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Pain Management Message Board

Pain Management Board Index

Hi: Have you tried looking at your insurance co's appeal process? I got a med covered that wasn't covered by going through this process. I would imagine that each co does this a little differently, but look through you policy for [U]appeals[/U], or [U]drug exceptions[/U], and call the co and ask how you go about doing this.

In my case I had to have my dr fill out a form that stated my med was medically necessary and that there weren't any drug alternatives for it. If for some reason lyrica isn't considered med necessary, you can still try to get an appeal or drug exception.

After you get this info follow through with it, and DON'T give up on the first turn down, if there is one. You never know they may agree the first time around. [U] Persistance[/U] is the key, and your drs help. Even if they turn you down once, you "have" a right to appeal the decision as well, so don't give up.

Try that and see what happens, and good luck. What type of insurance do you have, PPO, HMO, WC, Medicare etc?

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