Humana Denying Suboxone

Subject: Humana Denying Suboxone Sat 23 Apr 2011, 8:30 pm

Good Evening,

Thank you Dee for helping me to get back into the site.

I've not been here in quite some time. A few years ago I was on Suboxone and then I've had several surgeries and started my addiction all over again. So,I'm back and trying again. This time I'm going to try to not beat myself up as I've done in the past.
I found a great Dr. and best of all he didn't let me know I was a addict(I already know that) and didn't tell me what I HAD to do or would fail. He offered me the new Suboxone film and therapy and a few other sources for help.

Now,I should have known that was too easy without running into a problem.
Humana will not cover it. I went ahead and paid for a week worth of meds. No way will I be able to do that again. I'm appealing there decision. They said I could not be taking opiates or any other kind of narcotic. I tried to explain to them I'm aware of this and I was told they would contact me in 72 hours. As I was searching around last night I came upon a article that threw me into a panic. A dr. was writing how he had a pt. that was denied by Humana several times and that they changed there policy and didn't have to tell the provider that it was being changed. When I was on it before I had no problem.
Now,they willing to pay for my many scripts of narcotics but not for me to get off of them. I personally feel it's a attack of a addict,per say.
I have the link to the article but didn't know if it was okay to put it here or not.

I know without a doubt if I don't get this approved that there is no way I'll stay off the opiates,at least at this time with all the opiates I've had the w/d would be horrific.

I also have Lupus and a history of seizures. You would think if I was to have a seizure and end up in the hospital it would cost them awhole lot more than the price of the Suboxone.
I guess what gets me even more is,who is this person making a decision for those of us wanting and needing to get off the opiates? Obviously,someone sitting behind a desk with no knowledge of what these meds are for.

Anyway,I'll spare everyone the rest of my whining at this moment.
What I would like to know is if anyone else has had this problem with Humana? If so,what you were able to do to get approved.
If it is okay for me to link to the article I was referring to or someone would like to see it please let me know and I'll send it to you.

I'm so happy to know this group is still here. I know it was very helpful to me before. I didn't post much but I certainly read everything on here.

I love the lil Emotions u can insert in ur post. When I feel more at ease I'll use them.

Happy Easter!!!

Blessing to all

Marie

Subject: Re: Humana Denying Suboxone Sat 23 Apr 2011, 10:04 pm

Hello cajunmeme!
It was no problem at all. I understand your problem and am checking into it.
I did find the guidelines for Humana and am reading as fast as I can for you. I hate insurance companies and don't understand why they make things so difficult for patients.

No problem with that link, I would like too read that article and if you would post it, it would be a help.

I do see on here where they can change their formulary's but if a patient is on that current drug they will notify the patient and give them a 60 day notice.
I'm going to email you the Humana guidelines that I found. Please let me know if you get it. If not I can send it again.
In the meantime I am gong to keep reading tonight. I'll be here if you need me.
Please don't think your whining. This is what we are here for and I am happy to do whatever I can for you. Are you also on Medicaid or just the Humana?
Dee

Subject: Re: Humana Denying Suboxone Sat 23 Apr 2011, 10:15 pm

okay I'm back. Thank your for waiting for me to do a little reading about Humana.

The page that I was reading was the 2011 guidelines for Humana. According to this guide they do cover buprenorphine in the 2mg and 8mg tablets. They also cover Suboxone in the 2mg or 8/2mg tablets.
But that's just it, they cover the tablets, not the strips.

It maybe because the strips are still new. I'm not sure.
Which is weird. In the state that I live in effective January all new patents receiving Suboxone has to be prescribed the Strips in order for it to be covered by Medicaid. I know it's not the same as your insurance but I assumed it would be the same for all insurance companies.

When you talked to the people at Humana did they mention the tablets to you at all?

Here's the link so you can download and take a look at the guidelines. It's a large file and if you don't want to save it to your computer you can open it and read it online.
Let me know what you think.

http://www.humana-medicare.com/benefitsummary/2011pdfs/S2874004PDG1133711C.pdf

Subject: Re: Humana Denying Suboxone Sat 23 Apr 2011, 11:06 pm

nannamom wrote:: okay I'm back. Thank your for waiting for me to do a little reading about Humana.

