Reply to prescription plan no longer covering medication-what to do?

Forum Index » Health and Medicine

Reply to "prescription plan no longer covering medication-what to do?"

Subject:

Emoticons





More smilies

Text Color: Font: Close Marks

[quote=Anonymous]OP here of this post from last year...I appreciated everyone's input so much when I was going through this.  I was able to get the insurance company (cvs/caremark) to cover the Pentasa last year through my doctor's prior authorization letter.  However, they denied the prior authorization letter this year- In the denial letter, they reported that they want me to try the generic, Mesalamine ER or Sulfasalazine (which I have tried in the past twice-the first time, it resulted in my crohn's not being full managed and the second time I tried it later in life, I broke in hives and am now considered allergic to it).  I was really upset that the generic does not work for me--I have tried two different ten day trials of the generic Mesalamine ER, last year,  and my Crohn's symptoms emerge with bloating, diarrhea, abdominal discomfort.  As soon as I return to Pentasa, I feel great again.  I have tried 7 different crohn's meds over my lifetime--and the stomach wants what it wants :)

- My doctor will write a medical exception letter and their office will file the appeal   I guess I need to pray that it will be approved.  I think I'm just venting but let me know if you have any words of wisdom.

My insurance company will not count the prescription cost towards our individual/family maximum, if I need to pay out of pocket ($1,500 a month).  Unfortunately, we make too much to qualify for any patient assistance.   I am going to seriously look into canadian pharmacies again as a backup.  My union and benefits department won't get involved unfortunately.[/quote]

Options

	Disable HTML in this message
	Disable BB Code in this message
	Disable smilies in this message

Review message

Search Recent Topics Hottest Topics