Re: 5mg Daily Cialis- HM Ho! Ho! Ho!

[Guest guest]

NO, Ron; please don't hold your breath!!!

 

We have been through this. And the 5 mg daily Cialis, the way I understand, is

FDA approved. Correct me, guys and ladies if I am wrong.

Our uro tried about 3 times to get our insurance to approve the 5 mg daily. He

sent letters of medical necessity, documentation, etc. Even went to the top of

our insurance company. They turned us down flat. Said we could get the alloted

12 pills for 3 months (that's 4 pills per month) for a copay of only $160.

 

Hope you have better luck than we did.  Maybe we should try again. Although

hubby didn't tolerate the pills that well.  We are doing injections.

 

Take care--good luck and let us know what happens.

 

Debbie

Subject: 5mg Daily Cialis- HM Ho! Ho! Ho!

To: ProstateCancerSupport

Date: Friday, December 5, 2008, 12:39 AM

I finally found something that worked for me... the doctor's

samples were gone... and it was time to go out and buy my own.

I handed my pharmacist the prescription for quantity 30,

5mg Daily dose Cialis pills.

When I returned for pick up I was told that my HMO would

only pay for eight tablets (my monthly quota).

" No! No! " , I said. " This is a 5mg daily dose... That's

one per day. It's how the drug works " .

" Sorry " , said the pharmacist, " but your HMO does not allow more

than the eight pills a month " .

" ARRRGGHH! " , I said.

Not only that, but Cialis is not considered a formulary drug

and it's copay was over and above the maximum.

" ARRRGGHH! " , I said.

5mg " Daily Dose " Cialis has been out for close to a year now.

You'd have thought that my HMO would have revised their drug

policy by now, but- NO!

My HMO informed me that I could have my doctor submit a

request for consideration. If approved, I might get my 30

pills.

Do you think I should hold my breath? :-)

Ron

[Guest guest]

NO, Ron; please don't hold your breath!!!

 

We have been through this. And the 5 mg daily Cialis, the way I understand, is

FDA approved. Correct me, guys and ladies if I am wrong.

Our uro tried about 3 times to get our insurance to approve the 5 mg daily. He

sent letters of medical necessity, documentation, etc. Even went to the top of

our insurance company. They turned us down flat. Said we could get the alloted

12 pills for 3 months (that's 4 pills per month) for a copay of only $160.

 

Hope you have better luck than we did.  Maybe we should try again. Although

hubby didn't tolerate the pills that well.  We are doing injections.

 

Take care--good luck and let us know what happens.

 

Debbie

Subject: 5mg Daily Cialis- HM Ho! Ho! Ho!

To: ProstateCancerSupport

Date: Friday, December 5, 2008, 12:39 AM

I finally found something that worked for me... the doctor's

samples were gone... and it was time to go out and buy my own.

I handed my pharmacist the prescription for quantity 30,

5mg Daily dose Cialis pills.

When I returned for pick up I was told that my HMO would

only pay for eight tablets (my monthly quota).

" No! No! " , I said. " This is a 5mg daily dose... That's

one per day. It's how the drug works " .

" Sorry " , said the pharmacist, " but your HMO does not allow more

than the eight pills a month " .

" ARRRGGHH! " , I said.

Not only that, but Cialis is not considered a formulary drug

and it's copay was over and above the maximum.

" ARRRGGHH! " , I said.

5mg " Daily Dose " Cialis has been out for close to a year now.

You'd have thought that my HMO would have revised their drug

policy by now, but- NO!

My HMO informed me that I could have my doctor submit a

request for consideration. If approved, I might get my 30

pills.

Do you think I should hold my breath? :-)

Ron

[Guest guest]

NO, Ron; please don't hold your breath!!!

 

We have been through this. And the 5 mg daily Cialis, the way I understand, is

FDA approved. Correct me, guys and ladies if I am wrong.

Our uro tried about 3 times to get our insurance to approve the 5 mg daily. He

sent letters of medical necessity, documentation, etc. Even went to the top of

our insurance company. They turned us down flat. Said we could get the alloted

12 pills for 3 months (that's 4 pills per month) for a copay of only $160.

 

Hope you have better luck than we did.  Maybe we should try again. Although

hubby didn't tolerate the pills that well.  We are doing injections.

 

Take care--good luck and let us know what happens.

 

Debbie

Subject: 5mg Daily Cialis- HM Ho! Ho! Ho!

To: ProstateCancerSupport

Date: Friday, December 5, 2008, 12:39 AM

I finally found something that worked for me... the doctor's

samples were gone... and it was time to go out and buy my own.

I handed my pharmacist the prescription for quantity 30,

5mg Daily dose Cialis pills.

When I returned for pick up I was told that my HMO would

only pay for eight tablets (my monthly quota).

" No! No! " , I said. " This is a 5mg daily dose... That's

one per day. It's how the drug works " .

" Sorry " , said the pharmacist, " but your HMO does not allow more

than the eight pills a month " .

" ARRRGGHH! " , I said.

Not only that, but Cialis is not considered a formulary drug

and it's copay was over and above the maximum.

" ARRRGGHH! " , I said.

5mg " Daily Dose " Cialis has been out for close to a year now.

You'd have thought that my HMO would have revised their drug

policy by now, but- NO!

My HMO informed me that I could have my doctor submit a

request for consideration. If approved, I might get my 30

pills.

Do you think I should hold my breath? :-)

Ron

[Guest guest]

Ron,To reduce my out of pocket expense I asked my Doc to write an Rx for 20mg tablets which I split into four approximate 5mg doses. The cost for the 20mg is only slightly higher than the cost for the 5mg.I commented in greater detail on my experience with the 5mg dose in an e-mail I posted a few days ago if you are interested.Best regards,JSubject: 5mg Daily Cialis- HM Ho! Ho! Ho!To: ProstateCancerSupport Date: Thursday, December 4, 2008, 7:39 PM

I finally found something that worked for me... the doctor's

samples were gone... and it was time to go out and buy my own.

I handed my pharmacist the prescription for quantity 30,

5mg Daily dose Cialis pills.

When I returned for pick up I was told that my HMO would

only pay for eight tablets (my monthly quota).

"No! No!", I said. "This is a 5mg daily dose... That's

one per day. It's how the drug works".

"Sorry", said the pharmacist, "but your HMO does not allow more

than the eight pills a month".