The page that I was reading was the 2011 guidelines for Humana. According to this guide they do cover buprenorphine in the 2mg and 8mg tablets. They also cover Suboxone in the 2mg or 8/2mg tablets.
But that's just it, they cover the tablets, not the strips.

It maybe because the strips are still new. I'm not sure.
Which is weird. In the state that I live in effective January all new patents receiving Suboxone has to be prescribed the Strips in order for it to be covered by Medicaid. I know it's not the same as your insurance but I assumed it would be the same for all insurance companies.

When you talked to the people at Humana did they mention the tablets to you at all?

Here's the link so you can download and take a look at the guidelines. It's a large file and if you don't want to save it to your computer you can open it and read it online.
Let me know what you think.

http://www.humana-medicare.com/benefitsummary/2011pdfs/S2874004PDG11337

Nanamom,
Thank you so much for your time. This is so nice of you.

I'm going to go open that up and read it.
I'm on Soc.Sec. and Humana is with Medicare.
They wouldn't let me tell them much of anything other than someone will call me which I intend to get with them come Monday. They were more concerned with the past drugs I was taking.
If it means me having to change over to the tablets I'm sure my Dr. will do so. I have to say though with my darn addicted brain I liked the strips b/c I felt like I wasn't popping a pill in my mouth. I know that strange but to me the strips lasted longer. I've actually,cut them in half. Awhile back I remember someone from this site,posibbly it was you that had said.."Less is better". I've thought of that many of times.
I'm hoping I'm responding to your post correctly. I'm new to the site again and have to figure my way thru here.
I'm going to go check this out that you sent to me and let you know.

Once again,thank you so very much. We need more people like you.

Blessings,
Marie

Subject: Humana Denying Suboxone Sat 23 Apr 2011, 11:27 pm

Nanamom,
I'm not able to get into that link.
So,I'm going to go to the Humana site and try to pull it up. This gives me a great place to start. I don't know why I'm not able to open that file. I had gone to the Humana site the other day and was not able to find this or maybe I was just so upset I was over looking it.
I'll let you know.

Thanks
Marie

Subject: Humana Denying Suboxone Sun 24 Apr 2011, 12:35 am

Okay, I was able to finally open the link u sent me. When I tried to sign on at the Humana site and access to the site for the drugs covered it kept coming up saying,the site was temp. down. I went and pulled out the books on my coverage and I sure pray that I don't have to go thru all the appeals they talk about especially since it says I'm covered. Hopefully,it's just b/c of the strips but I'm not sure.
This is terribly stressful. If this is not resolved in a couple of days I won't be able to afford to buy more. I guess the best thing for me to do is to cut my dosage down and try to save as much as I can. They have passed there 72 hours of answering me but it will probably be said "72 hr. working days". Of which of course they did not tell me. I'm also going to run by my Dr. office and see if they can also fax something to them.
I know I must turn this over to God but I also know I have to do my part even if it is stressful.
I find a Dr. that is wanting to help me without all the stigma that goes with this only to have to fight with a employee that has no medical degree.
Hopefully,this will get resolved and some how it may help someone else so they won't have to go thru this.

Thank you for all your help.

I'm hoping maybe someone will come by this site and see this and perhaps had to deal with this and have some helpful suggestion.
I hope this is not going to be something we going to start seeing with Ins and Suboxone.

Happy Easter!!!!

Blessings,
Marie

Subject: Re: Humana Denying Suboxone Sun 24 Apr 2011, 12:37 am

That's ok don't worry. I saved the file to my computer just in case so I will send it as an attachment in an email now so you can have it.

About the strips. We do have some members here that are using the strips and they say they seem to work better for them. Quicker onset and a faster dissolve time.
I've had a lot of people tell me they cut them in half. I have a question about that. When you cut the strips in half, how do you store them? Are you able to put them back in the package they came in? Do you know how long they would last that way.
Say if you took 1/2 a day would it be okay that way.
I don't have any experience so far with the strips, but I imagine that since Vermont is taking steps to make sure new patients start on the strips it's only a matter of time before everyone else is switched over as well.
I'll go send that email now.

