Insurance and medication.

[Smartcloud1981]

I’ve been dealing with my prescription plan for the last few months. It denied a medication my neurologist prescribed for the fatigue I’m dealing with. He had to prescribe me something else which ended up making me more tired and giving me heart plapatations. I had to stop taking it. and now they have denied the medication he wants to use to treat the ms with. It gets very frustration as I’m sure most of you know.

[Kenu]

Insurance companies think that they are God😡. Why does a Doctor go to all the schooling to earn his degree and the insurance tells them what they can prescribe 😡. The Doctor is the one following your care and physically sees you and prescribes what’s best for you 👍, not someone in a cubicle in a high rise 😡. Try the cheap stuff first and get sicker than maybe give you the good stuff 😡. As you can see, health insurance companies upset 😠 me. The costs of DMT’s are so expensive , how can we pay that much and afford living 🤷🏼‍♂️. Sorry for the rant, I have problems with insurance companies attitude to health care 😠. Without a grant I would not be able to be on a DMT 👍. Good luck and I hope it works out 🙏🐾Ken

[Smartcloud1981 in reply to Kenu]

I totally understand. Ive never really had a lot of trouble until i got diagnosed. Now I just want to call them up and yell. I agree the insurance people who do not have the education as the doctor and they don’t see the patients should not get the say. I’ve been angry since they wouldn’t give me the right medicine for this fatigue now it’s worse.

[MaryMargaret1966 in reply to Kenu]

Kenu, I'm with you. It's not "really" about our health for health insurance companies. It's ALL about the money! Doctors care but let's not forget, every time they write a script for a med, they get paid for it. It's a never ending saga. ....

[MaryMargaret1966 in reply to Kenu]

I'm sorry about my rant. It all just infuriates me.

[Jeremyhess1980]

I was curious what was prescribed as I am also having trouble with fatigue. I’m going to start B-12 complex in the hopes that will help. I’m sick of being so tired all the time

Thanks

[Smartcloud1981]

He had me start with biotin along with the vitamin d I was on. Then he prescribed adderall, but insurance denied it because it was prescribed for my age or approved for ms fatigue. He put me on amantadin which is a Parkinson medication that show effectiveness for ms fatigue. Just did not work for me.

[greaterexp]

It can feel like insurance companies are anti treatment. I, too, hate that they make choices for us based on cold cost-benefit numbers, rather than on what our doctors prescribe based on what would best help us. We are forced to be our own advocates or find someone who can help navigate through it.

I hope you find something affordable that really helps.

[SueAB]

Smartcloud1981, Many insurance companies have patient advocates, Have you checked to see if your company does? I worked as a RX tech for years and they do make "exceptions" ask for an exception for the drug your Doctor wrote for.

[Smartcloud1981 in reply to SueAB]

I haven’t check yet. I’ve sent a message to see why I was denied, messaged biogen because they have advocates who can help, it was the weekend when I finally heard on the denial so next week I’ll make all the calls.

[Jesmcd2 CommunityAmbassador]

Have you asked your Dr about provigil? Or modnifinil? Smartcloud1981 I take the modnifinil it' the generic for provigil. And I love it.

You might have better luck.

J🌠

[WAshingtongirl]

Smartcloud1981 , I go through this annually with my insurance company. My neuro prescribes Ritalin for my fatigue. As it is for ADHD and not listed as an approved drug for MS (according to my ins. co.), they deny it. My doc then sends back paperwork saying why I need it, and it usually is approved for the year. It’s that time of year again and I am battling to get the Ritalin again. I hope your neuro is able to help you with whatever needs to get approved through your insurance company, but if not, I hope you are able to find an approved medication that works for you.💕

[rjoneslaw]

Has your dr done a formulary exception? For my insurance if the drug is not covered the dr does the formulary exception explaining why you need this medication and why you are unable to use a different medication . The exception is good for a year then you have to reapply . Once you get it be sure to keep track of when the exception is to expire try to renew a month prior to the expiration because it does take time but you can always do an expedited claim

[Smartcloud1981 in reply to rjoneslaw]

I will be talking to my neurologist tomorrow hopefully. He was out of medical last week when I found out about the ms meds being denied

[Momjules]

I have had the pharmacist at Walgreens refuse to fill my pain med unless I signed a paper for them to access my medical records!!

Needless to say, I haven’t been there since.

[Smartcloud1981 in reply to Momjules]

I don’t blame you I wouldn’t go back either.