Insurance companies drive me insane?
- 12 Apr 2013 by RachelinAZ
- 12 April 2013
- opana, pain, morphine, pharmacy, doctor, insurance
I have been trying to get on Opana since last fall. I did everything I was told to do. My doctor said as long as I do it (tried out morphine), there would be no problem.
My pharmacy is saying it needs to be pre-authorized. The insurance company is saying it doesn't.
My doctor's office is a gem. They *are* working on the issues. The PA even called CVS. I was hoping to start them this weekend, to make sure I have no issues.
I am praying they will reduce the pain so I can walk around to some extent. Help out my husband w/the home chores (ok, I don't WANNA do that, but it would be nice if I could).
I appreciate feedback and such <3
Opana is quite expensive but the insurance should cover it. The issues you are seeing are quite typical with any scheduled medication.
Hello RachelinAz. Welcome to the site. I have no answer per say. Perhaps another member might respond and have a solution too your situation. Regards pledge
Dont you love it when you are caught between the pharmacy saying you need PA and the insurance saying no but nobody wants to communicate with each other and they wont take your word for it! lol Poor girl. Was failing morphine supposed to be part of the PA (prior auth) process? Some insurances want you to try less expensive meds and fail them before they will pay for the more expensive choices. In my experience CVS is pretty good about working with you on stuff like this. Usually, the pharmacy will contact the insurance company when they process the med, because insurance will have to tell them if it needs PA and what the cost will be to you so the pharmacy knows what your copay is. So it would be the insurance company telling CVS they need PA. So did you finally get them or not? I finally got a new PM doc who is willing to work with me and he has done some changes and I'm feeling much much better.
I did some major cleaning projects and I also was able to help my husband paint a room to make it into my home office and for me, that is major! My oldest son was even surprised. He was like "you painted?" He was about 9y/o when I hurt my back so he mainly remembers me as the mom who is in pain all the time. I actually changed from Oxycontin/oxycodone to MSContin/oxycodone and in decent doses to work! This Dr gave me my Soma back too. So it has made a huge difference. So much better than my previous Dr who kept reducing and wouldnt rotate to anything different. My Dr mentioned that if the MSContin doesnt work for me then we might try Opana. I took Opana ER briefly several years ago and also used the immediate release version as breakthrough both with the Opana ER and also with OxyContin. I went off the Opana ER and went back to Oxycontin then because I felt the oxycontin worked better but that was before all the reformulations. Since Oxycontin was reformulated it doesnt work nearly as well. I havent tried the reformulated Opana so I couldnt tell you on that one. I hope you finally get your medicine and I hope it works well for you! Remember that I am an AZ girl too!
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