It all depends on your insurance. You will not know unless you call and ask. My covers everything 60% I pay 40% a lot of the medications they prescribe me require pre-authorizations as well. I have anthem. But like i said it depends on your Policy, and Insurance company. I would just call and ask them.

They do it all the time in there, it seems...  Same thing when I asked for oxygen.  Had to explore options myself and then beg for a prescription.  You would think they would be happy I am not someone coming in asking for narcotics and have someone from their office look into these things, like most doctors do, but it's always just "insurance usually doesn't cover that," and that's the end of it. 

I do plan to call my insurance and ask though.

None whatsoever, left empty handed.  They could have even told me to call my insurance myself and ask about this medication or that medication, but I didn't even get that much out of them.

My Imitrex and/or Samuvella DosePro injections (and DHE injections) are fully covered by my insurance company. They are limited to 8 Imitrex injections per month (Generic form-Sumatriptan injections), Sumavella DosePro is also limited to the same amount. However, the DHE injections are alos covered and I recived 60 injections per month (SYRINGES NOT INCLUDED and cost about $25 per month)

If the insurance company says "NO, not covered) at first, your doctor should write a "PA" letter explaining to them that YOU REQUIRE this medication and they should cover it. An insurance company in the states are techincally by law required to cover what your doctor prescribes or they are "Practicing medicine without a license" and on a patient they've probably NEVER met before. They MUST cover it and your doctor is THE KEY to getting this for you.

Also, you may want to try the GLAXCO PATIENT ASSISTANCE PROGRAM that will help (or GIVE YOU) Imitrex or Sumavella every month ... but again, YOUR DOCTOR IS KEY TO MAKING THIS HAPPEN!!) You can just ask you doctor or better yet, contact GLAXCO WELCOME yourself and they will send the paper work needed for your doctors statement and signature. They MUST also provide a WRITTEN reason for any and all denials.

And for the last time ... YOUR DOCTOR HOLD THE KEY !!

Good Luck !!

I4B !!

Caution: Your Doctor obviously doesn't want to go the 1st mile let alone the extra mile. Did she diagnose you with CH? CH is quite rare and most Doc's, Neuro's included know very little, especially how severe they are.

Depending on any Dr. to know what is required for CH is a common mistake. Educating yourself is in your best interest. My Neuro's staff will call the insurance when there's a question.

Like the others have said, call your insurance, you may be suprised. This Dr. works for you so demand good treatment for what is sometimes called "suicide headaches". The pain of CH doesn't wait.

Don

Where in MD are you. My Neurologist is great he is on OUCH.com. Neurology & headache treatment center. It's in Alexandria VA. Don't no how far away or if your willing to travel but if you tell them you suffer from clusters they will try there best to get you in quickly.

This is why I hate the whole concept of insurance.  Can you imagine having to have insurance to buy a car - and they say they cover GM cars, but not Ford.  What a crock.

I tell my doctor not to worry about the insurance - give me the 'script and it's my business to worry about the insurance.  Not like the doc has to worry about getting paid for Gods sake.  Anyway - get the script and then shop around.  I understand the cost issue - but getting a script on paper at least gives you options to buy it yourself where ever you want/can.

I strongly believe that health insurance is the biggest waste in the whole health care industry and wish we could shop for treatment just like we shop for food.  I pay $12K a year plus the first $6K in spending before I get any help with coverage.  Give me an old fashioned catostrophic coverage at a fifth the cost and I will cover the rest.  Then you would see doctors advertising, service improving and costs dropping.

Off the soap box - thanks for letting me rant.

Dr. Stuart Stark. He is great. Every appointment he has spent over a hour with me. The wait is a little long but worth the time he spends with you and the attention his staff gives.

No Problem. He is great when i first called they told me it was a 3 month wait. ( pretty typical with Neurologist tho for new patients ) but then they asked what was going on i told them i suffered from clusters and was getting hit every day and was not satisfied with my current Neurologist. They receptionist put me on hold for about 5 Min's came back and asked me to have my Neurologist to send over papers stating i have been diagnosed with clusters and they would see me sooner. withing 30 Min's i got a call asking if i could make it in the next day. It was amazing they always send me home with samples. If i cannot afford the prescription they will just tell me to come pick up some samples they always E-mail me just to see how I'm feeling. I love them. Even tho My CH is getting bad again he is trying everything and is so supportive and very knowledgeable, and even last time i was there i kept saying i just feel like giving up, I'm not gonna win. he kept trying to reassure me that he believes we will get this under control. That means a lot.