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        New Message Board Archives >> 2004 Posts >> FU@#*ng Insurance Companies!!!
        
(Message started by: jhammer on Jun 23^rd, 2004, 1:03pm)

Title: FU@#*ng Insurance Companies!!!
Post by jhammer on Jun 23^rd, 2004, 1:03pm

I was just informed that my insurance company denied a request for the drug that seems to be working for me. Who are they to decide what kind of treatment is appropriate? So now I'm almost 5 weeks into this cycle and I finally get a referral to see a neurologist...who's next available appointment is 9 weeks from now. The free samples are running low and so is my faith in traditional medicine.

ANyone know a good witch doctor? [smiley=furious.gif]

Title: Re: FU@#*ng Insurance Companies!!!
Post by Prense on Jun 23^rd, 2004, 1:53pm

Many of us have had problems with insurance at one time or another when dealing with CH. There are several here who know how to fight the fight. Remember, the insurance company is not denying you the prescription...just denying coverage.

Stick around...someone will be around with some suggestions.

Chris

Title: Re: FU@#*ng Insurance Companies!!!
Post by thomas on Jun 23^rd, 2004, 2:03pm

What drug are you referring too?

Title: Re: FU@#*ng Insurance Companies!!!
Post by Gator on Jun 23^rd, 2004, 2:18pm

9 weeks is too long to wait to see a neuro. Are there no other neuros in your area that you can get referred to? I have to drive 80+ miles to mine and I know of people on this board that drive farther than that.

What drug are they refusing to cover?

Here are a few articles to look at concerning insurance companies and limiting or denying med coverage:

http://headaches.about.com/library/weekly/aa-bc-trip-limits-a.htm

http://headaches.about.com/cs/advocacy/a/trip_limits_2.htm

http://headaches.about.com/library/weekly/aa-bc-error-a.htm

Gator

Title: Re: FU@#*ng Insurance Companies!!!
Post by Big Dan on Jun 23^rd, 2004, 2:58pm

on 06/23/04 at 13:03:56, jhammer wrote:

Try telling them it's an emergency and there is no way you can wait... mention the Suicide Headache name... usually gets results...

And speaking of 'Fucking Insurance'... I should look into that... this dry spell could have paid off big time.

-Big Dan

Title: Re: FU@#*ng Insurance Companies!!!
Post by jhammer on Jun 23^rd, 2004, 3:42pm

The doc put me on Vioxx...only problem is, the insurance company says that you need to be at least 65 or older to get a perscription for it. Well, I've got a 40 year wait until that happens, makes the 9 week wait for the Neurologist look like nothing.

I called and asked if there was another Neuro I could see sooner, but apparently this guy is the only one in the plan...and I have seen him in the past so it's probably better that I see him. Although he did incorrectly diagnose me back then.

I could use some of that 'Fucking Insurance' too...lol [smiley=crackup.gif]

Title: Re: FU@#*ng Insurance Companies!!!
Post by cootie on Jun 23^rd, 2004, 3:56pm

WHAT.......THAT'S CRAZY......oops sorry I was shouting ! Insurence co's piss me off.....esp when you have paid in for a lifetime all that money and they have............"restrictions" like that !!! I have several freinds on that med and they are far from 65 leme tell ya. Must be some small print issue with health long term bein on the med they have decided to follow. We are lucky to have an internalist doc that will help Brad get what he needs or thinks will work.......my doc is an ANGEL !! He knows some about CH and tries to stay up on meds.....and not much of a wait to get in to see him cept a few days if that . Could you check around at docs of this sort at clinics and ask if they are familiar with ch and get more help more often faster better ? I know a neuro is what you need.....ours had a 3 to 6 month wait and if you did not follow his program of so many vistis a year 'while out of cycle' no matter what he would not prescribe meds or get you in earlier. It was a joke to us......and he was quite a ways away for Brad to get out there and take a day off work in the meantime to do it. He charged us about $ 250.00 a visit too and insurence only cover'd a SMALL percentage. Our internalist will prescribe whatever Brad needs but.....the insurence co of course limits the amount of imitrex and with approval with doc calling there physicians line he can get more each month doin so......butt now hey will only cover generic. (the bastards) So......that sorta defeats our purpose cuz the dam shit should come in gold syringes for what it cost. I know.....it's a god send tho. Good luck.....sorry to repeat myself on all this to everyone else. Good luck to ya.......neo-nazi insurence co's suck Pam

Title: Re: FU@#*ng Insurance Companies!!!
Post by Woobie on Jun 24^th, 2004, 2:50am

on 06/23/04 at 15:42:22, jhammer wrote:

The doc put me on Vioxx...only problem is, the insurance company says that you need to be at least 65 or older to get a perscription for it. Well, I've got a 40 year wait until that happens, makes the 9 week wait for the Neurologist look like nothing.
[smiley=crackup.gif]

Ummmmmmmmmmm I took Vioxx when I was 25 - that is entirely BULLSHIT. It's an anti - inflammatory ... like celebrex. a cox2 inhibitor. like aleve or ibuprofen - they just work differently.. same goal.