Subject: Humana Denying Suboxone Sun 24 Apr 2011, 12:54 am

I got it,thank you.

Yes,you can cut it in half and the package it comes in is sealed tight so I've put it back in and save it till next dosage.
I would prefer the strips b/c with the tablet if u go to cut it some of it can scatter or u loose some of it. With the strip it cuts nicely and works quicker and I feel it last longer.

I'm emotionally exhausted now.....

Thanks for everything.

Marie

Subject: Re: Humana Denying Suboxone Sun 24 Apr 2011, 1:34 am

No problem Marie,
Get some rest and have a Happy Easter.

Subject: Re: Humana Denying Suboxone Mon 25 Apr 2011, 9:47 pm

Thought I'd give a update with my Ins. Humana.

I talked to someone this morning who told me to call my Dr. to have this Expidited. Well,to get someone to answer the phone or call u back is like a act of congress. so,I got up and went to the office with all the info and phone numbers needed. The nurse assured me she would handle this and call me as soon as she talked to them. I never heard back from her. I called the Ins. back and the Dept. for this was closed 15minutes ago.
However,I did get to talk to someone else and she tried to see if she could tell me anything. She could find NOTHING. This tells me either the Ins. Co. did not send the Appeal in last week and or the Dr. office has done nothing.
My guess is,they have both screwed this up.

Some how I'm going to try to get the money together to get 2 more days of the Suboxone. I can't keep doing this but if I don't do it I feel safe to say I'll go back to that nightmare of the pills. Not only would that not be good for me but I'd never get the Ins. pay for this and if the Dr. got wind of it he'd let me go so I feel I'm in a screwed up position.
If they would all do jobs many ppl would not have to go thru all of this. Don't they get that getting off of pain pills is a serious situation? Or do they just not care? I figure a little of both.

I'll keep u updated.

Marie

Subject: Re: Humana Denying Suboxone Tue 26 Apr 2011, 12:26 am

I know this is so frustrating and I do know how you feel. This isn't me that it's happening to and I am frustrated just reading it.
What do they expect you to do? Just sit there and say "oh it's ok?" It's not okay and it's not acceptable. But on the other hand just what are you supposed to do.

Do like you have and try to stay calm when you talk to anyone. I can bet you that when you do talk with the insurance company, the blame may be put on the doctors office. And when you talk with the nurse she may either say she did what she was supposed to or, she didn't have a chance to take care of it because she was so busy.

Cases like this make me appreciate my provider so much more. When I go in and ask for something to be done. It gets done. It is a small office with one office person. This person not only is the nurse but the receptionist as well. She just finished nursing school. And as busy as she is, she still finds the time to do what needs to be done.
My provider not only sees Suboxone Patients but other mental health patients as well. She has a full schedule all day but still finds time for whoever needs her.

Is there anyway that you can print out the $45 coupon ( I may have earlier said it was for $75 but I was mistaken, this one is for $45.00) to use for your Suboxone? It is for the strips and not the tablets. Since you are using the strips it may help. But you can only use it once a month so try to get what you can with it. At least to tide you over until you get this sorted out.
The makers of Suboxone do have the patient assistance program but it's only for people without insurance.
Here's the link for the coupon if you decide to use it:

http://suboxone.com/patients/here_to_help/copay.aspx?cid=subx
Once you click on that link you will see a button to click on for your card.
If you have a pop up blocker installed you will have to hold down the ctrl button on your keyboard to get the PDF file to load.
Once that file loads, print that page. Try to use card stock so the card will be stronger. You can use the card once a month until the end of September of this year.
Please let me know how it goes if and when you get to talk with either the insurance company or doctors office again. And you might want to do like you did today if you can, go into the office and don't trust thisto do done over the phone. When is your next appointment with the doctor himself?
Good luck, get some rest.

