Re: Injecting yourself -- careful of insurance requirements

[Guest guest]

Blue Cross of Ca. & BS of Ca. are one of the only insurances to do that. The

medication is dispensed with their approval. They are just trying to see who

will cave in and pay them back for the meds and MD visits. They have lost every

case that has gone to trial that I am aware of because yjey authorized it. A

retrospective study may stop future use but you sure can fight and will if they

want to take away what has already been used.

---------------------------------

What are the most popular cars? Find out at Autos

[Guest guest]

It is reminders like this that makes this site so valuable to me,

thank you.

I have two insurances and Blue Cross is my secondary, will be primary

in a couple of years. The insurance companies fought me a year ago

when I was going to start the shots, they obviously did not want any

money going out, they are just supposed to collect money, they are

non-profit you know. After the appropriate period my Dr advised me

that I could do what I wanted as he was at a dead end with trying to

convince them to allow Xolair. I called everyone I knew, my

Congressman, Senator (both State and Federal), and I shortly heard

back that they had " reviewed new information " on my case and I was

approved. I do not guess I am normally as aggressive as I was

fighting to get on Xolair, but my health is important and breathing

is not an option. I hear all the insurance problems and realize that

I will be fighting this battle as long as I am on Xolair and it can

get disheartening, but I can only handle what's on my plate now, and

be aware of the future possibilities..

On Feb 20, 2006, at 4:51 PM, MommaA wrote:

> Blue Cross of Ca. & BS of Ca. are one of the only insurances to do

> that. The medication is dispensed with their approval. They are

> just trying to see who will cave in and pay them back for the meds

> and MD visits. They have lost every case that has gone to trial

> that I am aware of because yjey authorized it. A retrospective

> study may stop future use but you sure can fight and will if they

> want to take away what has already been used.

>

> ---------------------------------

>

> What are the most popular cars? Find out at Autos

>

>

[Guest guest]

I am glad you went up the chain and caused a stir. Sometimes this is the only

way to go. I helped a mother in the Central United States get her 5 children

covered. The ins. co. authorized the first 5 months then pulled back the

authorization. She had 30 minutes 3 times a day for each kid set aside just for

medication and treatments. The ins co would only authorize 1 neb & 1 set up.

She had to thoroughly clean the 'set-up' between each child. ALL children were

off nebs in 3 months, this gave her back 25 minutes 3 times a day for meds. At

the 5 month mark, the baby was off all meds, and the others had not missed one

day of school. She was talking about being able to go back to work since her

day was not spent medicating all of her children. I encouraged her to contact

her Senators & Congressmen at State & Local levels. We got the ins co to see

the value of keeping these children healthy with Xolair. It took us 8 months,

but the children are back on Xolair and doing

phenomenally. My advice: Never give up the ship. I'll stand with you and

help you fight.

Pat

---------------------------------

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[Guest guest]

Holy. That is an amazing story. It is inspiring to

hear such dramatic stories. I kinda hoped that would

be me, but I have settled with the " slow and steady "

approach to cutting the pred. 7 mg and counting!!

__________________________________________________________

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[Guest guest]

Oh Boy, this insurance issue has me worried. I recently switched from Humana to

Aetna and the application has been in for 2 mos. Fingers crossed. If they deny

then I guess there's always the congressional route.

Carpenter <cowtrail@...> wrote: It is reminders like this that

makes this site so valuable to me,

thank you.

I have two insurances and Blue Cross is my secondary, will be primary

in a couple of years. The insurance companies fought me a year ago

when I was going to start the shots, they obviously did not want any

money going out, they are just supposed to collect money, they are

non-profit you know. After the appropriate period my Dr advised me

that I could do what I wanted as he was at a dead end with trying to

convince them to allow Xolair. I called everyone I knew, my

Congressman, Senator (both State and Federal), and I shortly heard

back that they had " reviewed new information " on my case and I was

approved. I do not guess I am normally as aggressive as I was

fighting to get on Xolair, but my health is important and breathing

is not an option. I hear all the insurance problems and realize that

I will be fighting this battle as long as I am on Xolair and it can

get disheartening, but I can only handle what's on my plate now, and

be aware of the future possibilities..

On Feb 20, 2006, at 4:51 PM, MommaA wrote:

> Blue Cross of Ca. & BS of Ca. are one of the only insurances to do

> that. The medication is dispensed with their approval. They are

> just trying to see who will cave in and pay them back for the meds

> and MD visits. They have lost every case that has gone to trial

> that I am aware of because yjey authorized it. A retrospective

> study may stop future use but you sure can fight and will if they

> want to take away what has already been used.

>

> ---------------------------------

>

> What are the most popular cars? Find out at Autos

>

>