It's used for arthritis, and other inflamation. Dont know why it's used for CH..

Are you SURE the insurance said you have to be over 65?? I know a lot of people taking it - (my sister for one - who is 23 right now.) but if so - i would LOVE to know what kind of insurance you have... i'll call them myself and argue with them.

Maybe they denied it because it's not a standard CH med??? Did the insurance company tell you the age thing ? or did your DR tell you that the insurance said that?

WOW. cheese n rice!

tina

Title: Re: FU@#*ng Insurance Companies!!!
Post by jhammer on Jun 24^th, 2004, 7:57am

Actually the pharmacy told me that one. My doc had to fill out a ton of paperwork to send to the insurance company (UPMC), who then promptly rejected it. This is the same BULL-SHIT kind of stuff that I went through last time...I don't know who to be more pissed at, the doctor for not making me feel better or the insurance company for not paying for it.

~Jake

Title: Re: FU@#*ng Insurance Companies!!!
Post by Redd715 on Jun 24^th, 2004, 8:47am

on 06/23/04 at 15:42:22, jhammer wrote:

The doc put me on Vioxx...only problem is, the insurance company says that you need to be at least 65 or older to get a perscription for it. I could use some of that 'Fucking Insurance' too...lol [smiley=crackup.gif]

I'm not sure what company is denying that covereage. I had a case of shingles a few years back that ran all the way down my left arm and Vioxx was one of the scripts I had for the inflamation and pain of that. I was only 35 at the time. No problem with my insurance. (had some at the time go figure)

I'd see if you couldn't get an over-ride letter sent from your prescribing doctor? When my son was little and on Ritalin I had to do that to get his script covered because the insurance would only cover the generic and his neuro insisted on the name brand. One letter and it was covered. It's worth a shot.

Title: Re: FU@#*ng Insurance Companies!!!
Post by Woobie on Jun 24^th, 2004, 2:50pm

you're right Jake - it's bullshit!

i would call your insurance - and ask them WTF? it doesn't make any sense to me

tina

Title: Re: FU@#*ng Insurance Companies!!!
Post by Samantha_Smith on Jun 24^th, 2004, 3:13pm

So basically they are denying you coverage based upon your age? Isn't that age discrimination? ( BTW I took Vioxx when I was about 26 years old for chronic migraines.) When I get pissed at insurance companies I tell them that if they don't resolve the issue at hand within 24 hours (or whatever amount of time) then I'll be calling the Banking, Insurance, and Health Care Administration to register a complaint. I don't know what state you are in but all you have to do is look in the Business Listings in your phone book and then look for "Vermont State of....." (or whatever state you are in.) That's one of the tactics I use. There are several tactics but that one tends to be the most effective. Good luck. If all else fails yell, scream and jump up and down. Samantha

Title: Re: FU@#*ng Insurance Companies!!!
Post by Charlie on Jun 24^th, 2004, 3:26pm

This pisses me off.

Try a greivance. I was successful with my dermatologist who was not on my plan. There is only one in my area.

Your doctor will have some samples. All this while screaming bloody murder all over the place. You can get the stuff on line in Canada. I don't know which one isn't a scam site though.

My HMO took my anti-seizure drug partially off it's formulary, I guess, and doubled the price. It's up to $40 a month instead of $20. My pharmacist helps a little by halving the number of pills when I refill or it would be even more.

Bastards find a drug that people with limited ability to earn need to survive and make it worse. I told them that they aren't thinking. What if someone broke a hip in a fall because they couldn't afford the drug and they got stuck with the hospital bill?

Kill. >:(

Here's hoping you get some ideas here.

Charlie Kill again >:(

Title: Re: FU@#*ng Insurance Companies!!!
Post by floridian on Jun 24^th, 2004, 3:28pm

Well, things are going to get worse before they get better. The Supreme Court just ruled that if an HMO denies you coverage, the only thing you can sue for is to get that coverage - and you have to do it in federal court. So to get the medicines that may cost a thousand dollars, you need to spend 5-10 thousand on a lawyer. If the insurance companies were allowed to be punished for denying coverage, then lawyers would take your case on speculation and share part of the fine against the company. If the insurance company drags their feet and you don't pay for needed procedures out of pocket, you can no longer legally blame the insurance company for any damages caused by the(ir) delay.

