I am SO HAPPY!!!

Although I was orginally denied coverage as VSL#3 is considered a "medical food", I appealed the decision with a specific note from my doctor and just got a letter in the mail stating that I will be covered for a 3 month supply!!!

This will save me tons of money as you all know VSL#3 is quite $$$$$.

***If at first you dont succeed, try try again***

Keith

Someone needs to change that 'medical food' designation. I just saw an article about a couple of children who can ONLY exist on a special formula/drink. Their families have had their insurance claims denied because it's considered medical food. One family was told that their insurance would only pay if they opted to tube-feed their child. So having surgery and having to maintain an oriface is better than drinking the stuff? Doesn't make sense, does it? It seems that medical food would be so, SO much more cost efficient for insurance companies. (Yes, I realize there are fine lines regarding medical food - but accepted medical foods could be outlined by the companies.)

I'm so glad you persisted and got your 'food.'

kathy

Great News!

I just received a letter stating that I will be covered for a 6 months supply of VSL#3. Better than the last time when it was a 3 month supply.

When my 3 month supply ended last summer, I sent in a request for continued covered and was denied. I then sent an appeal, and now November 18th, I finally heard back with them with an approval!!!

Since then I have been using Culturelle and am happy with it, but it still costs me around $45 a month. (2 boxes a month).

I sent the following to get it approved:

1) Personal Appeal Letter
2) Letter of Medical Necessity from my doctor using this form letter from VSL#3
http://www.vsl3.com/vsl3/pdf/SampleLetterofMedNecessity.pdf
3) A print out of the 17 page product Monograph, containing detailed information on the effectiveness and studies, etc.
http://www.vsl3.com/vsl3/pdf/VSL3ProductMonograph.pdf
4) Script from my doctor with dosage

First time was denied
Second time - Approved!

The letter from insurance said that they approved it because of "Three notable double-blinded random controlled trials have demonstrated the efficacy of the probiotic mixture VSL#3 in the primary prevention or maintainance of remission of pouchitis".

Never give up with insurance companies for any medical treatment. Persistance pays off.

Keith

Keith mine also coverd it at a 6 month time frame.. the only thing I have to do it have dr fill out paperwork every 6 months and they would extend it for 6 more. I dont take it now with my end illeo but if I wanted it for life it is covered. Great job on fighting the good cause and hope it helps you!

Great information Keith!
what insurance do you have?

Chickering - Aetna

Chickering is the student version.

Great news about the VSL#3, but for those who want to take Culturelle, you don't need to pay $45 a month for twice daily dosing. I buy online for a little more than $14 per box (30 capsules) with free shipping if you buy more than $100 in your order.
http://www.luckyvitamin.com/049100364049.html

Jan

I priced Culterelle at Walmart for $16.99 for 30 capsules. I bought it at Kroger's (grocery) for $19.95 earlier. $14 is great, but if you don't have a hundred $$ worth, sounds like the Walmart is the best deal...this is in Ohio though. Prices could probably vary where you go.

nys

Thanks for the link Jan Dollar!! I am currently using Culturelle and it has been working well. The few stores where I live that carry Culturelle cost around $20-$25 a box! Thankfully, we have a lower priced alternative to VSL#3.