Today's Insurance Company is sponsore... - Restless Legs Syn...

Restless Legs Syndrome

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Today's Insurance Company is sponsored by the letters "F" and "U"

ookla profile image
3 Replies

So, I went to U of M and the Dr there wanted me to try oxycontin, but since it may cause respiratory problems, wanted me to do a(nother) sleep study to make sure I didn't have sleep apnea. Well, the results came back that I have moderate sleep apnea. So no medication until I start using a CPAP. So I had a follow-up sleep study to figure out what sort of CPAP and setting I need. Got that done, got the prescription in, just needed to wait for it to come in, use it for a few weeks, then get on the medication and everything'll be great, right? Wrong.

The Insurance Company said they're not going to cover a CPAP for me. Apparently, the Dr uses 3% in their apnea formula, which gave me a score of 16; however, the Insurance Company use 4%, which gave me a score of 1 and they won't cover anything lower than 5. That's real cute.... just change numbers to get out of having to cover people.

The doctor sent them a letter of medical necessity, which we fully expect they'll ignore. In the meantime, the doctor prescribe oxycodone instead. Hopefully that will give me some relief from the RLS and if it makes me sleep apnea worse, we can do another sleep study and then resubmit to the Insurance Company.

I have to admit, though, I'm a little reluctant to start the oxycodone. I'm afraid of addiction, dependance, tolerance, side effects, etc. Anyway, that's the latest update. Hope you all are doing well and have found something that works for you.

P.S. Hey, guy against medication, please don't bother responding. Thank you.

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ookla
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ookla profile image
ookla

I'm not sure if it applies to all of them, but I was told my machine would be at least $1,500 (USD)... that doesn't include all the necessary accessories. :(

You should not be afraid of being addicted to oxycontin, this should be a link:

healthcentral.com/chronic-p...

I do really hope that your insurance company will give you a CPAP soon!! Must be terrible to have to fight for such a life necessary thing. I wish you all luck!

Here in Sweden we get them free, the goverment pays (we all pay by taxes), but there is a two (2) year long cue because there is not enough of doctors at the sleep clinics because the goverment does not want to pay for many doctors, Columbi egg! I am in that cue since two months, I can visit a privat doctor but then I have to pay for the CPAP myself and yes, it costs about 1500 USD.

Jaynielynne profile image
Jaynielynne

This is a bunch of bullcrap from the insurance. I would take the

medicine and then ask for another test. That's why we pay big

premiums.

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