Can federal health plans be legally compelled to cover (or consider covering) CoQ10 for Mito?

[Guest guest]

Any lawyers here? Wondering if there might be a way to convince or compel

health insurance plans - particularly federal plans, like Medicare, Medicaid,

the Federal Employee plans, etc. - to cover some of the cost of CoQ10 and maybe

some other supplements recommended for Mito. My thinking is that in a situation

where someone has a significant disease, for which there is no prescription drug

or other billable treatment, but a specialist recommends an over-the-counter

supplement like CoQ10 as a treatment, insurance plans should cover some of the

cost. I'm wondering if these plans or their contracts with or requirements from

the government have language to the effect that there can or should be coverage

in such a situation or that the enrollee can petition for an exception to

non-coverage policy in such a situation. Also wondering if any of these plans

have language or requirements from the government that they can or should cover

supplements that have orphan drug status for the disease or condition in

question. I'm wondering this since a few of you have mentioned that federal

plans, including Tricare, some state Medicaid plans and Blue Cross, sometimes do

cover some of the costs for CoQ10. It seems there should have been a provision

to cover a situation like this in the new Medicare Rx plan, but since it was

mainly written for the benefit of the drug companies, would not be surprising if

this wasn't even considered.

I am putting this question in writing to my Congressman after talking to his

aide on health care, per her suggestion. But I'm wondering if there are any

possible legal avenues here.

Will always take free legal advice, so thanks in advance!

Randall

[Guest guest]

--- Randall Bosin ranbo1@...> wrote:

> Any lawyers here? Wondering if there might be a way

> to convince or compel health insurance plans -

> particularly federal plans, like Medicare, Medicaid,

> the Federal Employee plans, etc. - to cover some of

> the cost of CoQ10 and maybe some other supplements

> recommended for Mito.

I'm a nurse, not a lawyer. But I'd be surprised if one

cold force health plans to add an OTC med. Even though

some brands of it have orphan drug status they are

OTC. Many health plans specifically exclude OTC meds.

Think of prilosec. It's not available in many health

plans because it's OTC.

Remember, also, that the cocktail's use is not

supported by double blind placebo controlled studies

so it's not really a (research supported) treatment

for mito.

Mom to the two best kids in the world!

http://www.caringbridge.org/visit/thomasandkatie

__________________________________________________

[Guest guest]

>

> > Any lawyers here? Wondering if there might be a way

> > to convince or compel health insurance plans -

> > particularly federal plans, like Medicare, Medicaid,

> > the Federal Employee plans, etc. - to cover some of

> > the cost of CoQ10 and maybe some other supplements

> > recommended for Mito.

>

>any interest in trying to compel one of the coq10 manufacturing

companies to offer their product at a reduced rate for individuals

with mitochondrial disease diagnosis? cannot hurt to ask, esp if one

could represent a significant # of individuals sufferring from the

disease......possibly thru the organization representing people with

mito diseses??? i think pharm companies have done so in the past....

[Guest guest]

Tishcon already does this - 10% discount with mito diagnosis. I'm not

sure about getting it with a suspected diagnosis.

laurie

> >any interest in trying to compel one of the coq10 manufacturing

> companies to offer their product at a reduced rate for individuals

> with mitochondrial disease diagnosis? cannot hurt to ask, esp if one

> could represent a significant # of individuals sufferring from the

> disease......possibly thru the organization representing people with

> mito diseses??? i think pharm companies have done so in the past....

[Guest guest]

--- Laurie Fitzgerald laurie.fitzgerald@...>

wrote:

> Tishcon already does this - 10% discount with mito

> diagnosis. I'm not

> sure about getting it with a suspected diagnosis.

It's still far less expensive to purchase it at

discount stores.

Mom to the two best kids in the world!

http://www.caringbridge.org/visit/thomasandkatie

__________________________________________________

[Guest guest]

and Randall

I think the important thing is that each of us finds a kind of CoQ10

that both helps us at a given dose that we can afford. Taking a dose

that is inadequate might be wasting money as far as I am concerned. It

is the same with taking some things in excess, as the body just gets

rid of it. For some us, Coq10 seems to make us worse. I think it is an

individual choice determined by our desires, response and ability to

pay the price. They sure aren't easy decisions.

laurie

>

>

>

>

>

>

>

>

> --- Laurie Fitzgerald laurie.fitzgerald@...>

>

> wrote:

>

> > Tishcon already does this - 10% discount with mito

> > diagnosis. I'm not

> > sure about getting it with a suspected diagnosis.

>

> It's still far less expensive to purchase it at

> discount stores.

>

>

>

>

> Mom to the two best kids in the world!

> http://www.caringbridge.org/visit/thomasandkatie

>

> __________________________________________________

>

[Guest guest]

Some of the studies Epic sent me make it seem as if CoQ10 (other than Tishcon's

Q-Gel) barely raises the plasma levels (at least at the dosages used, like 120

mg) and by inference, the tissue levels of CoQ10. I would think the researchers

who have used CoQ10 would have some sense of issues like this, since it would be

pretty important for any clinical studies.

Randall

Re: Can federal health plans be legally compelled to cover

(or consider covering) CoQ10 for Mito?

and Randall

I think the important thing is that each of us finds a kind of CoQ10

that both helps us at a given dose that we can afford. Taking a dose

that is inadequate might be wasting money as far as I am concerned. It

is the same with taking some things in excess, as the body just gets

rid of it. For some us, Coq10 seems to make us worse. I think it is an

individual choice determined by our desires, response and ability to

pay the price. They sure aren't easy decisions.

laurie

>

>

>

>

>

>

>

>

> --- Laurie Fitzgerald laurie.fitzgerald@...>

>

> wrote:

>

> > Tishcon already does this - 10% discount with mito

> > diagnosis. I'm not

> > sure about getting it with a suspected diagnosis.

>

> It's still far less expensive to purchase it at

> discount stores.

>

>

>

>

> Mom to the two best kids in the world!

> http://www.caringbridge.org/visit/thomasandkatie

>

> __________________________________________________

>

[Guest guest]

--- Randall Bosin ranbo1@...> wrote:

> Some of the studies Epic sent me make it seem as if

> CoQ10 (other than Tishcon's Q-Gel) barely raises the

> plasma levels

Many with mito have difficulty raising their CoQ10

levels even with huge doses of CoQ10.

Mom to the two best kids in the world!

http://www.caringbridge.org/visit/thomasandkatie

__________________________________________________