Subject: Humana Denying Suboxone Fri 29 Apr 2011, 8:40 am

I thought I'd give a update on my Appeal with Human and my Suboxone.

I've been dealing with this everyday for the last 2 weeks. I keep calling Humana and the Dr.'s office with no one answering me.
I finally started calling the Ins. several times a day and emailing them. The ppl that answers the emails really need to be educated about Suboxone. Actually,lots of them need to be educated.

Finally yesterday,Ins. Co. called me back. They told me that the Dr.'s office did NOT send the proper info. I called the Dr. office AGAIN and someone called me back shortly after. That was a miracle.
Well,she was full of a "defense attitude". I told her I was not trying to put blame on anyone,I just needed someone to help me.
I told her I was doing everything the Dr. told me with therapy and such. She acted shocked I was doing this. I also told her that I was very stressed out over this. She told me there was no need for me to be stressing. Excuse Me!!!!!
I faxed the info to her only to find out it didn't go thru.
When I checked my mail yesterday afternoon there was a letter from Humana telling me once again I can not be taking narcotics. Also,that I can not be on Methadone. I'm not on Methadone. They just don't get it.

They did say in the letter that it can be Expidited in 72 hours if my Dr. would say it could cause a health problem. Well,I have a history of seizures and if I have to go cold turkey that could very well cause me a seizure. I'm hoping that he will stress this.

The office opens at 5:00 Am. Can u believe that? So,I went to the office and brought the paper work to them and hopefully someone will do there job.
I was able to buy a few more Suboxone Films and trying to stretch them.

It's so sad to think that many ppl like myself have to go thru this.
The Ins. Co.'s need to be better educated for Suboxone.

If I can get this approved I'd like to be able to go forward and see what I can do to see how we can get this better understood. I don't know how or what I'll do but I can't just let it go.

I'll keep you updated in case anyone is having the same problem. If you are,don't give up.

Marie

Subject: Re: Humana Denying Suboxone Sat 30 Apr 2011, 12:16 am

(In this case it's big umph)

And the woman from the doctors office told you that there was no reason for you to be stressed out?!
Excuse me, but it is YOU and not her that is in fear of having to go without your medication. I would like to tell you my opinion of this office but with the position that I hold within this organization I don't think I should. Not on this forum anyway.

This is completely ridiculous that you have had to go through so much just to have the insurance company pay for a medication that is actually approved according to their formulary. And why did they say that you cannot be taking Methadone? That is also one of their approved drugs. I also noticed when reading over the guidelines this evening they pay for these medications if you were to receive them through the mail as well.
If you look at the information it says; MO which stands for Mail Order. Now doesn't that take the cake.
Anyway the lapse of help that you are getting from this office is inexcusable. I wonder how they would fair if they received a visit from the inspectors. If this keeps up, please think about filing a grievance. You would not have to give your name. Once a total of three complaints are received on a doctor they will launch an investigation. They will send someone in undercover to check out and see just what is going on. You can also file a complaint with Suboxone. They don't like it very much when the providers aren't doing things the way they should be.

You have worked hard on your recovery so it's not too much to ask for some consideration. If they do not want to do their job, then they do not need to be in the position they are in.
I agree with you completely Marie. If anyone else is going through the same problem, please don't give up.
It may take some time but there will be a light at the end of the tunnel.

Another question, why are they telling you that you cannot take narcotics? Is it because of your addiction? If so, don't they know what suboxone is? And about the reporting, I'm not sure and I can check this out but you may be able to report this to the insurance commission in your state. But like I said I'd have to check into it. I remember when I was hit by a car a couple of years ago, I was being stalled by the insurance company and I learned that I could report the company.
So, what about applying for medicaid in your state. Can you if you are currently on disability? I know that in my state because I am on disability I qualify for medicaid.
Thanks for the update. I am keeping you in my thoughts everyday.

Subject: Re: Humana Denying Suboxone Sat 30 Apr 2011, 12:18 am

I also wanted to ad that when this is over and you move forward to insure this doesn't happen to others, I will be behind you all the way. If you want help, let me know. I don't know what I can do. Just let me know. I'll do whatever it takes.
All it takes is one person to make a difference.

