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A letter ftom RX insurance

Oct 29, 2016 7:22 PM

Those kind of letters make me cringe even before opening it. This one says they will be changing what medications they cover on the first of the year. The only one of my medications that won't be covered is the Nucynta ER. (sigh) back to trying to find what will work for my pain.

Always something.

Oct 29, 2016 11:29 PM

Grrrrr. Every time we turn around insurance gets a burr up their butt that puts us back a painful step. I am sorry Mimikay. The new year is fast approaching and I know we will be scrambling trying to find a new med insur because they have raised the rates more than the business can absorb. I am blessed to have any at all. Went 4 years without & it ate up our savings at $600
A month.

Oct 30, 2016 1:27 AM

Mimikay, don't dispair!!! It doesn't matter if they said they don't cover it. The doctor can send in a letter for an override, and they give special authorization in writing that they will cover it for you. The doctor's office just has to send in a letter as to why you cannot come off this medication and that you need to have it for your pain and they will grant an override. (I did it with a prescription that cost $15,000/month and my insurance said they no longer covered it), my doctor sent the letter, I got the authorization and because my plan at the time had $0 copay for generic meds, I got it and paid nothing. It was renewed for 3 years until I had to change insurance and I also needed med change and couldn't take it any more because of drug interactions. So, not back to the drawing board... immediately back to the doctor before the first of the year to get this done.. sending well wishes and good karma. {{{Hugs}}}💕

Oct 30, 2016 3:12 AM

Sad! It's hard enough finding the right Dr the right med then dang insurance changes everything. Check to see if nucynta offers help on getting the med. Ik they offer coupons. Check your mail order company sometimes they offer meds for so much cheaper. Make sure your Dr. knows. Sometimes Dr. will prescribe your qty at the max. To hold you over while finding something that's covered. I worked for an medication insurance company. Ik

Oct 30, 2016 3:15 AM

I worked doing medical insurance claims issues for 12 years. I know that they are a pain in the ass!! However, the overrides do happen and that really would be the first thing I would try.

Oct 30, 2016 3:17 AM

Also ask your local pharmacy if you don't have insurance how much the med will cost. You may be surprised to find out your charged more using your insurance.

Oct 30, 2016 3:20 AM

ugh nucynta ER is expensive!! And a generic won't be a possibility til 2028! Ugh

Oct 30, 2016 2:06 PM

The letter have other options. One was Morphine which does nothing for my pain.

Oct 30, 2016 2:15 PM

I feel for you. Prayers your way!

Oct 30, 2016 3:26 PM

I your country's medical system gets better

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