 |
flea
Enthusiast
Reged: 05/17/02
Posts: 279
Loc: Recently moved to Mid-West, bu...
|
Re: Has this happened to you?.........
01/26/04 11:03 AM
|
|
|
Gottadoit -
If only it was that easy!!!!! I mean I attempted to get that decision overruled several times. Each time it would be denied I would get together a lot of information and subit it, in the hopes that those morons (excuse me, but by the time i received the lovely 3rd denial for approval, I was so angry....but most of all I was FRUSTRATED.
Gottadoit - - my insurance was quite adament when they decided I could find a much cheaper, yet exact substitute for the rather expensive Fioricet (and I am talking GENERIC Fioricet here, not even brand!!).
Each time I got denied, I countered with some really valid info on this, yet once again the big guns won.
I know it sounds strange that my insurance company covers most every other prescription that I need on a regular basis, but the big difference with the Fioricet is that they believe I do not need to get the more expensive generic version of Fioricet when I can just as easily get a prescription for Codeine and Fiorinal (excuse me here, I am not sure the name of the generic version of the Fioricet that comes WITHOUT codeine).
So there you go. No negotiations needed on my part, they have already decided!!!!
Basically they feel that I can get the same theraputic benefits from taking the generic version of the fioricet (whatever it is called exactly) and then combining it with the exact amount of codeine that the original prescription of Fioricet had in it.
Tada.......exact exchange, right? Well not to me. I would have to say that it is still a BIG WRONG!!
I really don't want to go overboard with my post again, so I will just briefly (as brief as my world allows, ha) say that for some CRAZY reason, when I gave this concotion a try it was as if I only took one aleve. Meaning my headache was not at all better (and even more importantly, no warm and fuzzy. HA HA I am just kidding.......kinda. ha)
Now this makes no sense whatsoever, right? ya right!!! I know this, but it is what it is. One would think that receiving the straight codeine along side a capsule that is exactly similar to the regular fioricet I get, minus the added codeine would be a great alternative for me. Actually some of you may even argue that this option is better in that I would then have the straight codeine on hand which could possibly come in hand in case I do need more relief from my ever present breakthrough pain.
Well that is not the case in my world!! I swear to you, they can take that straight codeine and shove it where the sun.......yea you get my point right.
I mean my insurance company must see things like this all of the time, but more likely than not they see the very opposite request come through. You know, people requesting the plain codeine and the other med in seperate form. Or at least I can only assume that this would be the more common request. That is unless others out there are like myself in that the regular codeine pill taken with a seperate capsule of the butabitol(sp?)/apap/caffeine does not work as well as a capsule with all 4 meds inside.
I can not explain it well, but this has been the case for some time now. I even had to do it like that when I did not have insurance but still got headaches and HAD to get a hold of the fioricet w/codeine. My doctor at the time also reccommended the possible, less expensive alternative to getting the meds in me for my headaches. I was so excited when I heard that because if it turned out to work the same way, then i could get the relief i needed all while saving over $40.00 per prescription. So you better believe I tried that option for several months. But I could finally take no more. Whatever it was, it wasn't workin' and I do not care if my current doctor or my insurance company thinks I am loco. It is what it is. Yea right, like I just love spending all of my time writing up an appeal for my medication, and I also just love giving as much extra money as i can to the ever needy pharmacies of the nation. um, ya right.
But no matter what my old records indicate, and no matter what my past doctors collaborated with me on, the insurance company does not believe that I can have a different reaction to the same exact medications, just because they come in different forms. And to be honest, if I were them I would probably agree too, but because i know this to be untrue, I will continue get this decision reversed and I will also continue to pay out of pocket for it. Now I only wish I did not get a warm fuzzy feeling from the one med that I pay on my own. Especially with how expensive it is!!!!
Now I'm sure several of you believe exchanging the fioricet w/codeine is an even exchange for the 2 pills of codeine and the fioricet w/out codeine, and I can totally understand how you would get to that conclusion. I myself would believe the same thing had this not happened to me!!!!
Also, I bet even more of you will probably say again that the strange physiological response I seem to have with these meds is just more proof that I am in deed having a test book example of a psychocymatic response,or otherwise known as Placebo effect.
My only response to those who think that is I do not believe this is possible. Because like the person that posted an experience about his mom giving him a pill w/out disclosing that codeine was in it, yet still having hallucinations, the same thing happened with me. I had both kinds on hand one regular fioricet, and the other 2 were the codeine and the regular fioricet w/out the codeine. When I got a headache, I asked my husband to hide the med(s) in a small piece of bread. He took a tiny piece and rolled either the 1 capsule or both the pill(codeine) and the capsule (F w/ou codeine). I was somehow able to swallow it w/out knowing what I was taking (I still secretly think my husband was trying to get me to choke to death, I mean I did ask him to make it a TINY ball, yet it somehow ended up looking like a jaw breaker. (apparently i somehow became someone that is able to swallow a huge hunk of bread w/no problem). If only that was a sport huh? I would win the gold for extreme swallowing (now get rid of those dirty minds people).
OK, please this is ridiculous. I have done it again. Sorry all. I swear to God I started this post out telling myself that this was going to be really short. Geez, I failed again!
--------------------
Flea
|
|
|
 |