Subject: Humana Denying Suboxone Sat 30 Apr 2011, 5:26 pm

Hey Dee,
Thanks for always responding to my post.

I can't get medicaid b/c I have a husband who has a job. I also can't get SSI b/c ot it. Only SS for my disability with the Lupus.

You know,it's so hard to find a Dr. willing to take my Ins. for the office visits for Suboxone that I'm at there mercy for the time being. I'm trying to not get too pissy just yet. Although,I have been with the Ins. Co.
I can't tell you how hard it is for me to not get pissy with the Dr. I'm not the kind to usually take this much incompetence especially when it comes to the Medical Field. I think alot of them are as clueless as can be. It's just a job to many of them.

You right about the Formula saying the Ins. covers Suboxone. I think if I hear one more time that I'm not to be on narcotics I might just scream.
It's really scary to think of what they put us thru and they know nothing about the drug they denying. If I was the kind of person to just say,Oh well,they say no so it's no. That's not my personality. It's also my life they playing with.
I know I'm not the only one out there with this problem. I would hoope anyone else to have this problem will not just accept NO.

I'll let you know what I decide to do after this is resolved and would greatly appreciate and accept your offer to help.

Don't you just love her telling me there is no reason for me to be stressed? That tells me right there that she doesn't understand addiction. I think they just blow many of us off as addicts and it's part of our punishment.
Trust me,I've punished mysel enough i certainly don't need anyone to have that attitude.

I'll keep in touch

Marie

Subject: Re: Humana Denying Suboxone Sun 01 May 2011, 12:48 am

Marie,
I don't have Medicare yet as I've only had my disability since last September. I have to wait 2 years before I am eligible and after hearing what you're going through I am thankful that I don't have it.
Having Medicaid is kind of similar when it comes to any doctor wanting to treat you.
When you first get Medicaid you have a certain length of time to find a primary care provider and notify Medicaid who it is. But the problem with that is there aren't really any in my area who are taking new Medicaid patients.
I told this to Medicaid and they gave me the names of some who do accept. But when you call them it is always the same old story. We aren't accepting new Medicaid patients so then you're pretty much screwed.
I can't really blame the doctors either, Medicaid doesn't pay much to the doctors that do accept it. It's kind of a no win situation. I hate to see how it is when everyone will be required to have insurance.
Education about Suboxone is a must. In fact it's my personal belief that anyone who works in an environment that deals with medication needs to have a certain amount of education about certain medications.
Take Suboxone for instance, in order to be able to prescribe it doctors are supposed to take a course and be certified to prescribe among other things.. The class they have to take is actually available online so anyone from that particular office can take the course.
Continuing education needs to be necessary for anyone who works in this field. This is our lives we are talking about. Yes, we are addicts but we are struggling to change our lives and that's not easy and when we have people who don't understand or even care it makes it that much harder.
Good luck Marie, I'm always here if you need me.

Subject: Humana Denying Suboxone Mon 02 May 2011, 7:59 pm

Okay here we go again with Humana.
As I do everday I called Ins. Co and the Dr. office of which no one has returned my calls. So,I thought let me try to call a different dept. and see if they could at least tell me if the Dr. office sent the info in.
She told me it looked like it was "pending". Now,I would like to think that means the Dr. sent the info in and they working on it. Or,do they know it's being appealed? Last time I was told they had not received anything from the Dr. I don't want to get my hopes up just yet.
Then I went into the fear of,what if they still deny me?

If ppl that get paid to at least answer the phone could call me back I'd at least know where I stand. If my Dr. didn't send exactly what they needed then I go to a higher appeal and this will take longer. As far as me having the Suboxene,I just went and bought enough for 5 more days. I'm really putting us in a bad financial situation. When I was popping pills like tic tacs it cost me 6.00..This is nuts. If I hear one more time that I can not be taking narcotics or that I have no reason to be stressed from them I know I'll have a freak attack.

If and this is a big if,but,if I get approved I bet it will take months to get my money back. However,just not having to put out anymore money would be a big plus. Also,I want to be able to move on in my recovery. I'm in a stuck mode right now.