Quote:

A healthcare liberal is a conservative whose family has been mugged by the insurance industry

Low cost, OTC alternative: Check out curcumin (from the spice turmeric) - it is a powerful anti-inflammatory that inhibits the COX2 enzyme. in the way that Viox and Celebrex do. A month's supply costs around $10.

Cyclo-oxygenase inhibitors may help some people with cluster headache. These drugs reduce the production of prostaglandin E2, which is involved in triggering other inflammitory molecules (CGRP, NO, etc).

Quote:

Carcinogenesis. 2004 Apr 8

Modulation of arachidonic acid metabolism by curcumin and related {beta}-diketone derivatives: effects on cytosolic phospholipase A2, cyclooxygenases, and 5-lipoxygenase.

Hong J, Bose M, Ju J, Ryu JH, Chen X, Sang S, Lee MJ, Yang CS.

Susan Lehman Cullman Laboratory for Cancer Research, Department of Chemical Biology, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854.

Aberrant arachidonic acid metabolism is involved in the inflammatory and carcinogenic processes. In this study, we investigated the effects of curcumin, a naturally occurring chemopreventive agent, and related beta-diketone derivatives on the release of arachidonic acid and its metabolites in the murine macrophage RAW264.7 cells and in HT-29 human colon cancer cells. We also examined their effects on the catalytic activities and protein levels of related enzymes: cytosolic phospholipase A2 (cPLA2), cyclooxygenases (COX) as well as 5-lipoxygenase (5-LOX). At 10 micro M, dibenzoylmethane (DBM), trimethoxydibenzoylmethane (TDM), tetrahydrocurcumin (THC), and curcumin effectively inhibited the release of arachidonic acid and its metabolites in lipopolysaccharide (LPS)-stimulated RAW cells and A23187-stimulated HT-29 cells. Inhibition of phosphorylation of cPLA2, the activation process of this enzyme, rather than direct inhibition of cPLA2 activity appears to be involved in the effect of curcumin. All the curcuminoids (10 micro M) potently inhibited the formation of prostaglandin E2 (PGE2) in LPS-stimulated RAW cells. Curcumin (20 micro M) significantly inhibited LPS-induced COX-2 expression; this effect, rather than catalytic inhibition of COX, may contribute to the decreased PGE2 formation. Without LPS-stimulation, however, curcumin increased the COX-2 level in the macrophage cells. Studies with isolated ovine COX-1 and COX-2 enzymes showed that the curcuminoids had significantly higher inhibitory effects on the peroxidase activity of COX-1 than that of COX-2. Curcumin and THC potently inhibited the activity of human recombinant 5-LOX, showing estimated IC50 values of 0.7 and 3 micro M, respectively. The results suggest that curcumin affects arachidonic acid metabolism by blocking the phosphorylation of cPLA2, decreasing the expression of COX-2, and inhibiting the catalytic activities of 5-LOX. These activities may contribute to the anti-inflammatory and anti-carcinogenic actions of curcumin and its analogues.

Title: Re: FU@#*ng Insurance Companies!!!
Post by jhammer on Jun 24^th, 2004, 3:36pm

I can't pronounce half the words in that article...but I assure you that you can find me in the spice section of the grocery store this evening! Thank you so much for the advice!

On another note I thought I'd try to find another Neuro that has an appointment sooner than 2 months away. The doc suggested I call the 'Headache Center' at the University...their next appointment is 3 months away. UGH!!!

Title: Re: FU@#*ng Insurance Companies!!!
Post by Woobie on Jun 24^th, 2004, 3:53pm

on 06/24/04 at 15:28:42, floridian wrote:

WOW Floridian........... is there NO end to your wealth of informatioN??

i'm gonna try that - so i dont spend so much on celebrex every month

thank you!

You RoCK fer real!

tina :-*

Title: Re: FU@#*ng Insurance Companies!!!
Post by floridian on Jun 24^th, 2004, 4:02pm

The plain spice is good and dietary levels of turmeric are correllated with several degenerative diseases. But to rival the effects of COX2 inhibitors like Vioxx, you probably have to get a concentrated extract - some pharmacies and most health food stores carry this.

