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Topic: Need Insurance Help (Read 424 times) |
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cbolony
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Need Insurance Help
« on: Jan 8th, 2003, 4:49pm » |
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My new insurance that started this month will only
give me two imitrex injection a month.How do i
get more from the insurance company.
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Silver_Dolphins
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Re: Need Insurance Help
« Reply #1 on: Jan 8th, 2003, 4:54pm » |
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Try this link. It is from the OUCH website.http://www.clusterheadaches.org/resources/ins.htm
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| « Last Edit: Jan 8th, 2003, 4:55pm by Silver_Dolphins » |
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Mark C
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Re: Need Insurance Help
« Reply #2 on: Jan 8th, 2003, 5:08pm » |
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Hi CB,
Good link SD,
I can tell you what I have done to sucessfully have the HMO cover an increased amout of triptans, both Zomig and Imitrex. I had my Neuroligst draft a letter of medical necessity of had him send it to the HMO. It worked. Much to my surprise it also worked for Zomig and Imitrex. I was suprised they approved both drugs, I dont think that is common. I was due a break I guess.
Also contact your Insurance company and see if they may have a patient advocacy program. You wont know till you ask. Good luck,
Mark
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cootie
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Re: Need Insurance Help
« Reply #3 on: Jan 8th, 2003, 6:57pm » |
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cbolony...listen to these guys here cuz they will be a heap a help to ya....they sure were to us....our insurence would approve only 9 pills a month...found out on here we should have the doc call the insurence co's hotline for physicians only and convince them why he needed more....haveing 2 to 4 attacks a day he obviously needed more. It did work...but...we had to go thru the same procedure every month ! Course not all insurence co's are the same....hope you can get around it. We did end up payin for some scripts ourself when doc was out of town ta call in and Brad'd beg borrow or steal ta get em...we had ta have em. So we had ta pay outa pocket and got NO reimbursement either. Then they raised the premium 33 % total fer the year recently.....dam'd if ya do, dam'd if ya don't comes ta mind. Good luck....you'll get lots of help here !!!! Pam
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Opus
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Re: Need Insurance Help
« Reply #4 on: Jan 9th, 2003, 3:31pm » |
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Here's how I got more meds.
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.
Opus 
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SommelierCH
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Re: Need Insurance Help
« Reply #5 on: Jan 13th, 2003, 9:27am » |
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I have this quote from THE Dr. Diamond,
Quote:| Diamond: First of all, I would have both your physician and yourself write a letter of appeal to your insurance company. It seems cruel to not allow a patient to have effective therapy, and sometimes a letter from your doctor can help get a medication approved. Most of the companies that make the triptans have prescription programs for patients who don't have medication benefits. You would probably have to fill out paperwork, but it's likely you could get some medication from the companies in this manner. |
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David J.
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Cerberus
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Re: Need Insurance Help
« Reply #6 on: Jan 14th, 2003, 8:55pm » |
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Mathematical equasion to get more of what you need from your insurance company......
B**** + B*****x B*****3= meds
hope this helped, oh, make sure you are applying the equasion to the proper people, that helps as well.
Cerebus
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