... that actiq can only be covered if patient has cancer diagnosis. I have severe pain from disc herniation and have been on for 15 months with my companies old insurance plan.(Healthnet). I had to go from 3 suckers per day down to zero and am not paying the 2500 dollars per month out of my own pocket for these. Am already taking long lasting and breakthrough medication in the form of fentanyl patches and dilaudid. The pain I experience can come on very suddenly and there is no substitute for the extremely rapid relief provided by the actiq suckers. Fentanyl patches are covered by my insurance for my ailment. In addition the literature section indications and usage provided by the manufacturer of the fentanyl patch states that before treating a patient with a modified release opioid such as the patch, an evaluation of treatment with an immediate release opioid is advisable. This sounds like a catch-22. Do I have any chance of appealing this rule or does anyone have any information on a program for cost reduction, etc?
Aetna nsurance won’t cover cost of actiq suckers for severe herniated disk pain Our policy says?
- Posted:
- 12 Sep 2009 by mac45
- Topics:
- actiq, pain, breakthrough pain
Answers (1)
14 Jul 2010
(Some Pharmacudical companies offer patient payment help, or discounts/coupons. You can contact the pharmacutical company if your Dr's office doesn't have coupons for you). Health insurance is being very difficult these days in giving patients what they need. Your Dr, or the medical assistant can contest this usually with a form- sometimes the insurance company will need in writing that a patient has failed other medications before they will finally approve a rx'd medication from your Dr. I don't know why insurance companies feel they can override a doctor's treatment plan.
Search for questions
Still looking for answers? Try searching for what you seek or ask your own question.
Similar questions
I need some advice on my breakthrough meds?
Hello, I have had severe back pain for 2.5 years due to a degenerated disk (L5), on my MRI, it looks like the one disk is obliterated while the ...
I am looking for a doctor in or around Lancaster, PA who prescribed Actiq?
I am a chronic pain patient and I was prescribed Actiq several years ago. I have tried various other pain medicines and nothing touches the pain like ...
Herniated disk in neck... does anyone know about this condition, that can help? I have had severe
... headaches and wondering if it's from this disk?
Does anyone know of any law suits over actiq. It ruined my teeth and will cost thousands to fix them
Has anyone had problems with there teeth after taking actiq?
