Suboxone: The Light At The End Of The Tunnel

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 Insurance woes

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nannamom
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PostSubject: Insurance woes   Wed 19 Mar 2014, 1:15 pm

Hi everyone
Just an update from me to you on my insurance and it's paying or not paying for my medication.
Medicare put me on a new part D this year. One they think is better for me in paying for my medications.

For Suboxone this one does require a PA where as the one last year never did.
I submitted my paper work about a week and a half ago. Last Thursday I picked up my prescription and they did pay for it. I never heard from them so I was starting to worry. After paying for it I thought well at least they paid.
The other day I did get a letter from the insurance company stating they would not cover my medication. The reason being:
You are not enrolled in a program. Oh hell yeah I am. I have been since 2006.
So now it is the appeals process. The wait time......
I am so often famous for telling everyone don't give up and appeal each and every time so that is what I am doing.
I will keep you posted as to how it goes.
Dee

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nannamom
Admin
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Female
Number of posts : 2207
Age : 59
Humor : Once you choose hope, anything’s possible. -Christopher Reeve
Registration date : 2008-11-09

PostSubject: Insurance update   Sun 23 Mar 2014, 2:48 pm

So to update everyone on my insurance woes. Last Friday I (the 21st) received yet another turn down from my insurance company dated March 14th. An exact duplicate of the one they sent before. Telling me that they would not pay for my medication as I was not enrolled in a program.
I read all of their wording very carefully to see what I might be missing.
Nothing there. So yesterday I called them to find out what was going on. I had been to my provider last Tuesday and they did resend the paperwork for an appeal so I wanted to know if they had any news since we did an expedited appeal. After much persuading the woman on the phone took another look at the paperwork, she told me I had been approved effective last Tuesday the 18th.
So instead of sending me the other denial, they should have been sending me the approval.
She assured me it would be in the mail.

I am happy this has been taken care of and at the same time I am still upset because of the worry I went through.
Anyone else have any similar experiences?
Much love,
Dee

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