Go Back   ISPINE.ORG Forum > Main forums > iSpine
FAQ Members List Calendar Today's Posts

iSpine Discuss Insurance cutting medication in the Main forums forums; I received a follow up email from the insurance co Aetna which stated that all rx pain meds will require ...

Reply
 
LinkBack Thread Tools Display Modes
  #1 (permalink)  
Old 09-26-2012, 06:00 PM
mwolf2022's Avatar
Member
 
Join Date: Jan 2011
Location: Philadelphia
Posts: 32
Default

I received a follow up email from the insurance co Aetna which stated that all rx pain meds will require pre-cert and also that the formulary has changed and limits will be lower.
__________________
2004 L5-S1 Microdiscectomy
2008 L5-S1 fusion stalif device
2009 new pain no diagnosis
2010 fusion exploration
2011 diagnosed bilateral piriformis syndrome
currently in pain all the time with little relief.
Looking for the Dr who can treat me.
Reply With Quote
  #2 (permalink)  
Old 09-27-2012, 12:59 AM
Senior Member
 
Join Date: Jun 2010
Location: Sierra Madre, California
Posts: 904
Default

I have been stuck in a pre cert nightmare with Aetna. I have needed this medication since April, part of the problem is the girl at the doctors office, but Atena is bad too.
I think that is just crazy. For my plan it takes 15 business days if all goes well , what are you supposed to do in the meantime. buy them for a fortune on the street? I guess you can buy them yourself with a prescription, but they are not cheap. It cost me $50 for 20 pills recently
judy
__________________










2007 ACDF 4-7
2008 hip , knee scope, hip replacement
2009 thoracic T-5 thru T-11fusion
2009 VATS T7-8, posterior only T11-12. removal of thoracic hard wear
2010 lung surgery
2010 T2-L2 kyphosis correction
2010 Kyphoplasty T-3, T-4
2011 Cervical osteotomy ,revision C4-T5
2011 Foot surgery
2011 Revision fusion T7 thru L4/laminectomy
2012 Hammertoe correction left foot
2012 Revision fusion T-12 thru L5
2012 Revision fusion L4-L5
Reply With Quote
  #3 (permalink)  
Old 09-27-2012, 03:39 PM
mwolf2022's Avatar
Member
 
Join Date: Jan 2011
Location: Philadelphia
Posts: 32
Default

My pm doctor's staff is pretty good , so I am hoping everything runs smoothly.

I do have around a months supply extra from days when I feel ok , so hopefully that will hold me over if needed.

Then Yesterday I received paperwork from my employer that they are looking into changing our insurance. So who knows where I will end up.
__________________
2004 L5-S1 Microdiscectomy
2008 L5-S1 fusion stalif device
2009 new pain no diagnosis
2010 fusion exploration
2011 diagnosed bilateral piriformis syndrome
currently in pain all the time with little relief.
Looking for the Dr who can treat me.
Reply With Quote
  #4 (permalink)  
Old 09-27-2012, 04:02 PM
Senior Member
 
Join Date: Jun 2010
Location: Sierra Madre, California
Posts: 904
Default

I hope your insurance change is for the better! If my pre cert gets approved for my medication on Oct 15th it will have been 6 months since the doctor prescribed it. No one needs to go through that nightmare. They also tell me it is a nurse at Aetna that makes the decision. My double PHD doctor prescribes it and a nurse denied it.!! Insurance companies have way too much power.
judy
__________________










2007 ACDF 4-7
2008 hip , knee scope, hip replacement
2009 thoracic T-5 thru T-11fusion
2009 VATS T7-8, posterior only T11-12. removal of thoracic hard wear
2010 lung surgery
2010 T2-L2 kyphosis correction
2010 Kyphoplasty T-3, T-4
2011 Cervical osteotomy ,revision C4-T5
2011 Foot surgery
2011 Revision fusion T7 thru L4/laminectomy
2012 Hammertoe correction left foot
2012 Revision fusion T-12 thru L5
2012 Revision fusion L4-L5
Reply With Quote
  #5 (permalink)  
Old 10-01-2012, 12:24 PM
Eddie G's Avatar
Senior Member
 
Join Date: Sep 2006
Location: Bayonne, NJ
Posts: 128
Send a message via AIM to Eddie G
Default

I was able to detox myself off the opiates. I went from 15mg. to 7.5mg to 4mg then zero. The withdrawals weren't bad at all compared to my pain level. It went from 7/10 to 9/10. I dont see how they can put me in a detox if Im off the opiates but now Im suffering terribly. I'm using my TENS and hydrocollator but cant use them forever. I need a pain manager not an addiction doctor. Addicts dont go from 90mg. to 15mg. for months and then detox themselves. (maybe they can I dunno) but I doubt any detox would take me now. Liberty Mutual should pay for every minute of my discomfort since their client ruined my life. (As I lay here in awful pain trying to prove a point to my lawyer,judge,LibertyMutual lawyer etc...) How stupid has pain management got??????WoW!!!
__________________
12/16/03 Work Accident
Herniation and DDD at L4-L5
4/1/05 Discectomy
Epidurals and facet injections
5/15/06 Discogram confirmed L4-L5 DDD also an asymptomatic L5-S1 tear
10/24/06 L4-L5 Prodisc surgery with Dr. Goldstein
CAT scans & X-Rays show ossification
Trigger Point Injections, Medial Branch Blocks, Acupuncture, Weekly Deep Tissue Massage
10/27/08 Discogram (positive L5-S1)
11/25/08 L5-S1 fusion with Dr. Goldstein
FAILED BACK SYNDROME
Liberty Mutual WC
Reply With Quote
  #6 (permalink)  
Old 10-01-2012, 07:43 PM
Senior Member
 
Join Date: Jun 2010
Location: Sierra Madre, California
Posts: 904
Default

Eddie G,
You certainly got off those meds pretty quickly. I do understand your severe pain and have been there myself. With little pain relief, I might add, but not with none. I don't know how you do this. I couldn't sleep at all when my pain was severe for 5 weeks . I have had other severe times, but reasonable amounts of pain relief or at least a doctor trying hard to relieve it. I sure hope you can get a good doctor who cares and can help you.
I am being referred to a new pain management doctor and will see him in 2 weeks. I hope he is better than my last one.
Judy
__________________










2007 ACDF 4-7
2008 hip , knee scope, hip replacement
2009 thoracic T-5 thru T-11fusion
2009 VATS T7-8, posterior only T11-12. removal of thoracic hard wear
2010 lung surgery
2010 T2-L2 kyphosis correction
2010 Kyphoplasty T-3, T-4
2011 Cervical osteotomy ,revision C4-T5
2011 Foot surgery
2011 Revision fusion T7 thru L4/laminectomy
2012 Hammertoe correction left foot
2012 Revision fusion T-12 thru L5
2012 Revision fusion L4-L5
Reply With Quote
Reply

Bookmarks


Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are On



All times are GMT. The time now is 09:35 PM.


Powered by vBulletin® Version 3.7.2
Copyright ©2000 - 2026, Jelsoft Enterprises Ltd.