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Old 11-30-2014, 05:02 PM
LIT LOVE LIT LOVE is offline
Magnate
 
Join Date: Mar 2010
Posts: 2,304
10 yr Member
LIT LOVE LIT LOVE is offline
Magnate
 
Join Date: Mar 2010
Posts: 2,304
10 yr Member
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Unfortunately, there was a major overhaul of WC rules in CA in January of 2013. The process is crazy now and yes, even with people that have been on the same meds for years, they're just refusing to fill them. Your doc has to fill out 2 new forms every appointment (a PR2 and I can't remember the 2nd) to request your prescriptions are filled, and if this isn't done, WC can flat out ignore the request. Even if it is done correctly, they can string you along for something like 10 days. If they deny you, you must respond to the paperwork that is sent which is new--my attorney did not explain it AT ALL when I called. WC flooded me with paperwork by submitting 3 reports on the same day concerning the same meds, listing incorrect dosages, and approving a reduced amount to withdraw me, but even those amounts were never filled. Then a few months after they started going through again! I went of pocket to the tune of $1500 in the past 6 months and WC will not reimburse for any of my meds now. Things got WORSE when my attorney did the official appeal, which I lost, and the law doesn't allow you to have a hearing anymore. I can't request for them to pay for those meds for 1 full year now. (You must use an IMR now) link: http://proclaimps.com/news/californi...es-for-2013-2/

If you have Medicare, you can attempt to put them through after getting the final denial which takes about 4 months.

There is a definite push to get everyone off opiates and WC in CA is taking advantage of it. My attorney's office said they're getting overwhelmed with calls from clients that settled their claims 20 years ago with open medical...

And just to give you a heads up, the ER was super nasty with me when I went in with withdrawals. They don't care if you can't afford your meds.

Mz Migraine listed this site to check your drug pricing:
http://www.goodrx.com/
which lowered the costs of one of my meds by about $300 a month.

And try these links as well:
http://ssdfacts.com/forum/index.php?board=33.0
http://ssdfacts.com/forum/index.php?board=26.0

A very inexpensive option is Methodone. It might be worth trying to see if it works for you--it's my fall back option if I can't afford the copays long term (or if they deny me as well) with Medicare Part D.

good luck!
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