"ARRRGGHH!", I said.

Not only that, but Cialis is not considered a formulary drug

and it's copay was over and above the maximum.

"ARRRGGHH!", I said.

5mg "Daily Dose" Cialis has been out for close to a year now.

You'd have thought that my HMO would have revised their drug

policy by now, but- NO!

My HMO informed me that I could have my doctor submit a

request for consideration. If approved, I might get my 30

pills.

Do you think I should hold my breath? :-)

Ron

[Guest guest]

Ron,

My insurance carrier would only give me 8 a month as well so my uro uped the rx to 20mg and I get 8 a month and cut them in half. I get mine mail order and I have to get a 90 day supply. My co-pay is $60.

Try to get your dr to do it to, I bet it will work.

Good luck,

Rick

To: ProstateCancerSupport Sent: Thursday, December 4, 2008 7:39:05 PMSubject: 5mg Daily Cialis- HM Ho! Ho! Ho!

I finally found something that worked for me... the doctor'ssamples were gone... and it was time to go out and buy my own.I handed my pharmacist the prescription for quantity 30,5mg Daily dose Cialis pills.When I returned for pick up I was told that my HMO wouldonly pay for eight tablets (my monthly quota)."No! No!", I said. "This is a 5mg daily dose... That'sone per day. It's how the drug works"."Sorry", said the pharmacist, "but your HMO does not allow morethan the eight pills a month"."ARRRGGHH!", I said.Not only that, but Cialis is not considered a formulary drugand it's copay was over and above the maximum."ARRRGGHH!", I said.5mg "Daily Dose" Cialis has been out for close to a year now.You'd have thought that my HMO would have revised their drugpolicy by now, but- NO!My HMO informed me that I could have my doctor submit arequest for

consideration. If approved, I might get my 30pills.Do you think I should hold my breath? :-)Ron

[Guest guest]

I have been fighting my HoMO since August over the 5 mg Cialis. It is a lifestyle drug and nothing more to them. They do not understand penile rehab. I asked one of the panel if they would go to rehab with a knee replacement. Answer? Of course. My response: Well how about me? I have just had an important part of me removed. This is needed for MY rehab. Turned down with dissent. Have another appeal scheduled for January (I think they are hoping I will disappear). Round 3 coming up!Steve S in ArkansasTo: ProstateCancerSupport Sent: Thursday, December 4, 2008 6:39:05 PMSubject: 5mg Daily Cialis- HM Ho! Ho! Ho!

I finally found something that worked for me... the doctor's

samples were gone... and it was time to go out and buy my own.

I handed my pharmacist the prescription for quantity 30,

5mg Daily dose Cialis pills.

When I returned for pick up I was told that my HMO would

only pay for eight tablets (my monthly quota).

"No! No!", I said. "This is a 5mg daily dose... That's

one per day. It's how the drug works".

"Sorry", said the pharmacist, "but your HMO does not allow more

than the eight pills a month".

"ARRRGGHH!", I said.

Not only that, but Cialis is not considered a formulary drug

and it's copay was over and above the maximum.

"ARRRGGHH!", I said.

5mg "Daily Dose" Cialis has been out for close to a year now.

You'd have thought that my HMO would have revised their drug

policy by now, but- NO!

My HMO informed me that I could have my doctor submit a

request for consideration. If approved, I might get my 30

pills.

Do you think I should hold my breath? :-)

Ron

[Guest guest]

If you go on the website for Cialis you will see a FREE TRIAL

OFFER. You can print out a voucher for a FREE TRIAL offer for a

30 day supply of 5mg or 2.5 mg. Cialis tablets or for 3 tablets of the

20mg or 10mg. All you do print it out, get a prescription from your

doctor and then go to your local pharmacy. IT'S FREE!!!!

Domenico

rkushnier wrote:

I finally found something that worked for me... the doctor's

samples were gone... and it was time to go out and buy my own.

I handed my pharmacist the prescription for quantity 30,

5mg Daily dose Cialis pills.

When I returned for pick up I was told that my HMO would

only pay for eight tablets (my monthly quota).

"No! No!", I said. "This is a 5mg daily dose... That's

one per day. It's how the drug works".

"Sorry", said the pharmacist, "but your HMO does not allow more

than the eight pills a month".

"ARRRGGHH!", I said.

Not only that, but Cialis is not considered a formulary drug

and it's copay was over and above the maximum.

"ARRRGGHH!", I said.

5mg "Daily Dose" Cialis has been out for close to a year now.

You'd have thought that my HMO would have revised their drug

policy by now, but- NO!

My HMO informed me that I could have my doctor submit a

request for consideration. If approved, I might get my 30

pills.

Do you think I should hold my breath? :-)

Ron

[Guest guest]

If you go on the website for Cialis you will see a FREE TRIAL

OFFER. You can print out a voucher for a FREE TRIAL offer for a

30 day supply of 5mg or 2.5 mg. Cialis tablets or for 3 tablets of the

20mg or 10mg. All you do print it out, get a prescription from your

doctor and then go to your local pharmacy. IT'S FREE!!!!

Domenico

rkushnier wrote:

I finally found something that worked for me... the doctor's

samples were gone... and it was time to go out and buy my own.

I handed my pharmacist the prescription for quantity 30,

5mg Daily dose Cialis pills.

When I returned for pick up I was told that my HMO would

only pay for eight tablets (my monthly quota).

"No! No!", I said. "This is a 5mg daily dose... That's

one per day. It's how the drug works".

"Sorry", said the pharmacist, "but your HMO does not allow more

than the eight pills a month".

"ARRRGGHH!", I said.

Not only that, but Cialis is not considered a formulary drug

and it's copay was over and above the maximum.

"ARRRGGHH!", I said.

5mg "Daily Dose" Cialis has been out for close to a year now.

You'd have thought that my HMO would have revised their drug

policy by now, but- NO!

My HMO informed me that I could have my doctor submit a

request for consideration. If approved, I might get my 30

pills.

Do you think I should hold my breath? :-)

Ron

[Guest guest]

If you go on the website for Cialis you will see a FREE TRIAL

OFFER. You can print out a voucher for a FREE TRIAL offer for a

30 day supply of 5mg or 2.5 mg. Cialis tablets or for 3 tablets of the

20mg or 10mg. All you do print it out, get a prescription from your

doctor and then go to your local pharmacy. IT'S FREE!!!!

