Monday, May 28, 2012
Tuesday, November 01, 2011 Hernibs asks

Q: My insurance refuses to pay for ER visit for migraine.

Even appeal was denied.What to do?

Having about 20 migraines a month, there are times that I have to go to the ER to interrupt the migraine after a few days of unsuccessful treatment. It happens usually 2-4 times a year.Now for the first time, my insurance refuses to pay for the visit ($1300). In my appeal I explained at length the nature of migraines and the necessity of going to the ER in despair( over the phone). Still...Has anybody got experience how to deal with this situation and make them understand and pay? I'm going to put everything in writing as a last attempt. Thanks.

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Answers (1)
Teri Robert, Health Guide
11/ 6/11 1:06pm

Hernibs,

 

-:¦:-•:*'""*:•.-:¦:-•*Welcome to MyMigraineConnection!*•-:¦:-•:*'""*:•.-:¦:-
Wow. The only time I've heard of insurance companies denying claims for ER visits is when they require that you check with your own doctor first and your doctor sends you to the ER somewhat like a referral. Many insurance companies do that. Have you asked them if a letter from your doctor would make a difference?
 
I'm really concerned that your Migraines are so frequent. Are you working with your doctor to find effective preventive treatment?
 
Please keep us posted?
 
Welcome again,
Teri
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11/ 6/11 3:04pm

Thanks for your concern.We've tried preventative meds for 3 years. Now for the first time two seem to help.2 SSRIs which, so far, I've not been able to tolerate.Having said that I just had my first migraine in 2 weeks today. So we shall see.

Re paying for ER, I sent a secomnd level appeal to ER. Migraine foundation has a form to fill in by your doctor you can take to ER. I did that this week. Hopefully it helps. Good luck!

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By Hernibs— Last Modified: 11/06/11, First Published: 11/01/11