Well, happy fvcking birthday to me

Scout05 · June 2010

Lovenox Coverage - denied.

Cigna can fvcking burn in hell.

AppleRidge · June 2010

WTF? Reasoning? I hate those sonsabitches. I assume you can appeal?

(And happy birthday, for real)

Scout05 · June 2010

Lovenox is not FDA approved to treat this condition, thus they will not cover it. My RE can send in articles to the contrary - which she is doing asap - and we have filed an appeal.

But let's get real. It's all up to them whether or not they want to give coverage and they clearly don't.

jen15lax · June 2010

Try heparin. Heparin might be covered.

My insurance is completely backward: Lovenox is covered, but it goes towards my deductible and a 30 day supply would cost me about $550. However, heparin, is NOT covered and while I have to pay for it it out of pocket, it's $160 for a 30 day supply.

You would think insurance would cover at least the less expensive Rx.

Also, did you see if your insurance requires you to use their specialty pharmacy for injectibles? Some companies require you to do their mail-order for specialty drugs to get it covered, and won't cover the same drugs rec'd from a local pharmacy.

AppleRidge · June 2010

ambrandau2:
Lovenox is not FDA approved to treat this condition, thus they will not cover it. My RE can send in articles to the contrary - which she is doing asap - and we have filed an appeal.
But let's get real. It's all up to them whether or not they want to give coverage and they clearly don't.

FDA allows use of any drug "off-label" once it's been approved, as long as there's some potential benefit. So, technically, this is FDA approved. I hope your RE can give them the what-for, given how commonly lovenox is used this way.

jen15lax · June 2010

ambrandau2:

Lovenox is not FDA approved to treat this condition, thus they will not cover it. My RE can send in articles to the contrary - which she is doing asap - and we have filed an appeal.

But let's get real. It's all up to them whether or not they want to give coverage and they clearly don't.

Oh. Didn't see this when I responded. Well fvck. I hope your RE can win this appeal! If all else fails though, maybe you can do heparin and not go through the insurance?

Scout05 · June 2010

jen15lax:

Try heparin. Heparin might be covered.

My insurance is completely backward: Lovenox is covered, but it goes towards my deductible and a 30 day supply would cost me about $550. However, heparin, is NOT covered and while I have to pay for it it out of pocket, it's $160 for a 30 day supply.

You would think insurance would cover at least the less expensive Rx.

Also, did you see if your insurance requires you to use their specialty pharmacy for injectibles? Some companies require you to do their mail-order for specialty drugs to get it covered, and won't cover the same drugs rec'd from a local pharmacy.

We did try this, and it was still denied.

I'll call my Re re. the Heparin, that's a really good suggestion. Thank you for that.

PeetiePie · June 2010

Ugh, I hope the appeal goes through or that they will approve the Heparin. I hate that you have to fight back and forth for all this!

suntoto · June 2010

I am so sorry, Allison!

Wynnieboo · June 2010

That a load of BS if you ask me, fvcking insurance companies think that they can get away with anything these day... mother fvckers!!

(Its Cruz by the way, the bump is being an a-hole and won't let me post with my real account right now)

Scout05 · June 2010

Wynnieboo:

That a load of BS if you ask me, fvcking insurance companies think that they can get away with anything these day... mother fvckers!!

(Its Cruz by the way, the bump is being an a-hole and won't let me post with my real account right now)

I noticed some new names for old posters. WTH Bump?

ade2be · June 2010

I'm sorry. I hope you can appeal....I had fertility meds denied before, but once my doctors office got involved, they approved them.

3ltlones · June 2010

I'm sorry, I hope your RE can figure something out and get it approved. Insurance sucks ass.

jen629 · June 2010

I am sorry hon:(

kew243 · June 2010

I'm really sorry Allison. It seems like you are getting so close to finding a solution to a problem and then insurance has to throw a huge road block in front of you. I hope it is only a road block and if we have to, all of us will make a human pyramid so you can jump over it! There has to be a way to get around it. Ugh.

Wynnieboo · June 2010

ambrandau2:
Wynnieboo:

That a load of BS if you ask me, fvcking insurance companies think that they can get away with anything these day... mother fvckers!!

(Its Cruz by the way, the bump is being an a-hole and won't let me post with my real account right now)

I noticed some new names for old posters. WTH Bump?

I have no idea, it just keeps telling us we need to verify our email address but there is no place to verify it...

Scout05 · June 2010

Wynnieboo:
ambrandau2:
Wynnieboo:

That a load of BS if you ask me, fvcking insurance companies think that they can get away with anything these day... mother fvckers!!

(Its Cruz by the way, the bump is being an a-hole and won't let me post with my real account right now)

I noticed some new names for old posters. WTH Bump?

I have no idea, it just keeps telling us we need to verify our email address but there is no place to verify it...

Bump, FTW Confused

arodanos · June 2010

That blows.

surfergirlkona · June 2010

Ugh I am so sorry, sweetie!

grr_aargh · June 2010

DUDE, that is absolute BULLSH!T.

You know what? Fricken misoprostil is off-label for inducing miscarriages, but they'd cover that, wouldn't they? (Mine did).

Maybe, just maybe, you could pull a hematologist into the mix and get a script through them and it'd be covered? Keep fighting. Are there ladies on PgAL who have done this? Maybe it's a coding issue?

Ugh. I'm sorry.

johannaknip · June 2010

What a load of shiit. I'm sorry!

bbhalphen · June 2010

I'm so sorry!

JaimieLee · June 2010

grr_aargh:

DUDE, that is absolute BULLSH!T.

This. I'm sorry Allison, I just wish ONE fvckin thing would go your way Sad

heathergirl67 · June 2010

grr_aargh:

DUDE, that is absolute BULLSH!T.

You know what? Fricken misoprostil is off-label for inducing miscarriages, but they'd cover that, wouldn't they? (Mine did).

Maybe, just maybe, you could pull a hematologist into the mix and get a script through them and it'd be covered? Keep fighting. Are there ladies on PgAL who have done this? Maybe it's a coding issue?

Ugh. I'm sorry.

IMO, it's an Insurance Companies are Evil and Will Try to Deny Coverage at Every Possible Opportunity Because if You Actually Started Benefitting From the THOUSANDS of Dollars You've Given to Them Then They Might be Slightly Less Profitable for Two Seconds issue. I know that a lot of times they'll drop someone, deny coverage, etc for stuff that you have every right to have covered. Because many people don't fight it. And even if they do fight it, and win, the insurance company doesn't have to pay for wronging that person. So there's no reason for them to not try doing that with everyone.

I know you're a bulldog and you won't stop until you get this fixed. But I'm sorry that you have to, ya know?

Orchard27 · June 2010

I'm so sorry you have to deal with this at all, but it's extra crappy on your birthday and with one of your EDDs around the corner. Sounds like the other girls have given you good advice-- good luck-- I hope it gets covered.