Domenico

rkushnier wrote:

I finally found something that worked for me... the doctor's

samples were gone... and it was time to go out and buy my own.

I handed my pharmacist the prescription for quantity 30,

5mg Daily dose Cialis pills.

When I returned for pick up I was told that my HMO would

only pay for eight tablets (my monthly quota).

"No! No!", I said. "This is a 5mg daily dose... That's

one per day. It's how the drug works".

"Sorry", said the pharmacist, "but your HMO does not allow more

than the eight pills a month".

"ARRRGGHH!", I said.

Not only that, but Cialis is not considered a formulary drug

and it's copay was over and above the maximum.

"ARRRGGHH!", I said.

5mg "Daily Dose" Cialis has been out for close to a year now.

You'd have thought that my HMO would have revised their drug

policy by now, but- NO!

My HMO informed me that I could have my doctor submit a

request for consideration. If approved, I might get my 30

pills.

Do you think I should hold my breath? :-)

Ron

[Guest guest]

Steve,

Whoever your HMO is they sound like a bunch of pricks. My HMO(Cigna)is usually pretty tough and when I go on line and look at the drugs that they don't cover all the so called "life style drugs" are list as NOT COVERED. When my uro prescribed my Cialis I told him that they will not cover it and he said that once you are diagnosed with cancer that puts you into a different category and most will cover it for some period of time. He said that there is a lot of activity in Washington(finally)about HMO's and how they cover post prostate surgery claims both for prescription drugs and things like implant surgery. He said that the HMO's are trying to keep a low profile on post prostate cancer claims and covering the claim rather then pissing people off(like they are you)and drawing attention to the issue. He also feels that its just a matter of time before they will have to give post prostate cancer treatment coverages the same attention as

other cancers.

My HMO, Cigna, agreed to cover my Cialis after two appeals for one year as a tier 3 prescription and I pay $60 for a three month prescription of 24 tablets. I just got a letter from them at the one year aniversary and they extended their coverage for another year without a fight. My uro prescribed alprostadile injections for me a couple of months ago and he said that they would most likely cover one or the other and they are covering both.

Its a dam shame that we have to fight them for the things that we need to feel whole again but I think the fights are finally showing results so don't' give up, and keep fighting!

Good luck,

Rick

By the way, who is your HMO? You need to put their name out here so everyone knows.

To: ProstateCancerSupport Sent: Thursday, December 4, 2008 11:39:54 PMSubject: Re: 5mg Daily Cialis- HM Ho! Ho! Ho!

I have been fighting my HoMO since August over the 5 mg Cialis. It is a lifestyle drug and nothing more to them. They do not understand penile rehab. I asked one of the panel if they would go to rehab with a knee replacement. Answer? Of course. My response: Well how about me? I have just had an important part of me removed. This is needed for MY rehab. Turned down with dissent. Have another appeal scheduled for January (I think they are hoping I will disappear). Round 3 coming up!Steve S in Arkansas

From: rkushnier <rkushnierverizon (DOT) net>To: ProstateCancerSuppo rtyahoogroups (DOT) comSent: Thursday, December 4, 2008 6:39:05 PMSubject: [ProstateCancerSupp ort] 5mg Daily Cialis- HM Ho! Ho! Ho!

I finally found something that worked for me... the doctor'ssamples were gone... and it was time to go out and buy my own.I handed my pharmacist the prescription for quantity 30,5mg Daily dose Cialis pills.When I returned for pick up I was told that my HMO wouldonly pay for eight tablets (my monthly quota)."No! No!", I said. "This is a 5mg daily dose... That'sone per day. It's how the drug works"."Sorry", said the pharmacist, "but your HMO does not allow morethan the eight pills a month"."ARRRGGHH!", I said.Not only that, but Cialis is not considered a formulary drugand it's copay was over and above the maximum."ARRRGGHH!", I said.5mg "Daily Dose" Cialis has been out for close to a year now.You'd have thought that my HMO would have revised their drugpolicy by now, but- NO!My HMO informed me that I could have my doctor submit arequest for

consideration. If approved, I might get my 30pills.Do you think I should hold my breath? :-)Ron

[Guest guest]

Steve,

Whoever your HMO is they sound like a bunch of pricks. My HMO(Cigna)is usually pretty tough and when I go on line and look at the drugs that they don't cover all the so called "life style drugs" are list as NOT COVERED. When my uro prescribed my Cialis I told him that they will not cover it and he said that once you are diagnosed with cancer that puts you into a different category and most will cover it for some period of time. He said that there is a lot of activity in Washington(finally)about HMO's and how they cover post prostate surgery claims both for prescription drugs and things like implant surgery. He said that the HMO's are trying to keep a low profile on post prostate cancer claims and covering the claim rather then pissing people off(like they are you)and drawing attention to the issue. He also feels that its just a matter of time before they will have to give post prostate cancer treatment coverages the same attention as

other cancers.

My HMO, Cigna, agreed to cover my Cialis after two appeals for one year as a tier 3 prescription and I pay $60 for a three month prescription of 24 tablets. I just got a letter from them at the one year aniversary and they extended their coverage for another year without a fight. My uro prescribed alprostadile injections for me a couple of months ago and he said that they would most likely cover one or the other and they are covering both.

Its a dam shame that we have to fight them for the things that we need to feel whole again but I think the fights are finally showing results so don't' give up, and keep fighting!

Good luck,

Rick

By the way, who is your HMO? You need to put their name out here so everyone knows.

To: ProstateCancerSupport Sent: Thursday, December 4, 2008 11:39:54 PMSubject: Re: 5mg Daily Cialis- HM Ho! Ho! Ho!

I have been fighting my HoMO since August over the 5 mg Cialis. It is a lifestyle drug and nothing more to them. They do not understand penile rehab. I asked one of the panel if they would go to rehab with a knee replacement. Answer? Of course. My response: Well how about me? I have just had an important part of me removed. This is needed for MY rehab. Turned down with dissent. Have another appeal scheduled for January (I think they are hoping I will disappear). Round 3 coming up!Steve S in Arkansas

From: rkushnier <rkushnierverizon (DOT) net>To: ProstateCancerSuppo rtyahoogroups (DOT) comSent: Thursday, December 4, 2008 6:39:05 PMSubject: [ProstateCancerSupp ort] 5mg Daily Cialis- HM Ho! Ho! Ho!