A few links that are less technical:

http://www.drweil.com/app/cda/drw_cda.html-command=MedicineChestDetail-pt=Medicine-medicineId=20
http://qualitycounts.com/fpcurcumin.html
http://www.doctormurray.com/Qarchive/curcumin.htm

Title: Other COX2 inhibitors
Post by floridian on Jun 25^th, 2004, 1:20pm

Cherries, which are an old folk cure for arthritis. Tart cherries are supposedly best, but bing cherries also work (eating 20 cherries for dessert each night is a pleasant medical regime ;) )

Blackberry leaves contain compounds that inhibit COX2 - these compounds are also found in grape seed extract, pine bark extract, hawthorn, and other plants. (see first abstract)

Peony root contains stuff that inhibits the COX2 enzyme (see second abstract). It is also reduces Nitric Oxide, is anti-spasmolytic and lowers cholesterol. There are two types of peony root - red and white. The red includes the root bark and is what I use (boil for an hour). I have been taking it the past few weeks as part of a formula that reduces CGRP (Cinnamon-hoelen-peony-tree peony-perisca). I am hoping to stay headache free as my summer cycle tries to gear up - will post on that in the fall when I know more.

Quote:

Naunyn Schmiedebergs Arch Pharmacol. 2002 Jun;365(6):434-41. Epub 2002 Apr 26.

Effects of prodelphinidins isolated from Ribes nigrum on chondrocyte metabolism and COX activity.

Garbacki N, Angenot L, Bassleer C, Damas J, Tits M.

Laboratoire de Physiologie humaine, Institut Leon Fredericq, Universite de Liege, Belgium. N.Garbacki@ulg.ac.be

Articular diseases, such as osteoarthritis, is the clinical expression of the loss of cartilage function. COX inhibitors are widely used in the treatment of such pathologies for their beneficial effects on inflammation but often produce a negative activity on cartilage synthesis.In this study, we determined the effect of different prodelphinidins, the major compounds isolated from Ribes nigrum leaves, on the proteoglycans (PGs), type II collagen (coll. II) and prostaglandin E(2) (PGE(2)) production by differentiated human chondrocytes cultivated in long term (12 days) and in clusters as well as their inhibition potential on COX-1 and COX-2 in vitro. Gallocatechin trimer (GC-GC-GC) showed the higher stimulation of PGs and coll. II production (1 microg ml(-1)) and the synthesis of PGE(2) was significantly reduced by gallocatechin dimer (GC-GC), gallocatechin-epigallocatechin (GC-EGC) and GC-GC-GC at 10 and 100 microg ml(-1). The inhibition of PGE(2) synthesis was confirmed by the in vitro test on purified COX enzymes, showing the selectivity of prodelphinidins on COX-2. However, the prodelphinidins had no effects on COX activity in the whole blood assay.Our studies suggest that the prodelphinidins fractions from R. nigrum may be useful as an additive agent in the prevention of osteoarthritis.

Quote:

Arch Pharm Res. 2003 Oct;26(10):832-9.

Inhibition of inducible nitric oxide synthase and cyclooxygenase-2 activity by 1,2,3,4,6-penta-O-galloyl-beta-D-glucose in murine macrophage cells.

Lee SJ, Lee IS, Mar W.

Natural Products Research Institute, College of Pharmacy, Seoul National University, Seoul 110-460, Korea.

Activated macrophages express inducible isoforms of nitric oxide synthase (iNOS) and cyclooxygenase (COX-2), and produce excessive amounts of nitric oxide (NO) and prostaglandin E2 (PGE2), which play key roles in the processes of inflammation and carcinogenesis. The root of Paeonia lactiflora Pall., and the root cortex of Paeonia suffruticosa Andr., are important Chinese crude drugs used in many traditional prescriptions. 1,2,3,4,6-penta-O-galloyl-beta-D-glucose (PGG) is a major bioactive constituent of both crude drugs. PGG has been shown to possess potent anti-oxidant, anti-mutagenic, anti-proliferative and anti-invasive effects. In this study, we examined the inhibitory effects of 1,2,3,4,6-penta-O-galloyl-beta-D-glucose (PGG) isolated from the root of Paeonia lactiflora Pall. on the COX-2 and iNOS activity in LPS-activated Raw 264.7 cells, COX-1 in HEL cells. To investigate the structure-activity relationships of gallate and gallic acid for the inhibition of iNOS and COX-2 activity, we also examined (-)-epigallocatechin gallate (EGCG), gallic acid, and gallacetophenone. The results of the present study indicated that PGG, EGCG, and gallacetophenone treatment except gallic acid significantly inhibited LPS-induced NO production in LPS-activated macrophages. All of the four compounds significantly inhibited COX-2 activity in LPS-activated macrophages. Among the four compounds examined, PGG revealed the most potent in both iNOS (IC50 approximately 18 microg/mL) and COX-2 inhibitory activity (PGE2: IC50 approximately 8 microg/mL and PGD2: IC50 approximately 12 microg/mL), respectively. Although further studies are needed to elucidate the molecular mechanisms and structure-activity relationship by which PGG exerts its inhibitory actions, our results suggest that PGG might be a candidate for developing anti-inflammatory and cancer chemopreventive agents.