Guest guest Posted December 9, 2003 Report Share Posted December 9, 2003 PLEASE CALL ME 1- . Maybe we can get this reversed . We can try :) Call & ask for enrollment . Carol or Meloyde. Explain what you have said her. Let them work with the ins. company & see what they can do . Sometimes they work Miracles. before they let you go, get transferred to me. OR talk to me first. I have an appt this morning at 9:30. they are filming our Rx for some TX fund raiser but after that , I am free BUT you really should talk to the other gals first & let the get working on insurance. Either way , we can do . We do most all insurances & both of those for sure(even if not in books --we are providers as a specialty Rx:):) LOVE & hugs, GrandmomBEV COLY Traci's has been on inhaled COLY for about 8 months. For the first 3 months we had Aetna insurance and they considered it a RX drug and we got it from the Walgreens Pharmacy. We now have BCBS and they consider it an IV drug.Even though Traci inhales it. So.. I can't get it anywhere but an IV drug supplier. We got the bill. for $675.00 for a 30 day supply. That is our 20% after the insurance pays 80%. We can't afford that every other month. Anyone have a solution? ------------------------------------------- The opinions and information exchanged on this list should IN NO WAY be construed as medical advice. PLEASE CONSULT YOUR PHYSICIAN BEFORE CHANGING ANY MEDICATIONS OR TREATMENTS. ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2003 Report Share Posted December 9, 2003 First, have the CF Center - even the Foundation - contact them and explain the use of Coly. Second, each state (in USA) has Insurance Board - I think - contact them. I believe that have to respond quickly. Do NOT pay!!!!!!!! Once you pay its hard to get the money back. Your problem is NOT uncommon. I think it really takes Dr., CF Center intervening.......... Good Luck. Rosemary in NY with 3 children (13, 11 and 7) with CF. I have a dog named TOBI and have coined the phrase " BREATHE DAMMIT " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2003 Report Share Posted December 9, 2003 I had a thought on this as I was going to sleep last night... I know that's a lot of money, but depending on your plan, you might have a yearly out-of-pocket maximum. I think if you have the BCBS POS or PPO plans that might be the case. Anyway, you should call BCBS and see about the reclassification, as already mentioned. I've found them to be highly inflexible (we have Blue Shield HMO) but it's possible you could get a sympathetic case manager and get things changed. Becky mom of Ricky 8 with CF and Andy 5 no CF > COLY > > > Traci's has been on inhaled COLY for about 8 months. For the first 3 months > we had Aetna insurance and they considered it a RX drug and we got it from the > Walgreens Pharmacy. We now have BCBS and they consider it an IV drug.Even > though Traci inhales it. So.. I can't get it anywhere but an IV drug supplier. We > got the bill. for $675.00 for a 30 day supply. That is our 20% after the > insurance pays 80%. We can't afford that every other month. Anyone have a solution? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2003 Report Share Posted December 9, 2003 Is there anyway you can get BCBS to reclassify the drug. You might try getting a case worker at BCBS to help you and then appeal to have the drug reclassified. If that doesn't work you might then have to file an appeal with your state insurance commissioner. It is time consuming but would work to your advantage. Also, if someone in your HR Dept. could contact the BCBS Sales Rep you might get quicker action - the sales reps usually get nervous if they think a company will change insurance due to poor service. Best of Luck, COLY Traci's has been on inhaled COLY for about 8 months. For the first 3 months we had Aetna insurance and they considered it a RX drug and we got it from the Walgreens Pharmacy. We now have BCBS and they consider it an IV drug.Even though Traci inhales it. So.. I can't get it anywhere but an IV drug supplier. We got the bill. for $675.00 for a 30 day supply. That is our 20% after the insurance pays 80%. We can't afford that every other month. Anyone have a solution? ------------------------------------------- The opinions and information exchanged on this list should IN NO WAY be construed as medical advice. PLEASE CONSULT YOUR PHYSICIAN BEFORE CHANGING ANY MEDICATIONS OR TREATMENTS. ------------------------------------ Quote Link to comment Share on other sites More sharing options...
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