I finally found something that worked for me... the doctor'ssamples were gone... and it was time to go out and buy my own.I handed my pharmacist the prescription for quantity 30,5mg Daily dose Cialis pills.When I returned for pick up I was told that my HMO wouldonly pay for eight tablets (my monthly quota)."No! No!", I said. "This is a 5mg daily dose... That'sone per day. It's how the drug works"."Sorry", said the pharmacist, "but your HMO does not allow morethan the eight pills a month"."ARRRGGHH!", I said.Not only that, but Cialis is not considered a formulary drugand it's copay was over and above the maximum."ARRRGGHH!", I said.5mg "Daily Dose" Cialis has been out for close to a year now.You'd have thought that my HMO would have revised their drugpolicy by now, but- NO!My HMO informed me that I could have my doctor submit arequest for

consideration. If approved, I might get my 30pills.Do you think I should hold my breath? :-)Ron

[Guest guest]

Steve,

Whoever your HMO is they sound like a bunch of pricks. My HMO(Cigna)is usually pretty tough and when I go on line and look at the drugs that they don't cover all the so called "life style drugs" are list as NOT COVERED. When my uro prescribed my Cialis I told him that they will not cover it and he said that once you are diagnosed with cancer that puts you into a different category and most will cover it for some period of time. He said that there is a lot of activity in Washington(finally)about HMO's and how they cover post prostate surgery claims both for prescription drugs and things like implant surgery. He said that the HMO's are trying to keep a low profile on post prostate cancer claims and covering the claim rather then pissing people off(like they are you)and drawing attention to the issue. He also feels that its just a matter of time before they will have to give post prostate cancer treatment coverages the same attention as

other cancers.

My HMO, Cigna, agreed to cover my Cialis after two appeals for one year as a tier 3 prescription and I pay $60 for a three month prescription of 24 tablets. I just got a letter from them at the one year aniversary and they extended their coverage for another year without a fight. My uro prescribed alprostadile injections for me a couple of months ago and he said that they would most likely cover one or the other and they are covering both.

Its a dam shame that we have to fight them for the things that we need to feel whole again but I think the fights are finally showing results so don't' give up, and keep fighting!

Good luck,

Rick

By the way, who is your HMO? You need to put their name out here so everyone knows.

To: ProstateCancerSupport Sent: Thursday, December 4, 2008 11:39:54 PMSubject: Re: 5mg Daily Cialis- HM Ho! Ho! Ho!

I have been fighting my HoMO since August over the 5 mg Cialis. It is a lifestyle drug and nothing more to them. They do not understand penile rehab. I asked one of the panel if they would go to rehab with a knee replacement. Answer? Of course. My response: Well how about me? I have just had an important part of me removed. This is needed for MY rehab. Turned down with dissent. Have another appeal scheduled for January (I think they are hoping I will disappear). Round 3 coming up!Steve S in Arkansas

From: rkushnier <rkushnierverizon (DOT) net>To: ProstateCancerSuppo rtyahoogroups (DOT) comSent: Thursday, December 4, 2008 6:39:05 PMSubject: [ProstateCancerSupp ort] 5mg Daily Cialis- HM Ho! Ho! Ho!

I finally found something that worked for me... the doctor'ssamples were gone... and it was time to go out and buy my own.I handed my pharmacist the prescription for quantity 30,5mg Daily dose Cialis pills.When I returned for pick up I was told that my HMO wouldonly pay for eight tablets (my monthly quota)."No! No!", I said. "This is a 5mg daily dose... That'sone per day. It's how the drug works"."Sorry", said the pharmacist, "but your HMO does not allow morethan the eight pills a month"."ARRRGGHH!", I said.Not only that, but Cialis is not considered a formulary drugand it's copay was over and above the maximum."ARRRGGHH!", I said.5mg "Daily Dose" Cialis has been out for close to a year now.You'd have thought that my HMO would have revised their drugpolicy by now, but- NO!My HMO informed me that I could have my doctor submit arequest for

consideration. If approved, I might get my 30pills.Do you think I should hold my breath? :-)Ron

[Guest guest]

I just got off the phone with my pharmacy.

They SAY that they will honor the free Cialis coupon

(www.Cialis.com) for 30 pills and go outside the HMO (Keystone

Health Plan East). We shall see! I remember trying

to do something like this before, but " BIG BROTHER HMO "

was watching and would not let it through.

What will happen next month and thereafter,

is still up in the air.

Replying on this site may be a catharsis, but we need

to do more than that. It appears that notifying the

Attorney General of your individual state may see more

action than waiting for Congress to do something.

In Pennsylvania, the HMO Consumer Advocate can be

reached at: 1- or toll-free 1-.

Hope this helps,

Ron

>

> Its a dam shame that we have to fight them for the things that we

need to feel whole again but I think the fights are finally showing

results so don't' give up, and keep fighting!

> Good luck,

> Rick

> By the way, who is your HMO? You need to put their name out here so

everyone knows.

> ________________________________

>

> To: ProstateCancerSupport

> Sent: Thursday, December 4, 2008 11:39:54 PM

> Subject: Re: 5mg Daily Cialis- HM Ho! Ho!

Ho!

>

>

> I have been fighting my HoMO since August over the 5 mg Cialis. It

is a lifestyle drug and nothing more to them. They do not understand

penile rehab. I asked one of the panel if they would go to rehab with

a knee replacement. Answer? Of course. My response: Well how about

me? I have just had an important part of me removed. This is needed

for MY rehab. Turned down with dissent. Have another appeal scheduled

for January (I think they are hoping I will disappear). Round 3

coming up!

>

> Steve S in Arkansas

[Guest guest]

What needs to happen is for the CEO of the insurance company to go

through this, and place him in our shoes. I'll wield the knife, you

hold him down. I've had more than one go around with the damn

insurance companies, and arghhhhhhhhhhhh is right. Gotta keep all our

bucks for those fancy buildings and baseball stadiums. Maybe the govt.

will bail the poor suckers out. lol

Don't hold your breath, Ron, have you checked on the cost of just

buying the extra you need outright? I know it's expensive, but so is

life long ED, and if it might help, worth doing perhaps for 6 months

or so. I did not, but thought about it. Just my thoughts.

