[marion06095]

I used to take Provigil (tried Newvigil – didn’t like it) from my Pulmonologist for fatigue. He is treating me for Central Sleep Apnea, which is probably MS related. It worked really well in combination with a sleep medication. I was mostly awake all day, and mostly asleep all night.

Now my Medicare part D drug insurance company has decided that they aren’t going to cover it for me any more. I’m not sure why they used to cover it, and don’t any more, but I was officially denied coverage. My Pulmonologist is putting together an appeal, or at least that is what I am told by his staff.

I know he isn’t doing all that he can do to justify coverage for me, because I know perfectly well that he can run another sleep study on me to test me for Obstructive Sleep Apnea, which is a covered diagnosis for Provigil.

This doctor is on really thin ice with me. He also cut my sleep medication from 20mg to 5mg. Why? I don’t know. I called and asked if it was an error, but they said it wasn’t. I’ve decided that if he doesn’t do what needs to be done to get me back on Provigil, and give me the correct dose of sleep medication I’ll find a doctor who will. I’m sick and tired of being half asleep all day long, and then unable to sleep at night because of inactivity.

[marion06095]

There may be hope for this doctor yet. I talked to his secretary on Friday, and she said the doctor put together an appeal to the insurance company. I guess we’ll see how good a job he has done in convincing them that I really need this drug covered. I’ll keep you posted.

[marion06095]

OK, I take it all back. The appeal the doctor wrote worked.

Nevermind.

[Hopeless]

So glad to hear he came through for you. Always great to hear some good news.

[Jules A]

I have no clue, and don't need to know, what sleep medication you are taking but there are lower dosing recommendations on Ambien for women to 5mg so whatever the case or medication it is likely your physician had a good reason for cutting your dose. Maybe give him the benefit of the doubt?