Update on Humana/Denial

[i][b]
If you gals remember the Dr. had increased my meds and the Ins. denied it. The Dr. office told me it was denied and that was it.
Well,I did lots of research and sent it to them and I got APPROVED. I have to say I'm shocked. I didn't really think I would but felt I had to give it a shot.

I must say that I believe God helped out with this one b/c according to the Dr. and his staff there was NO way that would ever get approved.

I hope that anyone that has read on this forum the problems I've had the last 4 months with Ins. that they will push forward and fight the Ins. They want us to give up. Don't give up.

Love,
Marie

[b][i]
Dee,I saw your post about putting all that info on another thread. Great idea.

What I did was point out to them that you can take 32mg. a day. I told them that once we had increased the dosage there was a significant improvement.

I also wrote a bit about my personal life and how I was trying to improve my life and health. I basically,threw alot a info at them and asked that they please reconsider there decision.

I really think like you said. Just like applying for Soc.Sec. they automatically deny you.
Can you imagine how many ppl have been denied and they thought that was it and had to accept that decision? I think there are many.

My Dr. office told me they talked to Ins. and they said they would not go up to 32mgs. and she told me AGAIN to find another way to pay for my meds. I'm sure many ppl have been told that.

I'm sure the next time I go to the Dr. office she will once again tell me how WE won the appeal. I'm going to tell her like I told her before. No,WE didn't we,I did.

After I wrote this I just realized that I might of put this in another thread. Please move it if need be.

Please anyone having issues with the Ins. don't except a deny. Appeal it and do it as quickly as possible. Also,give as much info as you can.

Love,
Marie

You are absolutely right Marie!
Dont'ever give up. Recovery is too important to let it go.
As long as you belive and fight for what is right, there is a chance.
It is when we give up that we lose before we even get out of the gate.
I can't tell you how happy I am right now.
Dee

One person CAN make a difference!

cajunmeme , What did you do for your med's the 4 month's that they denied it . Was you paying out of pocket for them and if so did you ever get your money back for it ?

[i][b]
Hey Flench,
Yes,I did have to pay the first month and it was terribly stressful. I used the coupon when they would let me. It really hurt us financially. I felt so guilty that I had to do whatever it took to get these meds approved.
I had lots of problems with my Provider and his staff. They told me time and time again they would not be able to do anything to help me and I'd have to find another way to pay my meds. Had I listened to them I would have probably been back to the many opiates I was taking. Of which,the Ins. had no problem paying for that.

After I got my approval I submitted all my receipts. they denied that. They denied everything.
Although,I DID get my money back.
Then just this past month my Dr. increased my dosage and I had to do the whole thing all over again.
I knew I couldn't and didn't want to go back to the opiates and had to fight with everything I could to get approved.

I really think that the Ins. automatically deny you with hopes we will go away. Many ppl do that. I was not in the financial positon to do that and I got very angry over the whole ordeal.

We don't get to pick and choose when we can pay our Ins. premium so why should we have to allow them to pick and choose what meds our Dr. gives us.

Anything that you send to the Ins. Co. be sure to keep copies and the date you sent them. Also,do not mail it in,fax it. It's much quickier to fax it.

Please let me know if there is anything I can help you with.

Marie

cajunmeme,

I see . Thanks for the help and info . This give's me some tool's to work with .