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Topic: Insurence 'woes'.......?? (Read 186 times) |
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cootie
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Insurence 'woes'.......??
« on: Oct 28th, 2002, 5:24pm » |
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Hello.....yipes....I was wondering about this insurence mess were running into if anyone has went thru it and had success ? Here's the problem......hubby was only allowed 9 imitrex pills per month....ok....freaked out but got that over-rode cuz the doc called the insurence's hotline and explained the situation like the insurence rep said we had to do to prove what we need and why. So we got the extra imitrex and he got 27 for the month of October. Just got a letter from insurence 'tonight' they want a 'written' explaination on WHY he needs more then 9 pills a month from the doctor and why they should let him have more kinda deal...what's up with that....the over ride went thru later last week? I got a sneaky feeling they don't want to keep up with this over ride deal in Novemeber...he only has 3 pills left and has been breaking the cycle, or keeping it manageable.... but it is still very touch and go...he still gets warnings he is in for a banger so he has to still continue the pills and is up about every single nite still around midnight to 2:00 am and sits up a while worrying cuz he feels them trying....if he is caught up in this without any he will probly have to start all over again. Life was just starting to get back to normal "somewhat" and not so tense after this past 3 weeks of "H" or threat of it. I thought everything was gonna be cool with the meds end of it till tonight....now I dunno !? They were actually supposed to decide if he could get an over ride for more then the 27 a month the insurence rep told me last week when I called her about this all.....don't look like they want much to do with it now or are fightin it and want to go back to the 9 pills deal only. Who can afford $ 400.00 or more a week 'cash' outa yer pocket deal for this stuff....he pays all this insurence every month and has all his life and now they do this....I'm ticked and worried as you can tell......thanks for listening to me whine.......I can't help but remember the year he had his cycle dureing the Xmas holidays years back...it was aweful and family wants you here or there or else deals..arghhhh !!!! Thanx so much......cootie
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domm
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Re: Insurence 'woes'.......??
« Reply #1 on: Oct 28th, 2002, 5:29pm » |
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Cootie - have you checked out the resources on the OUCH site in dealing with insurance companies? There is some outstanding information there.
Hang in and let us know how things turn out
domm
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cootie
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Re: Insurence 'woes'.......??
« Reply #2 on: Oct 28th, 2002, 5:51pm » |
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Thanks and am gonna check out the info now...I am new on this message board stuff so haven't been around to all the areas yet by a long shot....I'll keep ya posted....and again.....thanx all for lettin me whine away !!!! Cootie......>^..^<
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Bob P
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Re: Insurence 'woes'.......??
« Reply #3 on: Oct 28th, 2002, 6:10pm » |
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Last cluster, I had my doc write the scripts for the monthly alotment of all of the triptans. I'd get 9 Imitrex tabs, 6 Imitrex nasal sprays, 6 Imitrex injections, 9 tabs of Maxalt, 9 of the melt on your tongue typ, 9 Zomigs, 9 Amerges, etc. Then back the whole thing up with a stash of cafergot.
I did eventually get the insurance to us the injectables with a justification from the doc but even then they raised it to 18 a month.
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Opus
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Re: Insurence 'woes'.......??
« Reply #4 on: Oct 28th, 2002, 8:07pm » |
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Cootie, In case you didn't find this.I got this from the OUCH web site
Need More Imitrex?
If you need more Imitrex then your insurance company will provide and your doctor is willing to prescribe it, you can contact Glaxo Smith Kline directly, They have a division called "Reimbursement Resource Center" ( the name implies you have to pay up front, but that is not the case), Call them at 1-800-745-2967 option #4, give them the information they ask for, your doctor's name & number, insurance company info, etc. and they will assign you a case worker who will contact you insurance company and hopefully get them to increase the number of doses.
PJB
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cootie
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Re: Insurence 'woes'.......??
« Reply #5 on: Oct 28th, 2002, 10:58pm » |
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Wow "thanx everbody".....thanx very very much.....is the sole reason insurence co's are so strict with limits on imitrex because of the cost....I mean it's not like it is some sorta street drug at all and don't see why anyone would want to take any unless they had to...blahhh ! Is there a generic..I take it there isn't ? I used to do that prescription mail order few years back and I was shocked at how cheap the stuff was....( 3 month supply or so was cheaper then half of one month you got all at once) compared to once a month scripts from the pharmacy. It wasn't CH meds or nothin tho. Can you do that with imitrex....probly not. I'm going to call the insurence rep tomarrow and get input on this letter we just got from the co. and go from there.......thanx bunches......will keep you all posted of the progress !!! Mite help others that have to go thru this also with ins co's.....arghhhhhh........Cootie >^..^<
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| « Last Edit: Oct 28th, 2002, 11:02pm by cootie » |
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eyes_afire
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Re: Insurence 'woes'.......??
« Reply #6 on: Oct 28th, 2002, 11:07pm » |
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Hi Cootie.
Yes, it is strictly about money for the insurance companies. 
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