I have a Care Coach I spoke to today and she asked me what was my goals.
Gee,I'm so wrapped up in this Ins. crap that I'm unable to think beyond this.

My fear is to have to go cold turkey and we all know how bad that is. I'm always scared that it will be so bad that I'll go and try to get a script. I don't want to go back to that.

I know I've said this before,but,why is it so easy to get the pills and so difficult to get help to get off them?
I go back to these ppl in charge of my future to be better educated. It's obviously just a pay check to them.

I'll keep you updated and I pray to be able to come here and say let's celebrate that I got approved.

I would like to know if anyone else ahs had this problem with Humana or any other Ins.

Marie

Subject: Re: Humana Denying Suboxone Tue 03 May 2011, 3:48 pm

Then this for the time being is your goal. To get this insurance straightened out. Can your coach do anything to help? I'm not sure what the job of the Coach is.

Narcotics, I hate that words. Of course you know your not to be taking them and your not. You are abiding by your treatment or at least trying to.
I want to make some phone calls to different insurance companies and see what their stance is. I will let you know.

Subject: Humana Denying Suboxone Tue 03 May 2011, 4:26 pm

Oh Dee,
You won't believe this one.
I called the Ins. and they said they had nothing from the dr. office. So,I call them and she says that the Dr. does not do this for Appealing a Denial. I waited for 35 minutes for them to come back. She said I would have to find another way to pay for my meds.
I called the Ins. back and asked what I could do. She asked me for the Dr. phone number and put me on hold. She came back and said the answering service came on. I told her it was impossible to get them answer or call back.

So,I went to the office with the info,AGAIN. I told her the Ins. Co. said they do not need the Dr. to get involved. Nurse said,she could not say i could have a seizure without the meds and that she would have to involve the Dr. I asked her to please help me.
So,we'll see what happens.
I don't believe he has never done this before. The nurse wants me to just give it up.
I can't do that.
I do have a appt. with him next week and if this doesn't get resolved by then I'll talk to him. I'll also talk to him about Subutex b/c the nurse said he doesn't write scripts for that.

I'll let you know what happens.

Thanks for all your help

Marie

Subject: Re: Humana Denying Suboxone Wed 04 May 2011, 12:41 am

I do believe it. What I don't believe or can't get over is this office staff. The office staff needs to be properly trained in handling patients properly. I would like to be able to say this leaves me speechless but it doesn't I can think of a lot of things I would like to say but I can't on here. But I'm sure you get my drift.

No paperwork from the doctor's office? None? Then what have they been doing all this time. This reminds me of something that Beth went through with one of her providers. Believe me she has had some doozies. Her posts are somewhere around here.
She went through hell.

Have you asked the insurance company if there is a problem because of you being on the strips and not the tablets. I still don't get why they keep saying you cannot take a narcotic.

You might have to make some phone calls to find out what carrier you can switch to that will cover your prescription. I can't say enough... I don't understand. Maybe I am missing something here. Is plainly states your carrier covers Suboxone. Ask them (the ins company) why it states that if they won't.
Is there an office near you that you can do to in order to check on this.

If you didn't have any insurance at all it would be easier for you. The makers of Suboxone do have a patients assistance program that covers the cost of the medication for one year. But you cannot have any insurance.
I am keeping you in my prayers.

Subject: Humana Denying Suboxone Wed 04 May 2011, 1:43 am

So,Dee was Beth finally able to get it resolved with her Ins.?

I tried to find some info about the Lab that makes Suboxone and came up with nothing that I thought would help me. My Ins. not paying is the same as me not having Ins.

I'm thinking I'm going to call the Ins. tomorrow and ask to speak to someone higher up. Try to plea my case to them.

I just do not believe that my Dr. or any Dr. would tell a pt. to find rhe money for your meds another way. If he really did then he needs to change professions. If he didn't then this nurse needs to get her butt chewed out, bad.
She also needs to be careful b/c,catch back is a bitch. She may need the help from someone in the Medical field one day.

