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PostPosted: Thu Apr 28, 2011 3:36 pm 
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Thought I'd update on Humana denying my Suboxone.

Well,come to find out my Dr. office is not sending in the proper info. It's been 8 days I've been on Suboxone and I'd love to get some relief with this stress.
I also received a message from Humana telling me AGAIN that I can not be on any narcotics. I'm thinking they need to be educated on Suboxone.
I was able to finally talk to someone in my Dr. office and I got alot of defensive attitude. I did tell her that I'm doing everything that the Dr. has told me to do and I'm having problems with others doing there job so I can continue to get my Suboxone. I figure this will take the Dr. office another day or two to do what they are to do. I also faxed them the info. If I don't hear back from them soon I'll go back up to there office. It's damn near impossible to get the Dr. office to call you back.
I have been cutting the dosage down to try to stretch the Suboxone. On the positive side my husband has been very supportive in me buying for another 5 days. This stuff is not cheap,as you all know.
I feel terribly guilty putting us in this financial distress. I pray to get this resolved and get my money back.

I appreciate being able to vent here. I want to continue to move forward and not go back to the pain pills. I truly want that nightmare over.
I had this horrible thought of,can I get some pain meds if this doesn't go thru. I don't even want that thought in my damn mind.

Oh also, my dr. office told me that he does NOT prescribe Subutex. I didn't say this but I was thinking,then do your damn job.

Thanks once again for letting me vent here.

Marie


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 Post subject: Update on Humana/Denial
PostPosted: Mon May 09, 2011 8:09 pm 
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I wanted to pass this info on in case anyone else is having trouble with there Ins.

After 3 weeks and everyday trying to get the Ins. to help and my Dr. office I finally got approved today. What a relief this is.

There has been no post regarding this when I posted it but hopefully someone that is in need of help with there Ins. will see that if you fight with them hard enough you have a chance to win this issue.

My Dr. office told me to find another way to pay for my Suboxone. I thought that was terribly rude and left me stressed to the max. I do believe it's safe to say they didn't want to be bothered.

Ins. Co. got so tired of me I guess they saw I wasn't quitting. Maybe they did it to shut me up. That's fine with me as well.

I'm so thankful I didn't give up which of course they wanted me to do. As I told them,this is my life and my recovery,I couldn't give up.

So,if anyone is having this problem don't give up. If there's anything I might can help with pleaswe let me know.


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 Post subject: Good Job
PostPosted: Mon May 09, 2011 8:35 pm 
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Way to go.......

I do not have your insurance but I love your attitude. Sometimes the only way to be responsible for our own recovery is to be passionate. I am glad you didn't give up with your DR and the insurance company. Like you said who cares if they did it to shut you up. I have always believed that if you do the footwork things will happen......you are an example of that. I am glad it worked and you were viligant. I know you inspired some people here.

Jim


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 Post subject: Humana Denying Suboxone
PostPosted: Mon May 09, 2011 10:13 pm 
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Thanks Jim,
That was my reason for telling my story was hopefully give someone else hope and to not give up. I remember when I was in AA/NA years back that I would always hear them say to "do the foot work".
I got to tell though,this old chick's feet are tired from it...LOL

Marie


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 Post subject: perseverance
PostPosted: Tue May 10, 2011 11:51 am 
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I'm really glad you posted about this. I don't think many realize that you CAN fight back and you CAN get your needs met.
I remember my mother complaining about her insurance co not paying for something and her attitude was "oh well, I'll just pay it, no use saying anything" and I kept telling her that she needed to call them and fight for her rights. She's just say no, it was ok. It WASN'T ok! But that was her choice.

Good for you for going the distance and getting what you need. I hope others will read this and realize that it just takes some persistence sometimes...one shot and we give up...we wouldn't do that in our addictions!! we'd persevere to get our drugs, right??? LOL

Thanks for taking the time to post this.


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 Post subject: Humana Denying Suboxone
PostPosted: Tue May 10, 2011 6:34 pm 
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We must have the same mother's ChinaGirl. Mine use to say that also. The best was when she would say "she didn't want to bother them" Hell,bother whoever if you know you are right.

I just sent off my claims to get my money back and I plan on staying on top of that till I get it all back. They made this more inconvient than it needed to be. If they were educated on Suboxone I would never had been denied in the first place. They had me so damn stressed out.


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PostPosted: Wed Oct 26, 2011 11:17 am 
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Hi, i realize this is an older thread, but i'm hoping one or more of you can tell me specifically what you said to the insurance company that convinced them to pay...?? I just switched from a national company to a more local company out of Portland, OR and my doctor said his patients with this coverage have had trouble getting their subs paid for. So far they've paid, but he told me yesterday that they are required to pay the first 30 days. I'm just past 30 and they did pay, but i'm afraid that could change at any time. On my doctor's suggestion, i spoke with my new PCP and he was very supportive of sub treatment, and agreed to write a referral to my addiction doctor, which supposedly can help. My new insurance co has not flagged me for authorization yet, so haven't had to try anything yet. I just don't know what is going to happen, and it is critical that i continue to receive meds coverage. I paid cash for 2+ years, and i honestly don't know how i did it. Sometimes i felt like i was working for meds, month to month, or even week to week sometimes. I felt like a junkie doing anything (well, not quite anything) to get my DOC. With insurance coverage, i feel like any other human taking helpful medication...

I'm so glad i found this thread, because i probably wouldn't otherwise have known i had a chance to pursue it. How did you guys approach the insurance co? What did you say? Who did you speak to? I'd like to have my arsenal ready just in case...
Thanks for the inspiring information!

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PostPosted: Wed Oct 26, 2011 11:28 am 
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Hi Bandersnatch,
I had a fight of a life time to get my Ins. to pay for my Suboxone. Biggest thing is NEVER give up. They want us to.

First you have to get Denied then you can make a Appeal. If you have a Dr. office staff willing to help you that helps alot. Mine told me to find my own way to pay it.

Once you Appeal let them know how it has given u the quality of life since you have been on it. If you have any other health issues throw that in as well.
Follow up on every little thing they want you to do and be sure to make copies of everything you send them. Also,fax them instead of mailing any info.

If the time comes and you get denied please feel free to Private Message me or post again and I'll be more than happy to help you thru.

Good Luck

Marie


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PostPosted: Thu Oct 27, 2011 12:19 am 
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Thanks, Marie, that's very helpful! I hope i never have cause to need it... I'm still relatively newly insured (without any coverage at all since 2003) and appreciating life without a $500+/month prescription price tag. It was very rough. Felt like my entire life revolved around it, where now it's just a medication. It's difficult to describe the psychic shift involved. I feel so much healthier now.
Anyway, i appreciate your courage and persistence. You are paying it forward by telling your story here...
Much gratitude.

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When we remember we are all mad, the mysteries disappear and life stands explained.
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