Insurance Problem

I just started Suboxone Monday and am on Medicare and Medicaid and they still have not ok-ed my scrip .
nannamom , so that's what's going on ...

I was told the Dr had to do some paper work or something lke that but a this time I am having to pay for them . I had the money to buy just a week of med's . The scrip was for the strip's but the drugstore just had the tab's . I hope this get's workedout by Monday .

[i][b]
Beth,I've been on the strips and like them way better than the pill. A few years ago I was on the pill and like the strips way better. You can cut them easier. With the pill when u break it often it can have some crumbles and it takes longer to dissolve. With the strips u can dose at anytime in front of anyone and no one knows about it.

I hope you feeling better.

Love,
Marie

[b][i]
Flench,if you are on Medicare is your Ins. Humana?
If you are waiting on a PA from the Dr. office you may have to keep calling or go to the office.
Also,Humana is making it difficult to get approval on Suboxone. If you get denied please appeal it. I'm hoping that is not what's going on. I believe Dee put a thread with lots of info of what I went thru with Humana and my Dr. office.

This med is way to expensive and much needed to have to wait on others to get it. you may have to take it upon yourself to get them moving.

Trust me it's the last thing you want to have to deal with so early in recovery but it's so worth it.
If you need any help with this please do not hesitate to let me know and I'd be happy to help in anyway I can.

Marie

Thank's guy's but I'm kind of lost right now but I did call the doctor Wensday and she said she was working on it and to keep my finger's crossed . Now here it is Friday and I will call her when the office open's . Just what do I need to find out from her if she has not hear any thing ? Still reading . Wish I had found this forum a few day's ago . I had to pay the doctor $250 just to see him and he has me to see him again on the 26 but somethig is going to have to give becouse I give out .
cajunmeme , my plan is not with Humana it start's with and A . I can't remember the name I will have to find my paper work .

[b][i]
If it's a PA and it sounds like it could be then that is the easy part wants you get the staff to send it in. If you are close to the Dr. office drop by there and ask them about it. After the PA has been sent that is when they will decide if they will pay or not.
As I've said before,if they deny then u Must appeal it.
I can help you with that if need be.

Marie

Thank you cajunmeme . I will call them today when the office open's and see what else I can find out . Thank's again my new friend .
EDIT: Ok , I just off the phone with the doctor and it was denied and he said he just got some paper's in to sign and send in to appeal it .
Thanks again for the help . Suboxone is doing such a good job for me I don't want to give up just yet .

Flench,
Can you get a copy of the denial from the doctors office. It should not have been denied. Both Humana and Medicaid pay for Suboxone.

If you can get the denial letter (they should also send you a copy) it should have the reason for the denial.
Was it Humana or Medicaid that did the Denial?

[i][b]
Flench,Please do not wait for the Dr. office to handle this. Even if they do this you can do it as well. If it's Humana you can call them and they will tell you what to do.n You can also go to the Humana site and they have info on there regarding appeals.
Also,don't mail it in,fax it it is much quickier.

Have you ever had seizures? If so that will help with appealing it. Even if not you can let them know if you stop the opiates you could have a seizure.

Please let us know what's going on and let us help you. Do not rely on the Dr. office only.

Don't let them win.

Good Luck

Marie

Listen to what Marie is telling you. If this is Medicare, she really knows what she is talking about as she just went through the very same thing and because of her perseverance she was able to obtain her medications.

Either way, weather it be Medicare or Medicaid you should get your Suboxone. This is what having both is supposed to do. Take care of you.

Hey guy's . Just got in . I found my paper work and I have Aetna with Medicare and Medicaid . So do I need to call Aetna and find out why I was denied ? Thanks for all the help . I will be out by monday and this is starting to get on my nerve's . Look's like it's time for me to step in .
EDIT: I just went over there list of covered drugs (Aetna)and suboxoone is not on the list , oh boy ..

[i][b]
Oh no,Flench I hate hearing that. I know there has got to be a answer. Have you used the coupon yet this month? If you have not then you could use that to help you to buy some more. I know that's easier said than done. Trust me I know,I've been there.

I also want to suggest to you to save all your receipts so that when you are able to get approved you can get it back later.

This is the kind of stuff that makes me crazy. It was so easy to get the drugs we were wanting. Now we are trying to get off those drugs and it's a Act of Congress to get the drugs to get off the drugs. It makes no sense.

I know the fear and frustrating you are going thru but please do not give up. There has to be a answer. How about calling the Ins. and asking them about what you can do.

There is a soultion to every problem it's just so darn hard to find that solution some times.
Just please don't give up.

Please keep us posted.

Marie

flench,
Even if it's not on their list. It would still be a good idea to appeal it. I don't htink they wasnt any bad publicity because of they're not wanting to pay for treatment.
Substance Abuse Treatment is considered Mental Health Treatment. We all have rights here.

Thanks guy's ! I am going by and see the doctor myself Monday and see what's just going on and I am going to call the insurance company too . I will keep you all posted on Monday . I will ask tthe doctor if he can switch med's for me toif that would be cheaper . I am a good talker so if I can get the right person on the line I can get some where then .

Good luck! And if there is anything that we can do, let us know please.

Dee

Thanks Dee ! Suboxone is working so well for me it's unreal . I wish I had found out about it year's ago . Just in this week I have done more than I have done in a hole year . I remodled my bathroom , fixed my truck , cleaned the house where it is spotless . Like I am 20 year's old again and I turned 50 today , lol . I quit smoking , started going to church and I don't know what else I have done and that's just in one week . Give me a month with Suboxone and no telling where I will be .

You are so welcome!
It is always great to hear when great things are happening to people.
Recovery isn't always an easy task but with the help of being able to manage our addiction we can lead a normal life.

I am very happy for you. Things will work out for you. Sometimes it seems like the impossible I know especially when you are having a problem with the insurance company.

I remember when I first entered into recovery, I had no idea how much my life could change. I've gone from being someone who woke up everyday trying to figure out where I was going to get something to see me through the day to a person who is able to enjoy my life once again.
Sometimes I still remember the things I used to do and get that feeling of guilt, that part takes time to work through and I am making progress.
Have a good weekend and take some time for you to enjoy the new life you are beginning.