Stupid insurance.: The insurance doesn't... - My MSAA Community

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Stupid insurance.

dailygrump40 profile image
23 Replies

The insurance doesn't cover Horizant and the paper they sent my Dr says it can't be appealed because it is Gabapentin. I can take Gabapentin and get the same results. I say Bullshit!!!!! When I went to bed last night my pain on the pain scale was a 9. My legs throbbed and I did very little yesterday. Well, not enough that my legs should've hurt like that. I'll be making a Dr appt tomorrow. He's either gonna call the insurance company or find me something better. What really gets my guff is I told him I was on Gabapentin before at 3600 mgs a day when I switched to Horizant. Did he listen? He said, it's Gabapentin, there's no difference. I couldn't believe the difference when I first made the Gaba to Horizant switch. Lucky for me I have almost 3 mths of Horizant on hand. Hehehe. Am I switching back? Yup!!!!

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23 Replies
Kenu profile image
Kenu

Good for you 👍. I hope you can work things out and get back on Horizant🙏😉. I take it that it works much better? Ken 🐾🐾

dailygrump40 profile image
dailygrump40 in reply to Kenu

1200 mgs a day of Horizant verses 3600 mgs of Gabapentin and the Horizant actually got rid of the pins and needles feelings in my legs. I take Lyrica for the burning.

rjoneslaw profile image
rjoneslaw

my insurance tried to tell me that ampry and gabapentin was the same thing. Creative but dumb ways to get out of paying

dailygrump40 profile image
dailygrump40 in reply to rjoneslaw

I think I might've gotten a little belligerent about Amprya and Gabapentin being similar. Would've had to say that's like saying there's no difference between a squirrel and a deer. Why are there 2 different hunting seasons for them?

rjoneslaw profile image
rjoneslaw in reply to dailygrump40

You can just say by the time I got off the phone my meds were being shipped out

dailygrump40 profile image
dailygrump40 in reply to rjoneslaw

Good, Good, Good, Good. Very Good, Very Good. Sometimes it is good for us to release the stress.

All7 profile image
All7

You are right on the money. There is most definitely a difference between gabapentin and horizant. I have taken both for restless leg syndrome. I could not tolerate gabapentin. Horizant I have no problem at all, except that it doesn’t work that well after a while. Horizant is also extended release (once a day) whereas gabapentin you need to keep a steady dose in your system, at the risk (with me anyway) of becoming zombie-like.

Take what YOU need to.

dailygrump40 profile image
dailygrump40 in reply to All7

I take Horizant twice a day. I also need checked for RLS. My legs feel like there are a bunch of fingers pushing on them at the end of the day. Not spasm like. At least my legs aren't jumping around but if I move them it seems to settle some.

All7 profile image
All7 in reply to dailygrump40

I have to admit, the RLS is probably one of the worst things ever. It’s all the time, day and night, sometimes in one leg, sometimes the other, no rhyme or reason. The only help I get is with carbidopa-levodopa which I have to take at least once every 4 hrs or so to stay ahead of it, if the crawling feeling starts, it returns with a vengeance and it takes at least an hr for the med to take effect. Plus I take the horizant once a day around 5pm.

Ain’t life grand??

dailygrump40 profile image
dailygrump40 in reply to All7

Yup. Life is super-dooper. Hahaha

dailygrump40 profile image
dailygrump40 in reply to All7

How many mgs of Horizant do you take?

All7 profile image
All7 in reply to dailygrump40

600mg once a day. It was upped to 900mg but it was too much, even taking it at night. I was too foggy the next morning.

dailygrump40 profile image
dailygrump40 in reply to All7

I tried backing down to 900mgs close to 2 years ago but the pins and needles pain was to much. The Dr wanted to back me down off the full dose so if I needed to raise the mgs I take. I could.

MarkUpnorth profile image
MarkUpnorth in reply to All7

Just throwing tis out there regarding RLS , done them all for the rls, gabapentin, alternating with other RLS meds, as they do stop working. It's been quite a while now, but 2 magnesium citrates 250mg softgels. taken 2 hrs b4 bed, (have to set an alarm to remember), but that does the trick for me. Just a vitamin supplement that works better than any script did!

All7 profile image
All7 in reply to MarkUpnorth

Definitely worth a shot. Thanks for the info!

dailygrump40 profile image
dailygrump40 in reply to MarkUpnorth

Gonna try it also. Thanks

TracyBelle profile image
TracyBelle

Lucky you to have an extra supply on hand. My prior authorization for Horizant ran out so I have been without it for about 2 weeks now. I sleep fewer hours each night because I am woken up by the intense pain of laying in bed. How can the insurance company pretend that you don’t need your medications anymore when they just paid for it every month for the previous year? Nobody wakes up on January 1st cured and no longer in need of the medication they relied on every month just to survive the previous year.

dailygrump40 profile image
dailygrump40 in reply to TracyBelle

I just switched insurance companies. That's where mine is coming from. But, I do agree with you. The reauthorization is to make sure it's still working for you. I think, could be wrong, I have before. I will be again. Just saying. Hope you can get it straightened out. Soon!!!

Redskinfan1977 profile image
Redskinfan1977

I just went to my neuro and due to my pain being at a 9 also he prescribed Horizon and my insurance didn't cover it either. He prescribed another medication along with Baclofen again. He told me to increase Baclofen. I don't think it helps, but I will try it again. As for Horizon the insurance companies don't understand our pain. They suck. Good luck with everything.

stepsforNeeC profile image
stepsforNeeC

Hi, I pray your doctor gets this right for you and you can get back to feeling your best! Prayers and Godspeed. I went through a monster of a fight with Copaxone and the astronomical Co - Pay. Glatiramate is not quite the same for me. Give them a "TKO Punch with patient justice!!!!!!!! Keep me posted.

Peace and Blessings,

NeeC

dailygrump40 profile image
dailygrump40

Sent my pcp a message today about my medicine issues. He's the Dr that's in control of that problem. Let's hope it gets fixed soon and hopefully he answers me tomorrow.

dailygrump40 profile image
dailygrump40

Well my pcp upped the dose of gaba which tells me(correct me if I'm wrong) he's playing the insurances game. Showing that the Gaba won't work. The reason I think this is I was told to call in a couple days if the dose needs increased. It went from 1200 to 1800. Standard increase. It'll take a little time til I hit top dose, cause it is 3600 mgs a day. But, gotta play the game.

dailygrump40 profile image
dailygrump40

Was told Friday by my PCP if 2400 mgs a day of Gabapentin doesn't work to decrease the pain. I need to call a pain doctor. I'll be calling one in the morning.

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