Health Boards
Fri-12-08-2016, 01:29 AM
My insurance co will only allow TNF inhibitors or methotrexate for me, specifically, these were the grounds for denial. It's a private insurance co and they won't approve anything else until those are proven to fail. My doctor doesn't want me on the first (because of Lupus in my family, I don't have Lupus and I'm tested frequently), I don't want the second (I tax my liver enough with other drugs that cannot be replaced). If these are the grounds I don't see how coming up with other options is going to help at all. But I will look into all of them for research's sake, many thanks!
I don't know anything about appeals, how many you get. I think Cosentyx is up in 4 years here, then the arguments are moot, they won't have the corner. I had planned to get a better job in 1.5 years, but this is making me wonder what's more important. I wish I had a better doctor to plan this stuff out with. Anyway, 1.5 and 4 years are a long time to let this run its course. I was handicapped with my back all spring, and I always struggle with my feet. The rest I can live with.
So in all likelihood, I'm going to start this Otezla pack this weekend, have all the flu symptoms bc I am the commensurate 1% that gets them all, and then go through it for nothing bc that will be denied too.
It's just my entire body, no big deal. I see your point, Oxford United, I should definitely knock out my liver too before selecting a drug with my first, second, and third opinions. You know best. You are an insurance co after all.
I don't know anything about appeals, how many you get. I think Cosentyx is up in 4 years here, then the arguments are moot, they won't have the corner. I had planned to get a better job in 1.5 years, but this is making me wonder what's more important. I wish I had a better doctor to plan this stuff out with. Anyway, 1.5 and 4 years are a long time to let this run its course. I was handicapped with my back all spring, and I always struggle with my feet. The rest I can live with.
So in all likelihood, I'm going to start this Otezla pack this weekend, have all the flu symptoms bc I am the commensurate 1% that gets them all, and then go through it for nothing bc that will be denied too.
It's just my entire body, no big deal. I see your point, Oxford United, I should definitely knock out my liver too before selecting a drug with my first, second, and third opinions. You know best. You are an insurance co after all.