I promised terrie, but...I got it!

[gritsar]

The doctor's office just called to tell me they are calling me in a prescription for the medication I need, so....

I called the insurance company to see if they are going to pay for it this time. I explained to them why I couldn't take the neurontin, just like I couldn't take it ten years ago. I basically asked them "Are you going to pay for it NOW that I have lived thru a week of heck (with the side effects from the neurontin)???"
Their response? We can't tell you if we are going to pay for it or not until it is submitted at your pharmacy. If we don't pay for it, your pharmacist will contact the doctor and the doctor can submit the appeals form to us so we can decide whether it will be paid for or not.
In other words, we are starting back at square one.
Somebody please stop this hamster wheel! I want off of it now!!!!!

I'm not sleeping. I can barely eat. Considering giving up my vehicle or the little money I have saved up ($400) to buy the med. out right, only that wouldn't solve anything. Next month I would need it again and the insurance still wouldn't pay for it.


By the way, being as it's open enrollment time for medicare part D I have checked the plans for several different companies. All have the same step therapy policy in place for the medicine.

 

[Camelot Farms]

How are things today?

 

[gritsar]

Quote:
Hi Camelot!
I'm kinda exhausted today. The nerve pain kept me up most of the night and we had to be gone all day for a doctor's appt., my DHs, not mine.
I checked the pharmacy this morning, no prescription. Checked again this afternoon, still no Rx. Finally got both the pharmacist and the doctor's office on the same page and it seems the hold up is still the insurance company. They haven't faxed the preauthorization # to the doctor's office yet.
I'm hopeful that they will send it so I can get the med. tomorrow. What stinks is that I've been off the med. for a couple weeks now, so I'll have to start all over at 1 tablet for a week, then 2 for a week, etc., until I get to the point where it starts helping again.
Thanks for thinking about me.

 

[Iowa Roo Mom]

I'm still praying for you Grits, maybe by God's grace it will go through this time.

 

[3goodeggs]

It is so strange how some meds work for some people and some won't work for others. I love the neurotin. I sleep so well. I guess That is why insurance companies think it works for everyone. Because it works for some of us, but they would not have put so much money into more meds if it really worked for everyone.
Tylenol is a complete waste of time for me. useless. But my cousin swears by it.
The shame here is as someone else said, if the drug companies would stop advertising to US, like WE can prescribe them or get our insurance companies to pay for them, and just lower the price, then more people could actually benefit from them. I really hope you get some relief. They have finally decided that fibromyalgia is real, and they are still pretending that it isn't. I think that's rotten miserable and some how illegal. You are paying for insurance and they aren't providing their end of the deal.
I have been thinking about you, if that could alter their minds...that's an idea. everybody think that they will allow this and let's see if we can get cyber mind control of the insurance companies...oh wait, I assume they have minds.

 

[curliet]

The very same thing is happening with me. The insurance company is refusing to pay for the fibro meds, because the med was initially developed for something else, and there is no generic for it yet. So, they have offered a substitute, and the sub turns out to be neurontin. And the neurontin turns out to be just terrible, and it seems to actually make the FM worse. So, my doc says "here's some samples" and hands me a BAG full of little bottles. (Not the neurontin, but the FM drug.) And he writes a prescription. He knows that the insurance company will catch on and send a letter saying that they won't pay for the drug as soon as they find out that I filled the prescription, so the samples are for me to take while we wait for him to contact the ins co to explain to them that I can't take neurontin and MUST have the real stuff. Hopefully the ins co will allow them, but after hearing your story I'm not so sure. I sure do feel for you, know a little about some of your health problems and how they affect your life.....and if anyone deserves to have something that will make your days a little easier, it's you. Hope your dr is willing to really go that extra mile for you and fight this with you.

 

[gritsar]

Quote:
Hey T!

Yeah, if it was just the that the neurontin didn't help it would be one thing, but it makes everything much worse.
Being the stubborn person I am, I continued to try to take it hoping the side effects would get better as my body adjusted. Finally DH threatened to throw it away if I didn't stop taking it. That's how sick it made me.
Unfortunately the rheumatologists office is two and a half hours away, so samples are not an option for me; and they can't mail it.
We talked to our internist about it yesterday while we were there for DH's appt. He said the decisions made by the insurance companies about what medications are allowed is made by nurse practioners and pencil pushers, not doctors. He says the two drugs are nothing alike.

 

[gritsar]

Just a little FYI. I've been doing alot of reading lately and researchers think they may have finally found a determining factor in people that develop fibromyalgia. They've isolated a virus that grows on nerve endings. The researchers likened it to the way some folks develop shingles after having had chicken pox as a child. Interesting stuff.
If it was just the fibro. I was dealing with I maybe could handle it. Most of my current problems are related more to the hemangiomas. Nothing really to be done about those, since surgery is not an option. Just a matter of tricking the body into thinking its not feeling the nerve sensations that it is.

 

[maplesky7]

huh... it is interesting.


i'll hug ya anyway, even if you are flailing about and bashing your head on the wall...

love,
g

 

[gritsar]

Quote:
teeny tiny