Quote:
Originally Posted by numb
Hi All,
I have been on Lyrica for years to treat my RSD pain. Now my new insurance, blue cross, refuses to fund for it because RSD did not fit their criteria. I am appealing it now. Have anyone had this problem? Did you appeal and what was your outcome. If you win, what helps?
Because it is so expensive to pay out of pocket, i don't think i can afford long term. So i wonder what kind of medications do you folks use to help with your RSD pain?
Thanks,
numb
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Interesting that BC felt Lyrica did not fit the criteria. Do you know what does fit their criteria? Certainly ditching Lyrica is not going to save them money, in fact generally what fits RSD's criteria if very costly, much more than Lyrica. Lyrica is a drug that many pain docs would prefer their RSD patients would take instead of narcotics because of the DEA crackdown.
My wife who has RSD was denied by BC/BS in covering Ketamine infusions. On her behalf I appealed their decision and won. It took no longer than a week for a reversal. They did cover her infusions, both ketamine and Lydocain. As I recall you just have to make your case in that these meds have helped you control the pain.