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7 Replies
feelinghopeless - March 29

I have to get this out of my system before I explode!!!! I am trying to get treatment for my fibromyalgia and it is not going well. I am at an out of network facility, and prior to coming here, I called to see if I had any coverage for this facility. I was told that I had out of network coverage, so I took every penny I had, took a 1200 mile trip and finally thought my life was going to get back on track.

When I got to the clinic, I was told they required $25,000 because I didn't have out of network coverage. After A LOT of frustration, I was able to get approval for a medical evaluation. Now, the doctors want to start treatment and my insurance is denying it!!!!

I have been calling my insurance company over and over and keep getting the run around. I also have people telling me that maybe I should have gone to treatment in network and then I wouldn't have this problem. I have been to 25 doctors in the past 2 years that are in my network and I am still not better, in fact, I am worse!!!

I had a representative tell me today that maybe I should learn to read my policy more closely so that I knew what I was talking about. I was also told that my condition is not very serious, so the care coordination department would get to it when they have time. Meanwhile, I am in a hote, 1200 miles from home, sicker than a dog, no meds, no support, my job will be gone when I get back, and I don't know what to do!!!

I am very sorry for going off. I am alone right now and don't have anyone to yell with, and I have a feeling there is now a big red flag by my name on my insurance claim!


STAYLOR875 - March 29

I don't have much experience in going out of network as I have been afraid of the cost but I did want to tell you that I am sorry you are having to go through this and I hope they can get it taken care of for you so you can go back home.
Take Care, Sandy


ptalana - March 30

I just wanted to say how sorry I am that you are not only in so much pain, but also being treated so poorly by your insurance carrier. I live in Canada so I can't relate to the intricacies in health care in the US. I can however sympathize with being denied by insurance companies for treatment. I hope things turn around for you soon and that you're able to get the medical care you need and deserve.
No need to ever apologize for venting/ranting we've all been there. I hate to think that you're alone and suffering. I know it's not the same as having someone physically by your side, but we're here for you.
Please take care of yourself, Patty


axxie - March 31

Oh dear girl, how frustrating it must be, and to be alone at that, you are one brave soul to have driven all this and to boot being denied by the insurance company.

I do hope you can work out something with the insurance company and the clinic. I just hope some how you get what you need in treatment and that you get better soon.

It must be just damning to hell, I don't know if I would have the time or patience to talk to the insurance company to make them listen, I'm sure I would have thrown a fit if you know what I mean.

Please let us know how you are doing with this nightmare and intrusion of your insurance company.
None of us, would want you to be left behind. And please don't feel sorry if you are raving, it's good to throw it out there, it's liberates you of some aggravation and that can only be good for you.

Good luck and please let us know how things are.


Noca - March 31

I hate my school insurance too. They took 8 weeks to mail me my first cheque from the time I submitted the claim. It was 5 weeks for the 2nd one. Going to make a 3rd claim soon. I'll milk them for all they are worth. lol Down with insurance companies!


feelinghopeless - April 5

Thank you everyone! Iam still in a bad place. I ended up in the emergency room the past 3 nights because the pain is so bad. In order to get disabioity, I was told to make sure I go to a Fibromyalgia specialist so I have a better case. I explained this to my health care company and was told "you don't need a specialist, any doctor can give you drugs so just pick one and go, but you will NOT be going to the Mayo Clinic."

I left the clinic area and went to my mom's house about 7 hours away. Now I don't know what to do. I am guessing my job will not be there when I go back. I will probably be moving back to MN to live with my mom, but there are still no physicians in this area that treat fibro (well that at least have knowledge of it.) It is that way where I live in GA too.

I am at the end of my rope. I can't sleep and hurt all of the time. I am having horrible mood swings because I feel like I am being jerked around and don't matter to anyone. I am just a number. Once I move back to MN I won't have any insurance. this sucks!!!! Thanks for listening.


ptalana - April 6

Hi feelinghopeless, I'm so sorry to hear that you're still in such a bad place. What you need is a rheumatologist who deals with Fibromyalgia, and almost more importantly one thats fibro friendly. I know that you can contact your local hospitals physician referral service and they should be able to give you some names.
I can definitely relate to difficulties with insurance carriers. I have been fighting for the past three years to get my insurance carrier to cover my expenses following an accident I had at work. It's hard to fathom at times how these things can happen to good people just looking for help!!!!
Once you find a good doc he will be able to help you with appropriate meds and vitamin supplements, please make sure you get tested for vitamin D deficiency, as many of us are. In the meantime you can try to modify your diet by staying away from fried foods, lunch meats these contain nitrates a definite no no for us, nuts, citrus fruits, dairy, soda, products made with white flour. Many of these can trigger your symptoms. I would start keeping a daily diary of your sleep cycles, pain, and symptoms. Also make sure you have copies of all tests that have been done so far. Bring all of these with you to your appointment as they may help alleviate additional testing/expenses.
I'd also do as much research on fibro as you can, the blue boxes on the left side of screen hold a wealth of info. We fibromyalgics have to be our own health care advocates, so having an in depth knowledge of fibro is a must.
Please remember to us you are not a number and we all appreciate and relate to what you're feeling. We are here for you! Patty:)


Fantod - April 6

Yes, I also live near the Metro in Minnesota. Go to Fairview at Oxboro in Bloomington and make an appt. with Dr. Veum. He's an internist with lots of experience with fibro, and has been my doctor for a number of months. He's both knowledgable and compassionate, and I call him my guardian angel doc.


This is a post from solanadelfina who lives in MN.

You can also go to the National Fibromyalgia Association website and register. Then you can see a list of fibro-friendly doctors in GA. Reregister in your mom's name to see a list in MN.

I'm sure you felt it was necessary to go to the Mayo Clinic out of sheer desperation (which I can understand). But, I think that you may be misunderstanding the disability guidelines. You can see any pain specialist and/or rheumotologist that treats Fibromyaliga (FMS).

I qualified for disability in the fall of 2009 through a company called Allsup. They have a 98% success rate. You can find them on the Internet. They handle all of the paperwork. They had my case approved in 6 months. You will most likely not get disability based solely on diagnosis of FMS. There must be other, documented, underlying health conditions in addition to FMS. In my case, I have degenerative disc disease, severe anxiety, and a bunch of other issues.

In addition to a rheumotologist, you might also want to consider seeing a counseler who specializes in treating people with chronic illness. Calling the local hospital physician referral service should identify someone with that area of expertise. You will really have to have your ducks in a row to get the disability ball rolling to a successful conclusion.

I am so sorry that you have been through such a terrible ordeal. There is nothing worse than being ill and away from familiar surroundings. I wish you peace in your life. Take care.



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