I know that there are many frustrations with insurance companies and the different therapies/medicines we get to control P. My insurance company didn't bat an eye to pay $20,000.00 a year for me to be on Enbrel, but won't even consider a UVB home unit. If they look at the figures - it makes no sense at all. If I want to keep up my treatments, I have to drive approx. 2 hours round-trip 3x a week, not to mention take that same amount of time off work.
How do you go about getting a used home unit, what do you look for and what cost would I be looking at?
Any input would be greatly appreciated!
Sara

Hi Sara,
Recently I've been going through the long process of getting approval for my Narrow Band UVB home light unit. Several of the members were very helpful in providing me information to navigate the process. Here are the links to some key discussion on the topic...


this thread has a couple of blurbs about my own experience...

Others have had success in tan salons, I can't speak from personal experience. I hope this was helpful...I'm sure MikeK will be along with more links.
Good luck.
~Massiel

1 Attachment(s) Sara,
You have the right to appeal (if you haven't already). Usually you can appeal 2 or 3 times and then ask to go before a review board. You can also gather evidence that the treatment is working for you and causing hardship and then submit it with a comlplaint to the state. Insurance companies don't like headaches and the more you do the more likely it is that they will approve it.
Upon appeal, it's a good idea to request a dermatologist be part of the review process. Some times that option is not available until the second or third appeal.
I also had insurance problems and then around the time I was submitting my second appeal I had an offer to buy a used flat panel from a dermatologists office, so I went for it. I paid less for the used unit than I would have with deductibles and co-pays for the new unit (and my skin is 99% clear from the unit). So, you can give the NPF a call and see what links they have to used units.
If you are handy or know someone handy, you can get instructions from the NPF on how to build a unit at home. They used to have such instructions and I'm pretty sure they still do. I actually think it is pretty cheap to build a unit if you decide to look into that option.
I'll attach a letter I used for medical neccessity upon appeal. I got this letter from Steve, but made a couple of minor changes. I have other letters as well if you would like to see them. Also, Joey from the NPF wrote a letter as well.
Good luck!

Your drive time is unreasonable. If you have DME on your insurance policy and UVBNB works and it is prescribed this answer from the insurance is BS. You have a good case, go for it.

At the risk of sounding extremely stupid, what is "DME" on my insurance policy?
Basically, my insurance is really good and I have not had any problems to date with them, but when I spoke with them this morning, they said a home unit would not even be considered. They didn't even have a reason, just no. I just don't understand their concepts sometimes! It looks like I may have to go through that appeal process and see where it gets me. I'm going back to look over those links.

DME = Durable Medical Equiptment.
Many policies have seperate coverage for this category. This would be like wheel chairs, zofran pumps, crutches, blood pressure monitor, etc...

Sarah,
Did you speak with a costumer service representative, or someone higher up? I got no where with the CSRs...they really weren't savy about the use of the device, and i got different responses each time i called. Try the medical director, or claims department maybe?
~Massiel

but when I spoke with them this morning, they said a home unit would not even be considered.
If........................
you haven't called them everyday for a week...............
you haven't asked for 10 peoples supervisors...............
you haven't filed multiple grievances...........................
you haven't reviewed your medical insurance policy completely............
you haven't emailed them repeatedly on their website.............
you haven't submitted a claim for your UVB so you can have a
written response why they are denying your claim...................
you haven't received a prescription from your dermatologist
you haven't received a letter of medical necessity from your dermatologist.
you might continue to be a redneck because if you have P on your neck you may have been able to get rid of it with a home uvb unit.
Well anyway, thats what worked for me......stay on them. Until you have a formal denial in writing whatever that person said don't mean crap. It may be a lot of work but if you have DME and you live a long ways from treatment you should be able to get coverage for a home unit as prescribed by your dermatologist or MD/PCP.

Sara,
It was quite an ordeal to get my scooter---another DME. Don't give up!
Get a supervisor. Don't talk to the first person that answers the phone.
Get the name and talk to that person every time.
If DME is included in your insurance, you deserve to have a unit.

Hi,
I agree. Call every day, keep trying, and trying. I have been waiting for a scooter----I'm unable to walk----since Feburary. Finally last Tuesday I was approved by the insurace company. I do have a wheelchair that I use now. I ended up just calling and calling, all people, the wheelchair, scooter shop, the doctors, the insurance companies. I still don't have the scooter yet, but it's supposedly in route (they tracked it down today after I called again). Now I hear in will be in Tuesday or Wednesday-----I'll call again!!
Keep trying every which way and good luck,
Sandy

Hi,
I agree. Call every day, keep trying, and trying. I have been waiting for a scooter----I'm unable to walk----since Feburary. Finally last Tuesday I was approved by the insurace company. I do have a wheelchair that I use now. I ended up just calling and calling, all people, the wheelchair, scooter shop, the doctors, the insurance companies. I still don't have the scooter yet, but it's supposedly in route (they tracked it down today after I called again). Now I hear in will be in Tuesday or Wednesday-----I'll call again!!
Keep trying every which way and good luck,
Sandy
I am glad you're getting your scooter Sandy and your advice is absolutely correct in most cases with DME insurance. It's unfortunate but its often the strong that survive the insurance game. If you're weak and give in the insurance wins.

