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        New Message Board Archives >> Jul-Sep 2003 >> How Glaxo helped me. READ THIS!!
        
(Message started by: Jayne on Jul 6^th, 2003, 10:40am)

Title: How Glaxo helped me. READ THIS!!
Post by Jayne on Jul 6^th, 2003, 10:40am

ok, this might be a bit long and waffled so forgive me, but I need to give you all the information.

I signed up with "Blue Cross Blue Shield of Tennessee" last September.

I had not had health insurance in years.
The rep came to see me at my work and then handed me the long list of things to tick off that I was suffering from. The only thing that resembled was "migraines". So I ticked that. She wanted my doctors information so I gave it to her.
Blue cross came back to me and said ok,,your health insurance will be $148 per month, but no insurance will be given for "Headaches" I signed up.
I had been paying $74 for 100 pills of 180mg verapamil for a few years and everything was going well with that so I thought I would be ok. I was also truthfull about my pre exsisting as I didn't want them to find out and make me pay for any tratment I had been given.

Now to two weeks ago.

My CH's had been flaring up really bad..doctors visits $$$$$$.. botox...$$$$$$. Running out of trex....oh shit!
I talked to Nancy and she told me to call the Glaxo, patient re embursment hotline. 800-745-2967 So I thought what the hell, I'll try but I doubt anything will come of it.
I talked to a nice woman called Denise. She got my insurance info, my doctors info. She said she would get on my case and call me back. SHE DID..the next day!!
She said..ok, you are allowed one imitrex kit, per 26 days, but if you call your doctor and ask them to call the pharmacy benifits administation 888-413-2723 they will allow you 2 kits per every 26 days. I did this as one kit would cost me $35 with my co pay so I would rather get 2 kits for my $35 co pay.
Denise said she wanted me to test the system and call her back if there was a problem.
My doctors nurse did everything I asked and called in the script to Ekerds. (they know me well there because of my verapamil)
I called Eckerds on the way home from work to see if my script had been called in. The old lady who works for the pharmasist said "yes there is a pick up here for ONE kit" awwww god...it didn't work I thought.
I got there and I explained the story to my pharmasist.
he said.. " Yes I received a script for 2 kits, but I didn't fill is at I didn't think you had insurance and 2 kits would be $270, I didn't think you would want to pay for that"
I gave him my insurance card, and it went through...2 kits for $35...I was jumping up and down and hooping and hollering, he was laughing, anyone would think I had won the lottery.
Now as you all know, when the beast is hitting you bad, 2 kits per 26 days, is probably not going to be enough, but to me it was a sucsess, as imitrex is only used for "HEADACHES" and my insurance said NO COVERAGE FOR HEADACHES.
So I went back to see my nurse and thank her, and she said try it with your verapamil, as verapamil is used for many different things other than headaches. So I am going to try that when I have to re fill.

I have gone fom getting ZERO help from blue cross, to getting SOME help.

I am hoping nothing will come in the mail from Blue cross, but if it does I will call Denise again.

So there is my story of how GLAXO helped me...if your insurance is lying to you,cheating you, not disclosing all the info...call 800-745-2967 and see what you REALLY are covered for. This woman Denise was really on the ball..she knows what to say to these people and what "verbage" to use.

I hope this will help someone!

THANK YOU NANCY!

Good luck everyone
Jayne

Title: Re: How Glaxo helped me. READ THIS!!
Post by catlind on Jul 6^th, 2003, 11:24am

Awesome news Jayne!!!!!!!!! So glad that you were able to get the help you needed! It may not be everything you wanted, but it's better than nothing! There's hope yet!

Perhaps OUCH can start a rapport with the pharmaceutical companies to aid the process.

Cat

Title: Re: How Glaxo helped me. READ THIS!!
Post by don on Jul 6^th, 2003, 11:34am

Thats what I was thinking. I'll call them this week.

Title: Re: How Glaxo helped me. READ THIS!!
Post by stevegeebe on Jul 6^th, 2003, 12:27pm

Jayne,

I had a similar experience.

When I noticed that what my Dr. had prescribed (dosages) did not align with the quantity limits that the insurance had in place, I had my Dr. call the gate keepers at the insurance co. and a "distribution modification" was applied.

A window still is in place but it is less narrow than before.

Happy for you.

Steve G

Title: Re: How Glaxo helped me. READ THIS!!
Post by OneEyeBlind on Jul 6^th, 2003, 2:24pm

Great story Jayne. Love it when someone gets at least SOME of what they need !!!!!!!!!!!!!!!

Title: Re: How Glaxo helped me. READ THIS!!
Post by Karla on Jul 6^th, 2003, 9:01pm

What wonderful news. So happy for you.

Title: Re: How Glaxo helped me. READ THIS!!
Post by kissmyglass on Jul 6^th, 2003, 9:59pm

I have no insurance. Thanks to my neuro I am/was on Glaxos "Patient assistance program". They are giving me 5 statdoses a month for $5.00 co-pay. They have just done away with the Patient assistance program & formed 2 new "programs" One is "bridges to access" (thats the one that has Imitrex) & I dont remember the name of the other one. I just this past Thursday got on Bridges to access & picked up my first 5 Imitrex vials for $5.00. I need a lot more and my neuro is trying to get them to give me more. I believe they think 5 statdoses would be plenty for Migranes so my neuro is going to call them tomorrow & tell them 5 vials is a 2 1/2 day supply for my clusters. (wish me luck), I'll let you know how I make out. Anyway, the reason I'm writing this is they have a new phone # and it may save you a lot of time & aggrevation to have the new #. It's 866 728 4368
Good Luck,

Kev