doctor call the insurance and get a "prior authorization"
for you.

Most insurances will do it with a doctor's urging.

You don't have to go without. You just have to make some noise of the right kind!

Yes, do that. And call the insurance, ask to talk to a supervisor.

Tell him/her which meds your doc has RX'd for you, and that you will accept no substitutes - you have tried the alternatives and they do NOT work.

If the insurance does not want to pay, your next move will be to get online and contact the State of WA Department of Insurance to file a complaint. Tell them you are going to do that, too. They hate the idea of being buried under a ton of state paperwork. Give them a chance to make things right.

I have had to file complaints with ODI (my state's Ohio) and believe me, the problem was solved within days.



And now, all I have to do is mention ODI, and the insurance knows I mean business.

I am not asking for any benefits I'm not covered for, but they WILL pay for stuff I am supposed to get, and I am supposed to get my meds.


So are you.



Good luck.

They may need to talk to your pain guy anyway. Most insurance companies WILL budge if they are given docymented proof (your chart) that what they will pay for will not work. Had to do the same with my husband's stomach meds-called many docs from way back when my insurance changed and they suggestion OTC Pepcid-uh, hello, like we hadn't already thought of that! The doc can also help by getting "pre-approval" and pushing it through the system. However, he will also be on the phone going through the same elevator music, so if he agrees, send him a card-you know what he had to go through.
Hope that helps
Lori Lee