My plea for help is not health-related but insurance related.
I was 2 months into my Zithromax/Mepron protocol when Cigna decided not to reimburse for the Zithromax.
While I can afford to purchase Zithromax on my own, I was wondering if anyone had ideas for alternative treatment.
Please keep in mind that I had an allergic reaction to Minocycline last fall.
Thank you.
Posted by 5dana8 (Member # 7935) on :
Hi JustMeINCt;
You might want to ask your LLD about substituting Biaxin(clarithromycin) which,as I have heard,Is a close relative to zith.
I am on that now for babs along with alot of other meds.
Although pricey.I still think it is cheaper than the zith
Take care
Posted by CLC (Member # 7112) on :
They probably decided not to reimburse because zithro is now available in generic. It's my experience with Cigna (sux) that they'll look for ANY reason not to cover something.
Tell me -- do they pay for your Mepron? 'Cause they certainly won't cover it for me. They won't pay for my Malarone (which contains Mepron). They're reason?? They "question the efficacy of the treatment".
Funny - they cover anything that's cheap. Never seem to "question the efficacy". But if it's pricey, they'll use any reason they feel like, to deny coverage.
It's all a big game....
Posted by davidx (Member # 8326) on :
This is so strange. I have Cigna and they cover zithro and mepron (I'm on my second prescription of each). Actually, I guess i have the generic form of zithro and not the brand name but they do cover mepron. Why does the coverage vary from person to person?
I've actually had pretty good luck so far with Cigna (knock on wood) covering MRI, spect scan, etc.
-David
Posted by JustMeInCT (Member # 7237) on :
Cigna is paying for Mepron. I looked into generic Zithromax and the price difference was not compelling.
I can understand Cigna not paying for it; I just wish it was not in the middle of a treatment cycle.
I do agree that Cigna has been pretty good as they paid for my MRIs, cerebral spec scans and other tests along with Avonex 2x a week for my 'MS'.
Posted by 5dana8 (Member # 7935) on :
When I was on zith found it cheaper to get from Canada.
Still expensive but Cheaper than some US pharm's
Posted by JustMeInCT (Member # 7237) on :
Thanks for the information.
90 zithromax pills for $334 - sounds like a great deal. Kills my investment in PFE though.
Posted by HEATHERKISS (Member # 6789) on :
I took biaxin w/ mepron and it worked just fine. there is a new generic for biaxin also. Maybe they will pay for that?
How can you understand them not paying? Did you call them? How could they interrupt treatment?
Posted by trails (Member # 1620) on :
Yes biaxin as some said is a suitable "substitute" and adding artismisin (chinese herb) has also been highly recommended.
BUT--you CAN fight and WIN with Cigna. I had totally BIZARRRRO mepron/zith coverage and had to get my 90 supply thru the mail order every TEN days and pay 30 bucks each ten days too!
I called and tried and called and argued and faxed , until my current LLMD's secretary called them and BINGO I got all 90 pills for 30 bucks. They needed a pre-auth. THing is, my previous LLMD had called and they wouldnt allow the pre-auth, but this time they did? It made no sense to ANYONE including the Rx plan people.
Call your LLMDs office and ask them to call the rx plan to get a pre-auth on zith.
Good luck, would be interested in knowing how it turns out. Trails
Posted by JustMeInCT (Member # 7237) on :
I appreciate everyone's feistiness in this matter.
My LLMD and I fought Cigna for the first 180 pills. We have appealed their decision multiple times here and I believe that we have exhausted that process.
I do think that pursuing this through a Canadian mail order pharmacy makes sense.
Posted by Brad257 (Member # 4937) on :
So many corporate ho-ho's running our American health care system........
Posted by WildCondor (Member # 434) on :
Fight them to the death! They may also have a needy meds program through Pfizer who makes Zithromax, or you can take Biaxin or Ketek with the mepron along with artemesia. Good luck! Posted by iceskater (Member # 8655) on :
Hi: Try: www.medicinebridge.com Zithromax is on their list of medications. They list over 1200 meds they can help patients get access to.... hope that this helps Posted by liz28 (Member # 4946) on :
Sorry to beat this old drum again, but a month's worth of primaquine will cost you $30 out of pocket. It's like a "cyst buster" for babesia. I was only able to take it for two weeks before I ran out, but it cut my babs symptoms by 90%, after 1 1/2 years on mepron, artemisinin and ketek, with relapses every time I went off the abx, and rapidly increasing resistance to mepron.
Even though my symptoms came back because I stopped too soon, they were much, much milder than they were before starting primaquine, when I had a three-month, unstoppable, disabling fever. A local doc recently confided you take it for 21 days, with maybe 1-2 more courses if you relapse.
![[hi]](graemlins/hi.gif)