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PostPosted: Sat Jul 03, 2010 4:38 pm 
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Hello All,

I have written before and yet another issue with my dr and the sub program. I live in KY and there are very few dr's in a 70 mile radius that take insurance. My dr now does take insurance but is not a provider with my type of ins and my claims are being denied. My dr's office was origionally letting me make payments until they found out if my insurance would cover any expenses. Well now they just found out my insurance will not pay and they told me I have to pay my weekly dr's visits in full and catch up my last 8 wks appt's. I know people say you cannot put a price on your sobriety, but what are those to do that really do not have the funds to pay for it and cannot get any funds. I have tried applying for credit cards, selling everything I own of value, and we are almost ready to lose our house because our mortgage is so behind. I did so much damage to our finances during active addiction. I had to drop out of the sub program on Thursday and cannot find another provider that doesn't have outrageous fees or takes my insurance. I do have a few extra sub to get me by and stretch them out, but eventually those will run out too! I am very serious about my recovery and I know I am not ready to stop the sub at this point. I have only been on it a little over 2 months and I just do not think that is long enough for me to stop yet. I don't know what to do. Is it really like this out there....if you don't have money you cannot get help. I am scared of what will happen when my sub runs out and wonder if I relapse. Does anyone have any suggestions or has anyone experienced this happening to them. If so, please tell me what you did and what might help me. Why are most sub programs cash only? They say you can file a claim but my insurance does not cover claims for non participating providers. Any suggestions would be awesome. I think there should be some sort of assistance program for those out there who truely want help but just cannot afford it. Or atleast let you make payments until your situation gets better. And to make matters worse, my husband (military) is away for a couple of months and I do not have family here where I live. I am so stressed out about being all alone with two small children and no help with suffering through wd. I may end up having a nervous break down before it is said and done! Take care all and thank you so much for reading. Any comments would be much appreciated. Hugs...jlb


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PostPosted: Sat Jul 03, 2010 5:30 pm 
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I am SO sorry to hear about this. I can hear the fear in your words and I feel for you. What about your family/primary care doctor? Any doctor can prescribe it for pain, without the special waiver. Or maybe you doctor would be willing to do what it takes to get the waiver. It's just a thought. Have you reached out passed the 70 mile radius you've already looked in? Would it be worth it to drive two hours each way? Just another thought I had.

Again, I'm so sorry you're going through this. It's very easy to say we should do anything to pay for recovery, but sometimes that's just not possible. I know if my insurance stopped covering my appointments and meds I would be in the very same position. And I don't know why it's a mostly cash business. I hate to think that it's because doctors know we addicts are desperate. That's just too sad to even think about. Maybe because addiction treatment falls under mental health services? I really don't know. We've talked about this recently on the forum and I don't think anyone came up with any good answers. Just that it sucks.

Hang in there and remember to use this forum as the great support that it can be. I hope somehow we can help you out, maybe just by being here.

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-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


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PostPosted: Sat Jul 03, 2010 6:19 pm 
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Thank you Hatmaker for responding. The support here means everything...i think I am certainly going to need it. What you said about my primary care dr is a thought. We do have a good relationship. I do have some back pain and tennis elbow issues that she has prescribed mild narcotics for me in the past. I am just wondering if she could even prescribe sub for those issues because it is only mild to moderate pain. Wouldn't that be a big red flag for her to prescribe suboxone for those types of pain when sub would be used for severe pain? And just a question about the waiver. What do you mean by waiver? Are you talking about her becoming a certified suboxone physician or can she apply for a waiver for a specific patient?

I did broaden my search and found a few more dr's to call. Hopefully I can come up with something on Monday.

