Re: WE WON (Actiq)

On Sep 26, 4:52 pm, Mike Berkowitz
<mkb...@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxx> wrote:
On Tue, 25 Sep 2007 16:55:40 -0700, "cllmd" <cl...@xxxxxxxxxxx> wrote:
The suckers aren't at the door yet, but the paperwork came thru in our
favor.....the arbitration was binding, and they found that the insurance
must pay for the suckers.

more later......

thank you for putting up with me!
Lavon

A former doctor tried to get me Actiq but my insurance company said it
was only for cancer patients and that it must be prescribed by a pain
doctor. No exceptions.

How did you manage to win this one. Was it in CA? Was it PacifiCare?
(yes/no answer is all I need.)

Did you have to pay for the arbitration?

Mike

Aloha Lavon (and MIKE)!

OG took the thought right out of my head and posted it! IF "they"
don't get your medication to you within a week to TEN days, (is that
long enough?), let us know and I'll try and be the first to mail them
a letter with your case number on it if you would be so kind as to
supply it by email or on here (I don't see any harm posting it
here...does anyone?).

I don't want to give the immpression that I love fighting for OUR
RIGHTS, but there is just something about doing so and moving the
"giants" that's soooo rewarding! As long as I feel a wrong has been
done and my participation or actions will help 'right it', your dang
right I'll be happy to at LEAST write a snail mail AND an email to the
guilty party (to put it nicely). I'm VERY happy to do it for anyone
that needs the help.

So, don't be afraid to be a REAL SQUEAKY WHEEL about this decision.
Afterall, you won!

Aloha Just for Now, My Friend!

Mike!

Do you have a copy of your insurance policy? If so and you feel up to
it, why don't you take a look at their list of "exclusions" for the
Actiq and see if their "explaination" is REALLY in there or if this is
just something they added AFTER your prescription was written! If it
was, YOU can appeal that "fairy-tale" ruling and don't be surprised if
YOU win! When my insurance company denied covering my Provigil after
two years of me taking it and denying my appeals, I had a look and
damned it the thing hadn't been "amended" just before my prescription
date! (grrrrr...) so I either have to pay almost $300 a month for a
months supply of Provigil or $2 for a months supply of Dexedrine which
is a schedule TWO amphetamine (Provigil is a schedule FOUR!).

Unfortunately, the Dexedrine (God KNOWS I love any and ALL
amphetamines!) was turning me into some sort of a hyper-sexual (more
than usual! LOL!) 'beast and I bite the bullet and paid $283 for a
months supply of Provigil this month, just to take a break from
Dexedrine. I can't afford to do this every month for however long I'm
going to live, so I told my wife she'd better hurry up and get those
"black and blue" marks healed by the end of October because I'll be
going back to Dexedrine. LOL! (If my shrink would fight for me on
this, I WOULD get it covered. He's just a lazy ***...pardon my
'french').

Just a thought for you Mike. Could be worth checking into if you would
like to get them covered. I can imagine how expensive those "suckers"
really are! (yes, 'suckers' was meant BOTH ways, HA-ha!)

I'm VERY concerned about your health Mike. I can't believe the agony
you are living with! If I had the pain that you are describing, I'd
have gone to the ER a few times by now just to humiliate my doctor(s)
into giving me something, ANYTHING that would help me or figure out
just what exactly is causing this severe pain! I know you don't seem
to have the best of luck with doctors, however, you HAVE to keep
trying to find one that will do something to help you. I admire your
inner strength. I can't say I'd still be around if I had what you do.
I'm a wuss when it comes to pain. I can take all the pleasure anyone
(or myself) can deliver, but pain? NO WAY! TSK...

Take care and watch yourself. I want you to be around here for a long
time. You're a decent man (at least that's what I've read about you so
far! LOLOLOL!). OK?

Aloha Just For Now,
Hawaiian Wayne

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