jim

i know i hate ins. also they are so dumb about what they will cover and not. it just boggles my mind . .i hope that she is able to try and see if this will also help her like it is helping other ..

carrie

Jim King, I can't believe that either, well, yes I can. It makes about as much sense as AIG going to the St. Regis after they got their bail out $$$$$$$$. I'm sorry, that has to be so frustrating for you both. Susy is fortunate to have you batting for her. loretta

How is it that an Ins. Co. can over-rule a doctor's script? I never have understood that at all. I hope you get this mess straightened out. I take Opana ER, and it has given me hope..and I have a smile on my face,everyday. Sure, I have had some sleepless nights, but that is just part of RSD. It has nothing to do with OpanaER.

I will keep you in my meditation prayers.

Dew

Dew, I've seen pharmacist over rule her doctor's scripts. I hate insurance companies and have been fighting them for years now. I've battled 4 different insurance companies total, all in violation of the law. We've won every battle except an HMO who wouldn't recognize she even had RSD and stated twice to me they've never heard of it. I think there needs to be a class action suit against these hawks but it's difficult because of the different state laws etc. I called the insurance co and explained my wife now takes 2 40mg time release Oxy per-day and is trying something different for a week to see if it has a better effect. They gave us a toll free number for the doc to call and will most likely be approved today.

I am so sorry about the insurance co. they are such a pain in the ***. If she goes on it, ask your dr. for a credit card from the company that makes Opana. The card give you up to a $25.oo credit on your co-pay, every month for 12 months. It helps a bit. I really hope it help your wife. It will make her very sleepy at first, but I think it is worth it. Now that I'm on a regular dose, I'm not having to take as many naps as I did at first. In fact, I'm going to start driving to volunteer at the local spca. Keep us posted on what is happening and how she feels on it. My fingers are crossed.

Hugs
Mary

Hi Jim, try going to a smaller pharmacy not a chain. I go to a local pharmacy. they are farntastic they know how to work the insurance companies and will take the time which the chains will not do. I am on 40mg opana ER am and pm and could not make it with out it. good luck. CZ

lostmary, yes the doctor did give her a discount card from a Opana packet. I've been told the doc needs to fill out a form and fax to the ins co.
CZZ74, my wife has her regular pharmacy that she deals with but her doctor said to go to this particular one because the doc is known there and thought there would be less hassle, I suppose.
Also, what is the difference between these Opana drugs ie Opana ER and PM?

Now it seems a new battle is brewing with the insurance company. I just found out the insurance company refused the doctor's request for my wife to receive Opana. They said Suzy must take regular morphine first before they will consider Opana. She must take it for a month and if she doesn't take well to it they will consider Opana. You know, we do not have an HMO policy, but sure seems like it. I'm really sick of these people.

IS THERE A LAWYER INVOLVED WITH YOU ON THIS MATTER? If there was, he/she would nip this is the bud,pronto. The ins. comp. is attempting to take the cheapest way out. This is so sad, and your poor wife and you, stuck in the middle. I hope your doc steps up to the plate and talks to the ins. company to explain WHY Opana ER is superior to morphine.

Dew

The only lawyer we have now is one specializing in SSDI. We had another who was looking for a connection with her former employer and health insurance company to see if she was terminated from her employment do to the insurance company's negligence releasing both parties from any obligation pertaining to her RSD.
BC/BS told us Opana is not on their list of drugs because it is relatively new. The insurance company wants Suzy to take what they consider a generic version of Opana which appears to be morphine sulfate for one month first. 4 30mg per day and 2 60mg time-release per day. She started it yesterday and became somewhat ill from just one 30mg. Dew, Suzy seems to think that Opana is just like morphine and may make her ill anyway. I've explained that it may not be just like morphine even though it is morphine based, but it may not have certain side effects as morphine. Can anyone attest to this? Thanks!