Long-term Lyme disease treatment isn't cheap, and might not be covered

FRAMINGHAM, Mass. — Experts are predicting the risk of Lyme disease will soar this year because of the mild winter and some are even calling it ‘tickmageddon.’

But it's no laughing matter for one Framingham mother who said it’s a pricy problem that insurance doesn’t necessarily cover.

Shelia Statlender and her three children all have Lyme disease, although it’s unclear if they got it at their home in Framingham or somewhere else.

“They were sick for several years and missing school before we finally figured it out,” she said.

Statlender says misdiagnosis is common with Lyme disease, in part because it's difficult to find a doctor who's an expert in the field.

“We need better science and we need better information and then there won't be as much of a debate,” she said.

That debate, about how best to treat the disease and how much treatment insurance companies should be required to cover, came to a head in Massachusetts last July when Statlender helped get a law passed requiring Massachusetts insurance companies to cover long-term antibiotic therapy.

Gov. Baker and the Mass Association of Health Plans opposed the law, saying clinical evidence shows there are no beneficial effects to long-term antibiotics, and it could lead to antibiotic-resistant bacteria.

While the law passed, it doesn't apply to insurance companies whose plans are out-of-state.

“If you have a policy that originates in New York or Washington state where they don't have legislation, that company doesn't have to comply,” Statlander said.

Insurance companies that self-insure also don't have to comply.

Statlender said that while the law is a good first step, she continues to advocate for further legislation because she has friends with Lyme who have gone broke paying for medication.

Experts say if you've spent time outside doing something like gardening you can put your clothes in the dryer to kill ticks.  Also check yourself, your children, your pets daily for ticks.

Cox Media Group