How do I get CoQ10 covered?

[Guest guest]

We're wanting to start Maddie on CoQ 10 (chewables or softgels), and I wanted to get it from Epic4health, but they just told me they only take Visa, MC or Discover, they have nothing to do with insurance (Maddie has Cigna and a Medicaid waiver). Maddie's doc is willing to write a script, but where do we go from there? TIA.

Holly

[Guest guest]

Holly, I add my question to yours. I was just about to post the paragraph below

when I read your post.

I expect there is

probably a seasoned mito pro around who can guide us through the maze.

Someone on one of the Forums told me that some insurance companies will pay for

Q gel

with a mito disease diagnosis because it has an " orphan drug " status.

Just got off the phone trying to find out if my insurance company will pay for Q

gel

" because it has orphan drug status' and thay haven't a clue as to what I'm

talking about.

Neithe, to be honest, do I. Can anybody clue me in?

Thanks, Anita

[Guest guest]

> Holly,

I don't know what state you live in, I had to fight like crazy to

get 's tishcon qgel covered. The doc applied and appealed and

they said no. I wrote a letter and sent info on the use of coq10 and

mito. I also sent info on the better absorption of qgel as opposed

to other coq10. With a little threatening, ohio medicaid waiver

approved it. If you happen to live in Ohio it is covered now for

everyone. If not, I know that some other states are following suite.

I would start by getting a script and giving to the pharmacist you

use and they can start the process I believe.

Good luck, Dawn

[Guest guest]

Thanks Dawn,

The script itself is not a problem- it's the "what do we do with it after that" problem. Tishcon refers me to Epic and Epic says they don't take insurance. How do I get them to submit it/take the script one it is authorized, or do you use a special pharmacy? We go to Walmart, where the pharmacist has always gone out of his way to help Maddie. We're in NM, by the way.

Holly

Re: How do I get CoQ10 covered?

> Holly, I don't know what state you live in, I had to fight like crazy to get 's tishcon qgel covered. The doc applied and appealed and they said no. I wrote a letter and sent info on the use of coq10 and mito. I also sent info on the better absorption of qgel as opposed to other coq10. With a little threatening, ohio medicaid waiver approved it. If you happen to live in Ohio it is covered now for everyone. If not, I know that some other states are following suite. I would start by getting a script and giving to the pharmacist you use and they can start the process I believe. Good luck, DawnPlease contact mito-owner with any problems or questions.

[Guest guest]

Holly,

I would give the script to your pharmicist. Have him try to pre-

authorize it through medicaid. Once it is denied (which it probably

will be) then you can have your doc write a letter of appeal. Find

out from you pharmacist or doctor the fax # and the name of the

person handling the appeal for medicaid. I directed my info and

letter to him directly-Like a case manager or something. Write a

strong and threatening (not threatening them, but use phrases

like:If My child does not recieve this medication, they could

quickly decrease or die). It sound harsh but it works. Tell them

without their help, that you cannot afford to buy it.

If and when it is approved, our pharmacy buys it through epic and

gives it to me. They have a NDC number at epic for the liquid

qgel.This you have to have to get it approved.

Let me know if I can help any further, Dawn

[Guest guest]

Thanks Dawn-

Thats the info I was looking for. The insurance co. seems to think that if it isn't in their log it isn't available. Does the pharmacy have it sent directly to you?

Re: How do I get CoQ10 covered?

Holly, I would give the script to your pharmicist. Have him try to pre-authorize it through medicaid. Once it is denied (which it probably will be) then you can have your doc write a letter of appeal. Find out from you pharmacist or doctor the fax # and the name of the person handling the appeal for medicaid. I directed my info and letter to him directly-Like a case manager or something. Write a strong and threatening (not threatening them, but use phrases like:If My child does not recieve this medication, they could quickly decrease or die). It sound harsh but it works. Tell them without their help, that you cannot afford to buy it. If and when it is approved, our pharmacy buys it through epic and gives it to me. They have a NDC number at epic for the liquid qgel.This you have to have to get it approved. Let me know if I can help any further, DawnPlease contact mito-owner with any problems or questions.