Re: Vent - insurance coverage on Lidoderm patches

[Guest guest]

I hear you on the feeling crappy. i am stil fighting this stupid flu thing and i

got a flu shot. Go figure. I always say fight these insurance companies. they

have no right to dictate what we need for our illnesses.

Feel better hun.

Jeanne and Dave wrote:

First of all, I'm feeling crappy for about the 3rd day in a row now. I must be

fighting a virus or something.

Onto my vent - my insurance for prescription drug coverage will not cover

Lidoderm pain patches unless I have postherpetic neuralgia. I looked up what

this is. It's a nerve condition one gets after having had shingles. Since I've

never had shingles, they say I don't need the Lidoderm patches. This only

happened last October when I needed a new prescription for them. Prior to that,

they were always covered. I can appeal the decision, but I'm wondering if I

should bother? I would state that I have DDD in three discs on my lumbar spine

as well as FM, and that I have very painful back spasms that occur throughout

the day, every day, and that the patches help me on days when I need to be more

functional. Do you guys think I should bother to fight it?

Jeanne in WI

[Guest guest]

If your physician is willing to do the paperwork to appeal for an

exception, that's your best chance. If the doc can document other

unsuccessful attempts at controlling pain first, that's the best line

of defense. Some health insurance companies want to see a trial of

other treatments before paying for the more expensive

drugs/treatments. I've appealed on my drug plan and won (sort of).

The only proton pump inhibitor my insurance will cover is Prilosec

OTC. I have to take it twice a day, so the cost is just beyond me,

when you factor in all the drugs I have to take that have a $50

monthly copay. They will not allow nexium or any of the other first

rate drugs for GERD, now that Prilosec OTC is available. They

subsidize my Prilosec, not alot, but makes it possible for me to have

the meds that work for me. I don't even have any coverage for the

generic omeprazole. Very limited drug formulary for me. So, while

they allow the Prilosec 2 X a day, I have to pay double the copay to

get it. Very expensive health insurance coverage for me, both up

front on premiums, and every time I actually have to use it.

Girlsaylor

> First of all, I'm feeling crappy for about the 3rd day in a row

now. I must be fighting a virus or something.

>

> Onto my vent - my insurance for prescription drug coverage will not

cover Lidoderm pain patches unless I have postherpetic neuralgia. I

looked up what this is. It's a nerve condition one gets after having

had shingles. Since I've never had shingles, they say I don't need

the Lidoderm patches. This only happened last October when I needed a

new prescription for them. Prior to that, they were always covered. I

can appeal the decision, but I'm wondering if I should bother? I

would state that I have DDD in three discs on my lumbar spine as well

as FM, and that I have very painful back spasms that occur throughout

the day, every day, and that the patches help me on days when I need

to be more functional. Do you guys think I should bother to fight it?

> Jeanne in WI

>

>