Update: (re: Calling for Help)

[pocketnaomi]

OK, first let me say a huge thank you to everybody who contributed valuable advice as well as just plain sympathy and good wishes about the pile of unbelievable crap my health insurance company has decided to pile on my head. I've spent the last two days frantically researching and calling everyone on the planet who could possibly be able to help

Comments

[madfilkentist]

I just did a little searching and came across this article, which may be related to why your insurance company dropped Lyrica. Whether it's effective for the conditions discussed there may be completely unrelated to whether it's effective for you, but you could have gotten caught in the pushback.

[pocketnaomi]

Interesting. That might be part of it, yeah. As it turns out, I don't take it for anything directly neuropathy-related; I take it because my form of fibromyalgia is caused by microseizures inside the pain centers of the brain (we caught one on CT scan), and the Lyrica prevents the seizures. It's being used more in its anticonvulsant capacity than in its pain management capacity. But the insurance company can't be expected to know the difference.

[mdlbear]

That's *very* interesting; it suggests that other anticonvulsants might be usable. Lyrica may still be the best choice, but it leaves another direction to explore if it comes to it.

[pocketnaomi]

I've tried most of the closely related anticonvulsants. They don't do enough. They do a little, but nothing close to enough to keep me functional. Dunno why that one and not the others, but not arguing if it works -- just trying to KEEP it working. (Some of it may be that I'm on massive doses of Lyrica and my doctor doesn't want to prescribe massive doses of the others.)

[pocketnaomi]

Thanks for the advice. I'll make sure I carry the information.

[tigerbright]

And the pharmacy probably has a store number as well, which should be on the label of the prescription bottle.

[bercilakslady]

I missed the start of this. I'm glad you have a plan, and I'm sorry that you needed it in the first place. Here's to the insurance company getting its head out of its ass soon.

[pocketnaomi]

Thank you!

[wyld_dandelyon]

Oh, good luck!

Don't wait too long regarding the Pfizer forms--those programs can take a while and they sometimes change their forms without notice, so you have to go back and get the doctor to fill them all out again.

Also, those programs often require the paperwork to be faxed or mailed direct from the doctors' office, so if it's submitted from somewhere else it could be just discarded.

(Before My Angel qualified for Medicare D, I got way too much experience with those programs.)

[pocketnaomi]

OK, thanks -- I will be warned, and careful.

[pondside]

MY mind boggles when I hear tales of this kind of crap going on... 3rd world country?????

[pocketnaomi]

It sure feels like one sometimes. The health insurance industry is the only one I know of which makes a systematic business model throughout the entire profession out of consistently, in every instance possible, denying the customer the service for which they have paid.

[ebartley]

In my experience, "health insurance" companies pay for the routine stuff everyone needs to have- wellness visits, an occasional sinus infection, even an occasional emergency room visit - well enough. You know, the predictable expenses you could budget for and save the bureaucracy and layer of expense all around, but which if they fought on they'd make ALL their customers routinely furious. It's the major expenses that you really need insurance for which they fight you on. This is particularly problematic for you because you have chronic non-routine health expenses.

It's as if your car insurance paid for your oil changes, wheel realignments, and cracked windshields, but fought you tooth-and-nail when you actually got into an accident.

[pocketnaomi]

Yes. Which is really frustrating when the only reason you bought car insurance was in case you got into an accident; you could easily enough pay for the oil changes yourself. Of course, so can they, which is why they don't mind doing those, but object to anything that's actually expensive.

But since the whole point of insurance is so that, if you don't need large expenses, they get your money, but if you do need large expenses, you get their money, this constitutes flat-out cheating in my book