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        New Message Board Archives >> Jan-Mar 2003 >> Need Insurance Help
        
(Message started by: cbolony on Jan 8^th, 2003, 4:49pm)

Title: Need Insurance Help
Post by cbolony on Jan 8^th, 2003, 4:49pm

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.

Title: Re: Need Insurance Help
Post by Silver_Dolphins on Jan 8^th, 2003, 4:54pm

Try this link. It is from the OUCH website.http://www.clusterheadaches.org/resources/ins.htm

Title: Re: Need Insurance Help
Post by Mark C on Jan 8^th, 2003, 5:08pm

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

Title: Re: Need Insurance Help
Post by cootie on Jan 8^th, 2003, 6:57pm

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

Title: Re: Need Insurance Help
Post by Opus on Jan 9^th, 2003, 3:31pm

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 :P

Title: Re: Need Insurance Help
Post by SommelierCH on Jan 13^th, 2003, 9:27am

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.

David J.

Title: Re: Need Insurance Help
Post by cerebus on Jan 14^th, 2003, 8:55pm

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