Hi Debbie,

ttyl

>

> NO, Ron; please don't hold your breath!!!

>  

>

[Guest guest]

What needs to happen is for the CEO of the insurance company to go

through this, and place him in our shoes. I'll wield the knife, you

hold him down. I've had more than one go around with the damn

insurance companies, and arghhhhhhhhhhhh is right. Gotta keep all our

bucks for those fancy buildings and baseball stadiums. Maybe the govt.

will bail the poor suckers out. lol

Don't hold your breath, Ron, have you checked on the cost of just

buying the extra you need outright? I know it's expensive, but so is

life long ED, and if it might help, worth doing perhaps for 6 months

or so. I did not, but thought about it. Just my thoughts.

Hi Debbie,

ttyl

>

> NO, Ron; please don't hold your breath!!!

>  

>

[Guest guest]

What needs to happen is for the CEO of the insurance company to go

through this, and place him in our shoes. I'll wield the knife, you

hold him down. I've had more than one go around with the damn

insurance companies, and arghhhhhhhhhhhh is right. Gotta keep all our

bucks for those fancy buildings and baseball stadiums. Maybe the govt.

will bail the poor suckers out. lol

Don't hold your breath, Ron, have you checked on the cost of just

buying the extra you need outright? I know it's expensive, but so is

life long ED, and if it might help, worth doing perhaps for 6 months

or so. I did not, but thought about it. Just my thoughts.

Hi Debbie,

ttyl

>

> NO, Ron; please don't hold your breath!!!

>  

>

[Guest guest]

Hi !!!

Subject: Re: 5mg Daily Cialis- HM Ho! Ho! Ho!

To: ProstateCancerSupport

Date: Monday, December 8, 2008, 12:16 PM

What needs to happen is for the CEO of the insurance company to go

through this, and place him in our shoes. I'll wield the knife, you

hold him down. I've had more than one go around with the damn

insurance companies, and arghhhhhhhhhhhh is right. Gotta keep all our

bucks for those fancy buildings and baseball stadiums. Maybe the govt.

will bail the poor suckers out. lol

Don't hold your breath, Ron, have you checked on the cost of just

buying the extra you need outright? I know it's expensive, but so is

life long ED, and if it might help, worth doing perhaps for 6 months

or so. I did not, but thought about it. Just my thoughts.

Hi Debbie,

ttyl

>

> NO, Ron; please don't hold your breath!!!

>  

>

[Guest guest]

If your HMO will pay for 8 pills of the 20 mg, you can quarter tham

and still get a months worth. I know that method won't change the

gears of (negative) progress with your HMO, but for now it might at

least give you the daily dosing effect.

Short of that, you could mount a campaign of education with calls,

letters, e-mails to everyone you can think of from the pharmacy, the

drug manufacturing company, HMO, health & medical magazines,

newspapers and your government representatives.

Everyone has the right to persuit of happiness.

Best wishes, Mick -- Abilene, TX

PS: The VA allows (4) generic Lavitra pills per month and do not

budge even upon receipt of a daily Rx from civilian medical Doctors.

>

> I finally found something that worked for me... the doctor's

> samples were gone... and it was time to go out and buy my own.

>

> I handed my pharmacist the prescription for quantity 30,

> 5mg Daily dose Cialis pills.

>

> When I returned for pick up I was told that my HMO would

> only pay for eight tablets (my monthly quota).

>

> " No! No! " , I said. " This is a 5mg daily dose... That's

> one per day. It's how the drug works " .

>

> " Sorry " , said the pharmacist, " but your HMO does not allow more

> than the eight pills a month " .

>

> " ARRRGGHH! " , I said.

>

> Not only that, but Cialis is not considered a formulary drug

> and it's copay was over and above the maximum.

>

> " ARRRGGHH! " , I said.

>

> 5mg " Daily Dose " Cialis has been out for close to a year now.

> You'd have thought that my HMO would have revised their drug

> policy by now, but- NO!

>

> My HMO informed me that I could have my doctor submit a

> request for consideration. If approved, I might get my 30

> pills.

>

> Do you think I should hold my breath? :-)

>

> Ron

>

[Guest guest]

The adventure continues...

I just went over to my local pharmacy to pick up my free trial

perscription of 30, 5 mg Cialis. This after calling them to make sure

they had 30 tablets in stock.

:-) :-) :-)

The pharmacist informed me that the 5 mg Cialis mentioned

in the Lilly Coupon has a different packaging, and a

different National Drug Code number than the 5 mg Cialis

that he sells... So he could not fill the prescription. :-)

He assured me that he has now ordered the correct version

and that it will be there the next time I come in.

I'm glad gas is so cheap again :-)

I also made a call to the Pennsylvania Attorney General's Office

Health Services Division. They are sending me out a complaint form.

It's a good thing I can still get all the antidepressant pills I want

from my HMO. Another " LifeStyle " drug! :-)

Ron

>

> I just got off the phone with my pharmacy.

> They SAY that they will honor the free Cialis coupon

> (www.Cialis.com) for 30 pills and go outside the HMO (Keystone

> Health Plan East). We shall see! I remember trying

> to do something like this before, but " BIG BROTHER HMO "

> was watching and would not let it through.

> What will happen next month and thereafter,

> is still up in the air.

>

> Replying on this site may be a catharsis, but we need

> to do more than that. It appears that notifying the

> Attorney General of your individual state may see more

> action than waiting for Congress to do something.

>

> In Pennsylvania, the HMO Consumer Advocate can be

> reached at: 1- or toll-free 1-.

>

> Hope this helps,

>

> Ron

[Guest guest]

Ron,

Its funny(not really) that the HMO's will pay for all the Zoloft and Paxil that you can consume and as many trips to the psychiatrist that you deem necessary to try to deal with our ED related problems but they will not pay(easily)for the medication to solve the real problem. Dah........

Maybe someday.

Regards,

Rick

To: ProstateCancerSupport Sent: Tuesday, December 9, 2008 4:16:39 PMSubject: Re: 5mg Daily Cialis- HM Ho! Ho! Ho!

