posted
Wild Condor, I have been doing that for years and just kept getting rejected.Never could get a resonable explanation except something about "reformulation" All I remember is that it cost me 35.$ every time my Dr. submitted a letter.
Posts: 161 | From midwest | Registered: Jul 2007
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posted
Can you appeal this decision in your state? Many states have independent appeal procedures, but you have to go thru the ins co appeal procedure first. There are definite steps to take, read your contract.
Also, the CALDA/Lyme Times website has a special issue on this subject.
Posts: 8430 | From Not available | Registered: Oct 2000
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posted
Please contact these people. They are working with Dr. Burriscano to help Lyme patients find affordable meds. They will work with your insurance company or without. I got my IV rocephin down to $22.50 a day. They are now checking on a price for the mepron my daughter is on. www.hometech-rx.comPosts: 303 | From green bay, wi | Registered: Mar 2009
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posted
I forgot to add that this is an american company sending us american medicine
Posts: 303 | From green bay, wi | Registered: Mar 2009
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Rumigirl
Frequent Contributor (1K+ posts)
Member # 15091
posted
My insurance company wouldn't authorize it either (and I couldn't get it without preauthorization). Ridiculous! BUT, when I asked, they said if I bought it out-of-pocket, and submitted it under Medical, not pharmacy benefits, they would cover it 100%!
You could ask if it's the same with your company. If so, ask to have it in writing that it will be covered that way. \\Or maybe you could get it covered through Medical, but have the pharmacy bill the insurance company.
Otherwise, fight this!
Posts: 3771 | From around | Registered: Mar 2008
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Sammi
Frequent Contributor (1K+ posts)
Member # 110
posted
Hildy, make sure you find out why they won't cover it. My insurance also said Bicillin shots were not covered. When I asked further they said it wasn't covered because it is not a self-injectable med.
After more questions, I learned that it would be covered if and only if I went to a doctor's office to get the injection. Not convenient, but this is what I did to have it covered.
Ask questions. They may not tell you how it could be covered unless you ask.
Posts: 4681 | Registered: Oct 2000
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