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        New Message Board Archives >> Oct-Dec 2003 >> Insurance Co. say no to h2o ?
        
(Message started by: hopefull on Oct 3^rd, 2003, 9:46pm)

Title: Insurance Co. say no to h2o ?
Post by hopefull on Oct 3^rd, 2003, 9:46pm

Today nuero decided to add h2o and celebrex(not impressed with it ) to my verapamil and drop topral xl

then the insurance said We don't do h2o for clusterheadach!..

Anyone else have this problem?

Title: Re: Insurance Co. say no to h2o ?
Post by Ree on Oct 3^rd, 2003, 9:57pm

Last cycle in Massachusetts the ins co told us that if Dave wanted O2 he would have to go to the ER with a CH and show them that he could abort one. So we went without 02 last cycle. This time we asked and they gave it to us... fight for it... find some information here and type it up... there is an old post by Ted on how to get 02 but I foget where it is... maybe one of the Old Timers can help you to find the information... Good Luck Ree

Title: Re: Insurance Co. say no to h2o ?
Post by Zonie on Oct 3^rd, 2003, 10:59pm

Yep, same problem here. My ins. is Cigna and they only give it to folks with O2 Sat of 88 or under. They said there's no proof that it helps clusters. Oh yes, they do also give it for "morning" headaches, but not clusters. I am awaiting a referral from PC to Neuro and when I see him we are going to have a real "set-to". I picked my neuro after calling several to see which ones even treated headache patients. People would probably be amazed to know how many neuros won't see cluster patients.

What insurance do you have????

Title: Re: Insurance Co. say no to h2o ?
Post by brain_cramps on Oct 3^rd, 2003, 11:03pm

never had a problem getting h2o --- usually just turn on the tap ;D

grant ;)

Title: Re: Insurance Co. say no to h2o ?
Post by hopefull on Oct 3^rd, 2003, 11:10pm

...you'd think a company like Fluor Daniel would have great Ins....but they seem to chang it more than their underwear! So I never know from one year to the next but I think it's cigna!...This year ...who know in January...Which makes it hard to have to start all over again making your case!

Then you have to start with the phone person ..whos not a Doctor but thinks they are.....Oh hell better not get started.....we'll be here all night!

Title: Re: Insurance Co. say no to h2o ?
Post by OneEyeBlind on Oct 4^th, 2003, 12:23am

Ok, here I go again. Get a letter of "medical necessity" from your doc sent to the O2 company. The letter should state -

1. What you suffer from
2. Why O2 is considered a valuable abortive. Your doc should know this but you might have to print out some info for them .. white pages (that's medical studies) would give some creadance.
3. How much you need (what type of tank, etc .. and the flow rate).

Let me know how you make out trying this approach. I did it and got my O2 paid for.

Title: Re: Insurance Co. say no to h2o ?
Post by Dave_Emond on Oct 4^th, 2003, 4:32am

Did the same as 'ol One Eye,
Was turned down, got statement from neuro, sent letter of appeal, got O2.
(Wish it still helped, did for awhile though at least.)
Good luck, you can get it, they'll just try to see if you'll just let it go ... don't give in!
Dave

Title: Re: Insurance Co. say no to h2o ?
Post by BarbaraD on Oct 4^th, 2003, 6:59am

Off subject -- but my favorite O2 story is the guy who went to ER for O2 and when they put him in the wait area - he went thru the doors and found the O2 and pulled a "cigarette lighter" on them to get the O2. (Check the archives for the story).

Sorry this just reminded me of it..

Fight for the O2. It does help most of the time for so many of us.

Guess what really ticks me off is that insurance companies have started telling DOCTORS what is needed for PATIENTS treatment. Maybe this is something OUCH could help fight in the legislature. Get the insurance companies out of the diagnosis business. O2 is good for more than their "check" lists says. I just got thru fighting for 6 months to get it for hubby. BUT we got it!!!! He has alzheimers and Gee Whiz - it's working - he's a lot more alert in the mornings now. Imagine that! All we needed was a damn little thingy on his finger all night ONE night to tell that quack at Medicare that. Took six months to get that done!!!! UGHHHHH!

Off my soap box..... Good luck -

BD

Title: Re: Insurance Co. say no to h2o ?
Post by OneEyeBlind on Oct 5^th, 2003, 5:01am

Also, if you need to print out info on proof that O2 works .. look at the o2 button to the left. There are the "white pages" proving that O2 does abort cluster headaches and is in fact a legitimate abortive for clusters.

Here is the thread that Ree mentioned from Ted. this is also available under the O2 button.
http://www.clusterheadaches.com/wwwboard/messages/81233.html

The letter of medical necessity from your doc should do the trick, but if you need additional ammo, just look under that O2 button. Those people did a marvelous job with O2 info !!!!!

Title: Re: Insurance Co. say no to h2o ?
Post by Prense on Oct 5^th, 2003, 8:25pm

You can print this link out too...

http://www.clusterheadaches.org/medications.htm

It shows the flow rate and that it needs to be with a non-rebreather mask. I needed this to get the doc to fill out the paperwork correctly.

Be persistent...follow the advice here and you will be successful.

Title: Re: Insurance Co. say no to h2o ?
Post by juvy on Oct 6^th, 2003, 2:04am

h2O? last time I checked this was water. If the insurance co won't let you have 02, try going to the fire department or make friends with a welder.