The adventure continues...I just went over to my local pharmacy to pick up my free trialperscription of 30, 5 mg Cialis. This after calling them to make sure they had 30 tablets in stock.:-) :-) :-)The pharmacist informed me that the 5 mg Cialis mentionedin the Lilly Coupon has a different packaging, and adifferent National Drug Code number than the 5 mg Cialisthat he sells... So he could not fill the prescription. :-)He assured me that he has now ordered the correct versionand that it will be there the next time I come in.I'm glad gas is so cheap again :-)I also made a call to the Pennsylvania Attorney General's Office Health Services Division. They are sending me out a complaint form.It's a good thing I can still get all the antidepressant pills I want from my HMO. Another "LifeStyle" drug! :-)Ron>> I just got off the phone with my pharmacy.> They SAY that they will honor the free Cialis coupon > (www.Cialis. com) for 30 pills and go outside the HMO (Keystone> Health Plan East). We shall see! I remember trying> to do something like this before, but "BIG BROTHER HMO"> was watching and would not let it through.> What will happen next month and thereafter,> is still up in the air.> > Replying on this site may be a catharsis, but we need> to do more than that. It appears that notifying the> Attorney General of your individual state may see more> action than waiting for Congress to do something.> > In Pennsylvania,

the HMO Consumer Advocate can be> reached at: 1- or toll-free 1-.> > Hope this helps,> > Ron

[Guest guest]

Ron,

Its funny(not really) that the HMO's will pay for all the Zoloft and Paxil that you can consume and as many trips to the psychiatrist that you deem necessary to try to deal with our ED related problems but they will not pay(easily)for the medication to solve the real problem. Dah........

Maybe someday.

Regards,

Rick

To: ProstateCancerSupport Sent: Tuesday, December 9, 2008 4:16:39 PMSubject: Re: 5mg Daily Cialis- HM Ho! Ho! Ho!

The adventure continues...I just went over to my local pharmacy to pick up my free trialperscription of 30, 5 mg Cialis. This after calling them to make sure they had 30 tablets in stock.:-) :-) :-)The pharmacist informed me that the 5 mg Cialis mentionedin the Lilly Coupon has a different packaging, and adifferent National Drug Code number than the 5 mg Cialisthat he sells... So he could not fill the prescription. :-)He assured me that he has now ordered the correct versionand that it will be there the next time I come in.I'm glad gas is so cheap again :-)I also made a call to the Pennsylvania Attorney General's Office Health Services Division. They are sending me out a complaint form.It's a good thing I can still get all the antidepressant pills I want from my HMO. Another "LifeStyle" drug! :-)Ron>> I just got off the phone with my pharmacy.> They SAY that they will honor the free Cialis coupon > (www.Cialis. com) for 30 pills and go outside the HMO (Keystone> Health Plan East). We shall see! I remember trying> to do something like this before, but "BIG BROTHER HMO"> was watching and would not let it through.> What will happen next month and thereafter,> is still up in the air.> > Replying on this site may be a catharsis, but we need> to do more than that. It appears that notifying the> Attorney General of your individual state may see more> action than waiting for Congress to do something.> > In Pennsylvania,

the HMO Consumer Advocate can be> reached at: 1- or toll-free 1-.> > Hope this helps,> > Ron

[Guest guest]

I feel your pain. For the privledge of paying $12,000 a year for

health insurance they pay nothing for ED meds even for prostate

cancer. I try to get as many free samples from my doctor as I can and

split the 20mg pills in half as 10mg works great for me. Still the

cost is horrible.

>

> Steve,

> Whoever your HMO is they sound like a bunch of pricks. My HMO(Cigna)

is usually pretty tough and when I go on line and look at the drugs

that they don't cover all the so called " life style drugs " are list

as NOT COVERED. When my uro prescribed my Cialis I told him that they

will not cover it and he said that once you are diagnosed with cancer

that puts you into a different category and most will cover it for

some period of time. He said that there is a lot of activity in

Washington(finally)about HMO's and how they cover post prostate

surgery claims both for prescription drugs and things like implant

surgery. He said that the HMO's are trying to keep a low profile on

post prostate cancer claims and covering the claim rather then

pissing people off(like they are you)and drawing attention to the

issue. He also feels that its just a matter of time before they will

have to give post prostate cancer treatment coverages the same

attention as other cancers.

> My HMO, Cigna, agreed to cover my Cialis after two appeals for one

year as a tier 3 prescription and I pay $60 for a three month

prescription of 24 tablets. I just got a letter from them at the one

year aniversary and they extended their coverage for another year

without a fight. My uro prescribed alprostadile injections for me a

couple of months ago and he said that they would most likely cover

one or the other and they are covering both.

> Its a dam shame that we have to fight them for the things that we

need to feel whole again but I think the fights are finally showing

results so don't' give up, and keep fighting!

> Good luck,

> Rick

> By the way, who is your HMO? You need to put their name out here so

everyone knows.

>  

>

>

>

> ________________________________

>

> To: ProstateCancerSupport

> Sent: Thursday, December 4, 2008 11:39:54 PM

> Subject: Re: 5mg Daily Cialis- HM Ho! Ho!

Ho!

>

>

> I have been fighting my HoMO since August over the 5 mg Cialis. It

is a lifestyle drug and nothing more to them. They do not understand

penile rehab. I asked one of the panel if they would go to rehab with

a knee replacement. Answer? Of course. My response: Well how about

me? I have just had an important part of me removed. This is needed

for MY rehab. Turned down with dissent. Have another appeal scheduled

for January (I think they are hoping I will disappear). Round 3

coming up!

>

> Steve S in Arkansas

>

>

>

>

> ________________________________

> From: rkushnier <rkushnierverizon (DOT) net>

> To: ProstateCancerSuppo rtyahoogroups (DOT) com

> Sent: Thursday, December 4, 2008 6:39:05 PM

> Subject: [ProstateCancerSupp ort] 5mg Daily Cialis- HM Ho! Ho! Ho!

>

>

> I finally found something that worked for me... the doctor's

> samples were gone... and it was time to go out and buy my own.

>

> I handed my pharmacist the prescription for quantity 30,

> 5mg Daily dose Cialis pills.

>

> When I returned for pick up I was told that my HMO would

> only pay for eight tablets (my monthly quota).

>

> " No! No! " , I said. " This is a 5mg daily dose... That's

> one per day. It's how the drug works " .

>

> " Sorry " , said the pharmacist, " but your HMO does not allow more

> than the eight pills a month " .

>

> " ARRRGGHH! " , I said.

>

> Not only that, but Cialis is not considered a formulary drug

> and it's copay was over and above the maximum.

