‘He’s falling apart’

Family enters final fight for son’s ‘life-saving’ treatment


by Amanda Hara. Published: Mar. 21, 2024 at 5:35 PM EDT

Another story about the cruel bureaucracy of insurance. A child with PANS/PANDAS was healing from this devastating but treatable disorder with the help of IVIG. But when the family had to switch insurance companies, the new company, Cigna, deemed it not medically necessary, and now this precious child’s health has deteriorated to the point that the family has to consider residential care to keep their child safe. There is no way that residential care will heal a neuroimmune condition, which will lead to unnecessary suffering and higher costs for the insurance company, possibly for years and years to come. The decision is callous and foolish. We truly hope the family wins the appeal process.
“The dramatic change in Jameson came the moment he missed a treatment that had been helping, Lcompanyaura explained. Intravenous immunoglobulin (IVIG) is a treatment for moderate and severe cases of PANDAS. The out-of-pocket cost can run nearly $15,000 a month.
“He was doing so much better when he was doing the IVIG treatments. He had started to eat food by mouth. He had improved handwriting. He was able to work a light switch,” Laura said.
Laura and Corey both work for the Metro Nashville Police Department. However, when Blue Cross Blue Shield lost the bid for Metro Government, leaving Cigna as the only option, Jameson lost access to insurance coverage of IVIG treatments.
In two recent denial letters, Cigna informed the Walls that IVIG is ‘medically unnecessary.’
In a statement to WSMV4, Cigna Healthcare said, “While we cannot comment on individual cases, the health and well-being of the people we serve are our priority and we strive to resolve issues quickly.””

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