I have been very fortunate with my insurance. I have recently been approved and received my board band uvb light unit.
i did not apply for the most expensive (narrow and/or full closet) instead I took the middle road.
Panosol II
Broad Band
6 foot
4 bulb
it cost under $2,0000
National Biologics is the company who manufacture product
Was transported through a 3rd party. I believe the name was Griffin. This was done because my insurance would not pay National Biologics but they would pay Griffin.
If you would like these phone #'s I will forward them to you.
My insurance is Cigna and they have covered it 100%!!!!!!!!!!!!!!!!!!!!
Entire process took approximately 2 months
I started my first treatment today.
National Biologics will also tell you information you need from doctor etc...
I wish you all the good fortune that I have had with mine
Geralyn

Hi Sara,
You've been given some great advice. I agree with it 100%. You also might want to get the NPF involved in the discussion. They have an insurance advocacy service that goes to bat for people involved in disputes such as yours. Here's a link to a description of their service: and here's a link to a discussion about how the assistance that the NPF gave to one family in their successful battle for a home UVB unit: .
I hope this helps!
Good luck.
Keep us posted.
Mike

I had trouble getting my insurance co to cover my NB UVB light box, too. That is until I sent in an appeal letter describing the pain I was in and how it was affecting my life. I also sent in 5 or 6 photos of my P. Guess I probably got the message out that the light box was NOT going to be used for TANNING purposes. I just got my box last week. It's so nice to be able to do my treatments at home now!

I had trouble getting my insurance co to cover my NB UVB light box, too. That is until I sent in an appeal letter describing the pain I was in and how it was affecting my life. I also sent in 5 or 6 photos of my P. Guess I probably got the message out that the light box was NOT going to be used for TANNING purposes. I just got my box last week. It's so nice to be able to do my treatments at home now!
That is so funny that you sent in photos, I have to say that when I was in my grievance for the goeckerman I was planning on attending the second grievance meeting (the one I could attend) without a shirt! No lie.
But the smart thing about what you did is that you got your point across and you should be commended for that!
So if you're fighting for a lightbox and your severe, Send in your photos! Smart, smart, smart.............jworley. Thanks for sharing that! And congratulations on getting your lightbox. If you have a second, let us know size, type, and manufacture. Also curious if had a successful course of uvb at the derms first.

I got a NBC Panasol 6' unit. It is a UVB narrow band light. NBC was great to work with. Once I got past my insurance company, it only took about 1-1/2 weeks to get the paperwork processed and actually get the unit. It was shipped to my house already assembled. All I had to do was unpack the bubble wrap around the bulbs.
I was having a little success with the light at the doctors office, but I just couldn't get there often enough to get the proper treatment. You evidently need to have the light frequently in small doses. I was getting it twice a week for 3-1/2 minutes each time. Now I'm going 2 minutes every day. I've had it about a week and have already noticed a difference. My hands, which were my worst part, are not cracking as bad as they were. I hope it continues to help.
It is sort of funny about me sending in photos to the insurance company. One of their reps actually called me personally to tell me they were approving my appeal because of the photos. She said her supervisor couldn't argue with the photos! Evidently a lot of people try to get these lights for tanning purposes through their insurance and therefore most insurance companies AUTOMATICALLY decline the original claim (even with a doctor's request!). If you're applied for a light for home, go ahead and have the doctor send in color photos (lots of them and even close ups!) with the original request.

My insurance company didn't bat an eye to pay $20,000.00 a year for me to be on Enbrel, but won't even consider a UVB home unit. If they look at the figures - it makes no sense at all.
I hear you loud and clear! My insurance, Blue Shield of California, shut down my attempt to get a full body UVB home unit. Yet they have already paid out almost $10,000 for UVB Derm office treatments. Common sense is not in the Medical Insurance handbook.

You know, the insurance companies raise our rates because health care is so expensive, but they obviously do not pay attention to figures. They just look at things in black and white and don't bother to look at the big picture. From what I have read, most insurance companies are the same and have their "policies" about what is covered. They really need to look at things on a case by case basis. I know that would be time consuming on their part, but I believe the insurance industry could save a LOT of money if they looked at all the figures, thus rates could be lower. I realize this is a very idealistic view, but it makes sense to me if they did it that way.
I am definately going to pursue it further. Thank you all for sharing your experiences with this and information on what I can do. I appreciate all the input!
sara