>

> " ARRRGGHH! " , I said..

>

> 5mg " Daily Dose " Cialis has been out for close to a year now.

> You'd have thought that my HMO would have revised their drug

> policy by now, but- NO!

>

> My HMO informed me that I could have my doctor submit a

> request for consideration. If approved, I might get my 30

> pills.

>

> Do you think I should hold my breath? :-)

>

> Ron

>

[Guest guest]

I feel your pain. For the privledge of paying $12,000 a year for

health insurance they pay nothing for ED meds even for prostate

cancer. I try to get as many free samples from my doctor as I can and

split the 20mg pills in half as 10mg works great for me. Still the

cost is horrible.

>

> Steve,

> Whoever your HMO is they sound like a bunch of pricks. My HMO(Cigna)

is usually pretty tough and when I go on line and look at the drugs

that they don't cover all the so called " life style drugs " are list

as NOT COVERED. When my uro prescribed my Cialis I told him that they

will not cover it and he said that once you are diagnosed with cancer

that puts you into a different category and most will cover it for

some period of time. He said that there is a lot of activity in

Washington(finally)about HMO's and how they cover post prostate

surgery claims both for prescription drugs and things like implant

surgery. He said that the HMO's are trying to keep a low profile on

post prostate cancer claims and covering the claim rather then

pissing people off(like they are you)and drawing attention to the

issue. He also feels that its just a matter of time before they will

have to give post prostate cancer treatment coverages the same

attention as other cancers.

> My HMO, Cigna, agreed to cover my Cialis after two appeals for one

year as a tier 3 prescription and I pay $60 for a three month

prescription of 24 tablets. I just got a letter from them at the one

year aniversary and they extended their coverage for another year

without a fight. My uro prescribed alprostadile injections for me a

couple of months ago and he said that they would most likely cover

one or the other and they are covering both.

> Its a dam shame that we have to fight them for the things that we

need to feel whole again but I think the fights are finally showing

results so don't' give up, and keep fighting!

> Good luck,

> Rick

> By the way, who is your HMO? You need to put their name out here so

everyone knows.

>  

>

>

>

> ________________________________

>

> To: ProstateCancerSupport

> Sent: Thursday, December 4, 2008 11:39:54 PM

> Subject: Re: 5mg Daily Cialis- HM Ho! Ho!

Ho!

>

>

> I have been fighting my HoMO since August over the 5 mg Cialis. It

is a lifestyle drug and nothing more to them. They do not understand

penile rehab. I asked one of the panel if they would go to rehab with

a knee replacement. Answer? Of course. My response: Well how about

me? I have just had an important part of me removed. This is needed

for MY rehab. Turned down with dissent. Have another appeal scheduled

for January (I think they are hoping I will disappear). Round 3

coming up!

>

> Steve S in Arkansas

>

>

>

>

> ________________________________

> From: rkushnier <rkushnierverizon (DOT) net>

> To: ProstateCancerSuppo rtyahoogroups (DOT) com

> Sent: Thursday, December 4, 2008 6:39:05 PM

> Subject: [ProstateCancerSupp ort] 5mg Daily Cialis- HM Ho! Ho! Ho!

>

>

> I finally found something that worked for me... the doctor's

> samples were gone... and it was time to go out and buy my own.

>

> I handed my pharmacist the prescription for quantity 30,

> 5mg Daily dose Cialis pills.

>

> When I returned for pick up I was told that my HMO would

> only pay for eight tablets (my monthly quota).

>

> " No! No! " , I said. " This is a 5mg daily dose... That's

> one per day. It's how the drug works " .

>

> " Sorry " , said the pharmacist, " but your HMO does not allow more

> than the eight pills a month " .

>

> " ARRRGGHH! " , I said.

>

> Not only that, but Cialis is not considered a formulary drug

> and it's copay was over and above the maximum.

>

> " ARRRGGHH! " , I said..

>

> 5mg " Daily Dose " Cialis has been out for close to a year now.

> You'd have thought that my HMO would have revised their drug

> policy by now, but- NO!

>

> My HMO informed me that I could have my doctor submit a

> request for consideration. If approved, I might get my 30

> pills.

>

> Do you think I should hold my breath? :-)

>

> Ron

>

[Guest guest]

I believe that many are experiencing the same issue. That is why I am being so adamant about appeal after appeal. I have been turned down twice and am going to be as tenacious as a pit bull with a bone, not just for me, but for all other patients enduring the same problem. One panelist last time said, "If we give it to you, every one will want it! Why do you think we should we make an exception for you?" I went into a statement and they cut me off. DENIED! I go to my urologist and ED specialist Thursday. I will take all the samples they will give me!I have not yet begun to fight!Steve S in Arkansas________________________________To: ProstateCancerSupport Sent:

Wednesday, December 10, 2008 1:25:04 AMSubject: Re: 5mg Daily Cialis- HM Ho! Ho! Ho!I feel your pain. For the privledge of paying $12,000 a year for health insurance they pay nothing for ED meds even for prostate cancer. I try to get as many free samples from my doctor as I can and split the 20mg pills in half as 10mg works great for me. Still the cost is horrible.>> Steve,> Whoever your HMO is they sound like a bunch of pricks. My HMO(Cigna)is usually pretty tough and when I go on line and look at the drugs that they don't cover all the so called "life style drugs" are list as NOT COVERED. When my uro prescribed my Cialis I told him that they will not cover it and he said that once you are diagnosed with cancer that puts you into a different category

and most will cover it for some period of time. He said that there is a lot of activity in Washington(finally) about HMO's and how they cover post prostate surgery claims both for prescription drugs and things like implant surgery. He said that the HMO's are trying to keep a low profile on post prostate cancer claims and covering the claim rather then pissing people off(like they are you)and drawing attention to the issue. He also feels that its just a matter of time before they will have to give post prostate cancer treatment coverages the same attention as other cancers.> My HMO, Cigna, agreed to cover my Cialis after two appeals for one year as a tier 3 prescription and I pay $60 for a three month prescription of 24 tablets. I just got a letter from them at the one year aniversary and they extended their coverage for another year without a fight. My uro prescribed alprostadile