On a side note....I am seeing a therapist that I go to weekly. He knew about my financial issues and started doing some research for me also. There is a dr within their practice that specializes in addiction and CAN prescribe sub. I was so excited when I heard of that news because my therapy office takes my insurance too. I was thinking I could just see the dr at my therapist office and get sub there and I would be on my way. So we made an appt with this new dr there and just got more bad news about money. Tell me if you think this is correct. The Dr said he could not prescribe me sub, even though he is certified, through that particular therapy office. He said he had a clinic an hour away where he runs a sub program and he would have to prescribe it there. That does not make sense to me. If you are a dr and you can prescribe sub does it really matter which office he would prescribe it from? Of course his clinic is cash only and to expensive for me to attend also. So that really bummed me out. Do they have special suboxone rules that you know of that involves location where you prescribe? I personally think he could just give me a script, but unfortunately they want the big bucks that come along with addiction.

Again, thanks so much for your response. Let me know what you think about above. Oh, I meant to tell you before that I think you are doing wonderful things with your sub groups. I checked out the website but could not find ANY sub group meetings anywhere close to me. I sooooo wish I could attend your groups. Keep up the great work you are doing!! You are making a difference.


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PostPosted: Sat Jul 03, 2010 6:48 pm 
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Hi again, jlb,

I've never heard of a doctor, sub or otherwise, needing to prescribe from a specific location. Sounds like that particular doctor is just very inflexible and may want you to be part of their entire suboxone treatment program. Too bad your therapist can't make some headway with her/him. That's a shame, because it could have worked out well for you.

In order to prescribe suboxone/subutex for addiction a doctor needs to have a special waiver and I believe an additional/special DEA number. But if it's prescribed for pain, they don't need that waiver. That's not to say that any given doctor would be willing to prescribe it. I don't believe your pain needs to be considered severe to take suboxone or that it will necessarily raise any red flags. There are non-addicted patients who for whatever reason don't want to use or continue to use regular, full agonist, narcotic pain meds. My doctor is a sub doctor, but he writes my script for pain - I have a chronic pain condition and I take it for both addiction an pain. (Personally I think he writes it for pain so he doesn't have to count me among his 100 sub patients (he's also my primary care doctor), but that's beside the point.)

All you can do is talk to your doctor and ask. I'd be honest and tell her/him your situation. I would hope s/he would want to help you, especially considering they've given you pain meds in the past. What the hell, it's worth a shot, right?

Lastly, thanks so much for your kind words. I've been a bit frustrated lately about my meetings, because attendance has been very low, but I'm trying to remain optimistic. I did get a new member last week and she and I hit it off really well, so that's promising.

Good luck with your doctor. Keep us posted.

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


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PostPosted: Mon Jul 05, 2010 11:15 am 
Hi jlb - so sorry. I'm finding myself in a similar situation. Since Oct. I've been going to a sub doc who I believed was "in network" with my insurance. So I just paid a co-pay for each visit. Then last month they told me they weren't in network and they would have to submit all my visits back to induction to see if I had out of network benefits (which I thought I did). So far the insurance hasn't paid a dime. So the office left me a message saying I had to pay in full at my next visit.
Anyway, I spoke directly to the DOCTOR about it and he was willing to help me out. He gave me a month script for sub with a refill so I could have 2 months to straighten things out.
So despite what the OFFICE says speak to the doc directly, s/he is the one who is invested in your recovery and might not be so quick to dicharge you. Good luck,
Lilly


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PostPosted: Mon Jul 12, 2010 4:34 pm 
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I am in the same situation. My insurance only covers 2 docs in Columbus and surrounding areas (within 120 mile radius), needless to say those doctors have 8+ month waiting lists to be seen. I am on a waiting list for both clinics but in the meantime I have to pay out of pocket for my visits. My initial visit was $475 and my script was $485. Of course every subsequent visit (monthly) is "only" $175. Of course this seems rediculously expensive but then I remember how much I spent each month while I was using. I've already become depressed that I'll be forking out that much mone tomorrow at my monthly appt.

I hope something turns around for you as I know exactly the fear you have. I am a single mom of 3 little kids and have no choice but to do this for their sake and for the physical and mental well-being of myself.

Good luck and just keep faith that things will work out.

Lisa


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