Re: melt down - battling insurance co. for anti-depressants

[Guest guest]

Dang!!! I have BCBS as well. I take Cymbalta. I hope I don't lose mine!!! I

am not taking it for pain, maybe that is why you can't get it, if you are taking

it for pain and not depression. I don't know, so don't get mad. Just curious

as to why they would remove it from the accepted list.

Annie

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[Guest guest]

Annie - don't worry - I'm not mad. Maybe at the insurance company but

that's about it.

We (myself as well as the doctor) were trying to tell the insurance company

that I take the Effexor as part of my fibro which goes hand in hand with the

depression - they said when the drug comes in, they don't look at the

diagnosis or what it's given for - only that it falls under the category of

mental illness and it's refused. I asked about other anti-depressants (even

Cymbalta) and they said they would not be covered, unless you have some type

of rider or provision in your policy that covers mental illness. Hope you

have a better outcome than I did.

It's funny because they covered it all of last year and just now are denying

it.

Teri (central WI)

Re: melt down - battling insurance co. for anti-depressants

Dang!!! I have BCBS as well. I take Cymbalta. I hope I don't lose mine!!! I

am not taking it for pain, maybe that is why you can't get it, if you are

taking it for pain and not depression. I don't know, so don't get mad. Just

curious as to why they would remove it from the accepted list.

Annie

[Guest guest]

Teri,

I am covered under metal illness, so I hope I won't have a problem. This is

just ridiculous!!! Good luck,

hugs,

Annie

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[Guest guest]

I have BCBS too, through my hubby's work. Policies through companies, it is the

company that decides on what will be covered and what won't, to cut down on

their corporate expenses. The more things they allow, the higher their costs

and the higher the employee's costs as well.

As far as the drugs go, I think they really want people to use the cheapest

options available. The only ones I've been denied at this point are the

Lidoderm patches and the Provigil. My psychiatrist was able to obtain

authorization for the Provigil. I still need to file an appeal with regards to

the Lidoderm patches. Our drug coverage is through Medco. They try to get

me/us to see how we can save money by trying a cheaper alternative. For

example, I take Nexium, and they encourage me to switch to generic Prilosec.

But years ago, Prilosec did not work well for me, so I don't want to switch. So

far, I don't have to, it's only a suggestion.

It sounds like Teri's biggest problem is that she has an individual policy,

so they can say no all they want to, and she doesn't have much leverage to fight

with. And we know that each person reacts differently to the anti-d's and has

one that works the best. The insurace co's don't care, it's all about the every

lovin' dollar to them.

If it helps any Teri, I did switch from Effexor to Cymbalta without any

difficulty. I did taper off the Effexor while going on the Cymbalta. I had had

a bad experience prior to this going off Effexor to something different without

tapering off and ended up on the psych floor for a night. So do not stop cold

turkey, Teri. Take care.

Jeanne in WI

Dang!!! I have BCBS as well. I take Cymbalta. I hope I don't lose mine!!!

I am not taking it for pain, maybe that is why you can't get it, if you are

taking it for pain and not depression. I don't know, so don't get mad. Just

curious as to why they would remove it from the accepted list.

Annie