injections for me a couple of months ago and he said that they would most likely cover one or the other and they are covering both. > Its a dam shame that we have to fight them for the things that we need to feel whole again but I think the fights are finally showing results so don't' give up, and keep fighting!> Good luck,> Rick> By the way, who is your HMO? You need to put their name out here so everyone knows.> > > > > ____________ _________ _________ __> From: wonderwhat <wonderwhat72@ ...>> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Sent: Thursday, December 4, 2008 11:39:54 PM> Subject: Re: [ProstateCancerSupp ort] 5mg Daily Cialis- HM Ho! Ho! Ho!> > > I have been fighting my HoMO since August over the 5 mg Cialis. It is a lifestyle drug and nothing more to them. They do not understand

penile rehab. I asked one of the panel if they would go to rehab with a knee replacement. Answer? Of course. My response: Well how about me? I have just had an important part of me removed. This is needed for MY rehab. Turned down with dissent. Have another appeal scheduled for January (I think they are hoping I will disappear). Round 3 coming up!> > Steve S in Arkansas> > > > > ____________ _________ _________ __> From: rkushnier <rkushnierverizon (DOT) net>> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Sent: Thursday, December 4, 2008 6:39:05 PM> Subject: [ProstateCancerSupp ort] 5mg Daily Cialis- HM Ho! Ho! Ho!> > > I finally found something that worked for me... the doctor's> samples were gone... and it was time to go out and buy my own.> > I handed my pharmacist the prescription for quantity 30,>

5mg Daily dose Cialis pills.> > When I returned for pick up I was told that my HMO would> only pay for eight tablets (my monthly quota).> > "No! No!", I said. "This is a 5mg daily dose... That's> one per day. It's how the drug works".> > "Sorry", said the pharmacist, "but your HMO does not allow more> than the eight pills a month".> > "ARRRGGHH!", I said.> > Not only that, but Cialis is not considered a formulary drug> and it's copay was over and above the maximum.> > "ARRRGGHH!", I said..> > 5mg "Daily Dose" Cialis has been out for close to a year now.> You'd have thought that my HMO would have revised their drug> policy by now, but- NO!> > My HMO informed me that I could have my doctor submit a> request for consideration. If approved, I might get my 30> pills.> > Do you

think I should hold my breath? :-)> > Ron>

[Guest guest]

I believe that many are experiencing the same issue. That is why I am being so adamant about appeal after appeal. I have been turned down twice and am going to be as tenacious as a pit bull with a bone, not just for me, but for all other patients enduring the same problem. One panelist last time said, "If we give it to you, every one will want it! Why do you think we should we make an exception for you?" I went into a statement and they cut me off. DENIED! I go to my urologist and ED specialist Thursday. I will take all the samples they will give me!I have not yet begun to fight!Steve S in Arkansas________________________________To: ProstateCancerSupport Sent:

Wednesday, December 10, 2008 1:25:04 AMSubject: Re: 5mg Daily Cialis- HM Ho! Ho! Ho!I feel your pain. For the privledge of paying $12,000 a year for health insurance they pay nothing for ED meds even for prostate cancer. I try to get as many free samples from my doctor as I can and split the 20mg pills in half as 10mg works great for me. Still the cost is horrible.>> Steve,> Whoever your HMO is they sound like a bunch of pricks. My HMO(Cigna)is usually pretty tough and when I go on line and look at the drugs that they don't cover all the so called "life style drugs" are list as NOT COVERED. When my uro prescribed my Cialis I told him that they will not cover it and he said that once you are diagnosed with cancer that puts you into a different category

and most will cover it for some period of time. He said that there is a lot of activity in Washington(finally) about HMO's and how they cover post prostate surgery claims both for prescription drugs and things like implant surgery. He said that the HMO's are trying to keep a low profile on post prostate cancer claims and covering the claim rather then pissing people off(like they are you)and drawing attention to the issue. He also feels that its just a matter of time before they will have to give post prostate cancer treatment coverages the same attention as other cancers.> My HMO, Cigna, agreed to cover my Cialis after two appeals for one year as a tier 3 prescription and I pay $60 for a three month prescription of 24 tablets. I just got a letter from them at the one year aniversary and they extended their coverage for another year without a fight. My uro prescribed alprostadile

injections for me a couple of months ago and he said that they would most likely cover one or the other and they are covering both. > Its a dam shame that we have to fight them for the things that we need to feel whole again but I think the fights are finally showing results so don't' give up, and keep fighting!> Good luck,> Rick> By the way, who is your HMO? You need to put their name out here so everyone knows.> > > > > ____________ _________ _________ __> From: wonderwhat <wonderwhat72@ ...>> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Sent: Thursday, December 4, 2008 11:39:54 PM> Subject: Re: [ProstateCancerSupp ort] 5mg Daily Cialis- HM Ho! Ho! Ho!> > > I have been fighting my HoMO since August over the 5 mg Cialis. It is a lifestyle drug and nothing more to them. They do not understand

penile rehab. I asked one of the panel if they would go to rehab with a knee replacement. Answer? Of course. My response: Well how about me? I have just had an important part of me removed. This is needed for MY rehab. Turned down with dissent. Have another appeal scheduled for January (I think they are hoping I will disappear). Round 3 coming up!> > Steve S in Arkansas> > > > > ____________ _________ _________ __> From: rkushnier <rkushnierverizon (DOT) net>> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Sent: Thursday, December 4, 2008 6:39:05 PM> Subject: [ProstateCancerSupp ort] 5mg Daily Cialis- HM Ho! Ho! Ho!> > > I finally found something that worked for me... the doctor's> samples were gone... and it was time to go out and buy my own.> > I handed my pharmacist the prescription for quantity 30,>

5mg Daily dose Cialis pills.> > When I returned for pick up I was told that my HMO would> only pay for eight tablets (my monthly quota).> > "No! No!", I said. "This is a 5mg daily dose... That's> one per day. It's how the drug works".> > "Sorry", said the pharmacist, "but your HMO does not allow more> than the eight pills a month".> > "ARRRGGHH!", I said.> > Not only that, but Cialis is not considered a formulary drug> and it's copay was over and above the maximum.> > "ARRRGGHH!", I said..> > 5mg "Daily Dose" Cialis has been out for close to a year now.> You'd have thought that my HMO would have revised their drug> policy by now, but- NO!> > My HMO informed me that I could have my doctor submit a> request for consideration. If approved, I might get my 30> pills.> > Do you

think I should hold my breath? :-)> > Ron>