I'll keep you updated

Marie

Subject: Re: Humana Denying Suboxone Wed 04 May 2011, 10:48 am

It is certainly worth a try to give the higher ups a call.
I would write everything down that you want to say to them in the order of importance and stress those facts.
Repeat them if necessary.

One of the things I would want to know is WHY if they don't pay for this medication why is it in their formulary. Is it because of the type of Suboxone. Strips VS tablets, You are taking a medication for the Treatment of opiate addiction.
You are not taking a narcotic for any other reason. Ask them how it needs to be coded when submitted through insurance. Sometimes the way it is coded makes a big difference.
There is a code for ongoing treatment, acute etc.

About Beth, when I said the doctor reminded me of what she went through with her previous doctor was the incompetence of the staff and her doctor.
She didn't have insurance and did qualify for the patient assistance program. It took some time but she did get her medication.
Good luck today Marie

Subject: Humana Denying Suboxone Thu 05 May 2011, 2:43 pm

Hey Dee,
So,yesterday I called the Dr. office and they told me they turned over to the Dr. The same Dr. that they said didn't do this. I don't know if they really did do this. He may decide to wait till her sees me next week.

So,I called the Ins. this morning and told them everything that has been going on. I asked her since I can't get my Dr. to help what could I do?
She told me to fax a letter to the Grievance Dept. and tell them everything I told her. So,I did that and was very honest that I wasn't proud of becoming addicted to pain pills and I'm seeking out treatment. i also told them they could see on all the meds i take and I that I take Lamitical for the sizures. I also told her that I take Forteo injections b/c my osteoporsis is so bad and if I had a seizure it could very easily cause a bone broken.
I would think if they thought about this they would see this could be dangerous for my health.

I know that the Co. that makes Suboxone only helps if u do not have Ins. If I get turned down again,then it's as if I have no Ins. They may not see it that way.

I want this to be over with so I can move on.

I'll keep you posted on what's going on.

Marie

Subject: Re: Humana Denying Suboxone Thu 05 May 2011, 7:42 pm

Well at least I am glad that you were able to speak with someone who told you to file a grievance. It should not have come down to this but it has and you have no choice.
You have been patient and have done everything that is asked of you.
Make sure you make a copy of everything that you send in for your own records.
I hope that you are triumphant in this. I know there are many people who have to be going through the same thing as you but we haven't heard from them.
I am hoping that this will be able to help someone else in the long run.
Take some time for you this evening Marie. I know you must be exhausted.

Subject: Humana Denying Suboxone Thu 05 May 2011, 9:51 pm

Exhauted is not even the word for what I feel.
Like you said I know there are others having the same problem and that is my reason for coming forward. I'm sure there are many that have just let it go thinking there is nothing they can do about it. That's what the Ins. Co. wants us to do.
I feel like I'm fighting for my life here. When ppl finally get to the point of wanting to get clean this should not be the problem they have to deal with. We have plenty other problems to take care of and this should not be one of them.

I'm hoping that whoever reads my letter that I sent to the Ins. will think about it. I let it be known about the seizures of which they can see by the meds I'm taking.
I know they prefer the Dr. do this but in this case I have to do it myself. the only thing I have for backup is they can see i take meds for the seizures. I keep thinking surely they not going to take the chance of that happening to me. However,I'm just a piece of paper coming across there desk.
I also feel,if they deny me again they putting themselves in jeopardy if something were to happen.

I'm going to call them AGAIN tomorrow and see what they say.
I can not continue to pay for this med. I've put us in a terrible finacial situation.
Nobody should be under stress when they first get clean. It's one of the biggest things they teach you. To keep your stress level down.

I think what scares me is that if they deny me again that I don't know if I can stay clean for very long without the Suboxone. Maybe that makes me weak but it's a fear I have.

Thanks for allowing me to talk about it here.

Marie

» Oh No,Here We Go Again With Humana
» Update on Humana/Denial
» Suboxone Day 14 - Addiction 0 / Suboxone 14
» How Long can I stay on Suboxone
» How much are you having to pay for your Suboxone?