Re: CoQ10 Insurance Appeal

January 18, 2004

I have to take my hat off to you!!! What you have put together is awesome...it is amazing and so easy to follow and to read...I plan on using it to get the Q10 and riboflavin covered.

Thank you for helping us and others. Great Job!!!!!!!!!! {{{{{{{{}}}}}}}}}

Mom to Zachary 3 1/2 yrs old SCAD Variant and Complex I and IV

5 yrs old and not tested yet

CoQ10 Insurance Appeal

hi everyone,with the help of many wonderful people (thank you thank you thank you!),many websites, much research and a few long lonely nights spent with mycomputer (as I too am fighting the insomnia lately)TAAAAA DAAAAAH !!!!!!Here is what I have put together so far and what I am going to useto appeal to our prescription drug plan to get our Co-Q10 covered.If they don't approve it, I am going to appeal to our medical insurancecarrier (a different company) to have it covered under durable medicalequipment per the FDA regulation. The first page is a list of what I am going to include when I have all my information. I numbered the document by the different sections included. I have not received the doctor's letter yet for either of us so I haven't includedit. I also have not drafted the family letter as I am going to expand on our physician's notes in my personal appeal. Also, the state of Indiana does not have legislation yet to force the company to comply, so that is also not there. Some states do have legislation in place. I know from some previous emails that some people here were trying to get a list together of the states with the legislation already in place. It would be helpful to get that list together or have it if it is complete yet. Also the Health and Human Services Letter I had to scan and theninsert it in as an image so I hope there aren't any problems with anyone reading that. I have saved this in MS Word document format so if you loose the formatting don't worry too much. It shouldn't be too hard to figure out. It is 10 pages the way I have it formatted though. If you can't get this off the groups page,please email me directly at wisecam@... and I will email it directly to the address you specify. Good luck everyone! Lets make these companies pay !!!! Hope this helps,

AnnMarie- Complex IVMarried to my best friend Rick, mom of (14), (11), Cassandra(5 1/2)and Joe(4) - complex IV, lactic acidosis, CP, tethered chord syndrome,dysautonomia, and a smile that never quits :-) Please contact mito-owner with any problems or questions.

January 18, 2004

I was able to get the approval for CoQ10 from Medicaide with the help

of a letter from Dr. Korson and an explanation of how CoQ10 works

with the mitochondria, from Austen's neurologist, Dr. Anselm. This

was in July of 2003. To this date I have still not been able to get

it from the pharmacy (who has been as helpful as possible). Everytime

I have tried to talk to someone at Masshealth, I am given the

runaround. No one seems to know the " code " ,or...number in the

pharmacy book....I can't find anyone who will help me out and talk to

me in a language I can understand! I think that they make it so hard,

in hoping we will give up! Does anyone have a pharmacy code for

CoQ10 -because it is a vitamin, it doesn't have a drug code!? I

haven't given up yet but am getting tired of the struggle!

Gwen

mom to Austen GA2

> hi everyone,

> with the help of many wonderful people (thank you thank you thank

you!),

> many websites, much research and a few long lonely nights spent

with my

> computer (as I too am fighting the insomnia lately)

> TAAAAA DAAAAAH !!!!!!

> Here is what I have put together so far and what I am going to use

> to appeal to our prescription drug plan to get our Co-Q10 covered.

> If they don't approve it, I am going to appeal to our medical

insurance

> carrier (a different company) to have it covered under durable

medical

> equipment per the FDA regulation.

> The first page is a list of what I am going to include when I have

all my

> information. I numbered the document by the different sections

included.

> I have not received the doctor's letter yet for either of us so I

> haven't included

> it. I also have not drafted the family letter as I am going to

expand on

> our

> physician's notes in my personal appeal. Also, the state of Indiana

does

> not have legislation yet to force the company to comply, so that is

also

> not there.

> Some states do have legislation in place. I know from some

> some people here were trying to get a list together of the states

with the

> legislation already in place. It would be helpful to get that list

> together or have it if

> it is complete yet. Also the Health and Human Services Letter I

had to

> scan and then

> insert it in as an image so I hope there aren't any problems with

anyone

> reading that.

> I have saved this in MS Word document format so if you loose the

formatting

> don't worry too much. It shouldn't be too hard to figure out. It

is 10

> pages

> the way I have it formatted though. If you can't get this off the

> groups page,

> please email me directly at wisecam@n... and I will email it

> directly to the address you specify.

> Good luck everyone! Lets make these companies pay !!!!

> Hope this helps,

>

> AnnMarie- Complex IV

> Married to my best friend Rick, mom of (14), (11),

Cassandra(5

> 1/2)

> and Joe(4) - complex IV, lactic acidosis, CP, tethered chord

syndrome,

> dysautonomia, and a smile that never quits :-)

January 18, 2004