don't have insurance, so I'm going to stop complaining now. Or at least until next time the company pisses me off.

Blogging about it helps for some reason, so thank you for letting me do this. :)

Echocardiogram results; Bystolic Q&A

Drum roll, please....

No hole in my heart! Woohoo. I was ready to have heart surgery too. Of course, I would have ruled out other things first. Anyway, if you have no idea what I'm talking about, see my last post. I encourage everyone who has headaches/migraines to get the test done though, assuming your insurance covers it, because ya never know...

So moving on to other things, this health Web site called Wellsphere publishes my blog (among other blogs) and they have a Q&A section, so I decided to ask a question. Here's the link, and here's the Q&A:

Q:

Is anyone else on Bystolic (nebivolol) for headaches/migraines?

I've been on it (5 mg/day) for at least six months, and while my migraines have gone away for the most part, I still have about 10-15 headaches a month. My neurologist thinks it's helping my migraines, but I'm not sure if it's that or something else. I didn't have many migraines that often to begin with.

If you're on it or have tried it, please weigh in. Is it helping? Did you have any side effects? (I haven't noticed any except for a slower heart rate). I'm nervous about being on such a new medication when I don't even think it's helping.

Thanks!

-Heather

A:

Heather,

Bystolic is a beta blocker, and beta blockers are quite effective Migraine preventive medications for many people. However, after five months, it's working as well as it's going to unless you increase your dosage. If you're worried about Bystolic because it's new, there are many older beta blockers you could try, including propranolol/Inderal (Note from Heather - I've tried these; bad side effects)

You are definitely still having too many Migraines. Research is increasingly showing that Migraine is a progressive neruological disease that can cause brain damage in some patients. Those who have three or more Migraines a month are at more risk for such damage than people who have fewer than three Migraines a month.

For more information, see Is Migraine a Progressive Brain Disease? and Yes, Migraines Can Cause Brain Damage.

Don't just settle. It's far too important. If your doctor won't work with you to find better treatment, it's time for a new doctor.

Good luck,

Teri

(Back to Heather:)

Now, Teri isn't a doctor, but she seems to have a lot of knowledge when it comes to headaches and migraines. Check out her blog here.

Speaking of migraines, I had my first one in a while (I mostly get headaches) on Friday. I'm nervous that since I've had my IUD for two years, my body is getting used to it and I'm going to have migraines like I did when my body got used to The Pill. I hope I'm wrong, but we'll see.

To wrap up this post, I'd like to thank God for the good test results today!

Echocardiogram

On November 10 I will have an echocardiogram at my neurologist's office. For those who are not familiar, research has shown that many people who have a hole in the heart also suffer from migraines. My mom, who is a nurse, saw this on tv and encouraged me to get a test - an echocardiogram, or ultrasound of the heart.

Two really neat things for which I give God the credit - when I asked my neurologist about the test, I found out that a cardiologist actually comes to their office every Monday and can perform the test! The second absolutely extraordinary thing is that my insurance is actually going to cover the test! Praise God! Although they weren't certain they'd cover it at first, I wrote them a letter explaining how I was born with a functional heart murmur, which could be from a hole in my heart, so that might have helped.

So what happens if they find a hole? I'm trying not to think about that, especially since my aunt was telling me about someone who died from having surgery for a hole in his heart (but his was necessary and not related to migraines) - she told me this without knowing about my test too! But, there are people who have had the surgery and had a reduction in migraines.

I encourage you to read this post from The Daily Headache, a really neat blog that you've probably visited. The comments are particularly interesting.

I'll post my test results next week. Until then, hope you have a headache-free week (starting tomorrow - I mean, how can you NOT have a headache on election day? hehe).

News Item

Heart repair may give migraine relief

By Tina Hesman Saey
ST. LOUIS POST-DISPATCH
08/29/2007

Doctors soon will know whether sealing a small hole in the heart can cure a big pain in the head.

In worldwide clinical trials, researchers are closing a passageway through the heart in migraine sufferers and then waiting to see if the headaches go away or get better.

Click title to read more.