My in.surance changed & now denied my rx. Because i don't have cancer. Is there anything I can do? In 3 mo.s my quality of life has ceased & I'm rapidly losing bone,muscle,& joint movement. They denied my & my Dr.s appeal. I need help.
If they denied your appeals, about the only option is to pay out of pocket. The problem is that Actiq is only FDA approved for cancer pain. How they figure that cancer pain is worse thn any other, I dont know. It gripes me-pain is PAIN! Did they give you any option to appeal again? Have you spoken with Cephalon, Inc to see if they offer any patient assistance since you would be essentially a cash pay patient?
I suggest that you find out the qualifications of the people who are behind the denial and also find out what medications the insurance company will approve and then see if your doctor agrees with any of the approved medications for you to try and if your doctor does not agree with any of the medications on your insurance companies list then I suggest that you see if you can sue your insurance company - you will need to really look at your contract and also consider asking your doctor to get additional letters of medical need from other pain specialists and other pain clinics and have them specify why they believe that your fentanyl is the best medication for your medical issues and have you tried the fentanyl patches? The patches manufactured by Mylan are very good and they are not too large and the adhesive works very well too - Best of Luck - try to resolve this without resorting to sueing but always know that you have the right to legally fight for what your need- see if your doctor will write for the fentanly patches and if your insurance company will approve them.
- Actiq Information for Consumers
- Actiq Information for Healthcare Professionals (includes dosage details)
- Side Effects of Actiq (detailed)
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