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LJO
New Member


Date Joined Jul 2007
Total Posts : 3
   Posted 7/24/2007 10:25 PM (GMT -6)   
My 33 year daughter, mother of 4 young children, suffers from debilitating migraines which are increasing in frequency.  Her insurance has carried a rider that prohibits any dr. visits, etc. to do with migraines.  Where do we start?  She is nursing her 9 month old baby and does receive sample medications from her dr. who is sympathetic but unable to get around the insurance situation.
 
Thank you for any suggestions!
 
 

baseballmomof3
Regular Member


Date Joined Apr 2007
Total Posts : 189
   Posted 7/25/2007 7:25 AM (GMT -6)   

Good Morning.  First, I have never heard of an insurance company excluding one problem (unless maybe it is suicide).  Maybe someone else on here can address that.  But, if your daughter has a health insurance policy and is having problems with migraines, can't you appeal the "no migraine" visits?  Has she had a CT or MRI?  For one, if she is having severe headaches, the only way that other things besides migraines can be ruled out is through one of those tests.  I can't imagine an insurance company not allowing you to have your head checked to make sure there isn't something else going on.  I would fight this 100%.  Are migraines the only excluded illness/problems of this policy?  If you don't mind my asking, what insurance company does she have?

I am sorry if I am rambling, but I am completely flabbergasted over this.  For her to have this pain and not be able to get treated is unbelievable.  Maybe there are others on here (snugglesrn, etc.) that can give you more advice.  I feel for your daughter.  I have three children and I couldn't function to raise them without my migraine meds and my neuro doc.  In fact, yesterday morning, I woke up with a horrible migraine and had it not been for my meds, would most definitely had been in the ER.

Good luck and let us hear from you!


DX:  Migraines since June, 2006, kidney stones
 
RX:  Daily - Verapamil, Trileptal
PRN:  Relpax, Prednisone, Dilaudid, Lortab, Lidocaine Nasal Spray


Jana042
New Member


Date Joined Mar 2007
Total Posts : 10
   Posted 7/25/2007 8:02 AM (GMT -6)   
I have insurance, but am also unable to see a doctor regarding anything to do with migraines as it is a pre-existing condition. However there is a certain time limit on my insurance for this. For me, I can begin seeing a neuro in October.

Will your daughter's insurance policy ever cover her migraines?

LJO
New Member


Date Joined Jul 2007
Total Posts : 3
   Posted 7/25/2007 9:34 AM (GMT -6)   
They will cover migraines if she has five years with no visits to the dr. for them or medication prescribed.  I am calling the insurance commissioner to see if this is legal.  Thanks for your responses.

baseballmomof3
Regular Member


Date Joined Apr 2007
Total Posts : 189
   Posted 7/25/2007 11:15 AM (GMT -6)   
Were migraines a pre-existing condition for your daughter?  I can't wait to hear if this is the case.  Also, since the PCP seems to be helful, maybe talk to him and see if he can finagle enough sample meds from the pharmaceutical rep to keep your daughter with both preventitive and abortive meds (although, I am not sure what is safe for her to take while she is nursing the baby).  Many times the reps can use their samples at their discretion (my husband has worked for a pharmaceutical company for 20 years) and often will help a patient that is in need of their meds.  Her doctor would be the one to request this of the rep so it is definitely worth a try.  I am so sorry that she is having to go through this - I can't imagine having to deal with the pain and sickness of migraines with having four young children and no way to get any help. 
 
Please keep us updated.  Tell her that she is in my thoughts and prayers.
DX:  Migraines since June, 2006, kidney stones
 
RX:  Daily - Verapamil, Trileptal
PRN:  Relpax, Prednisone, Dilaudid, Lortab, Lidocaine Nasal Spray


snugglesrn
Regular Member


Date Joined May 2007
Total Posts : 40
   Posted 7/25/2007 11:37 AM (GMT -6)   
I am sorry to hear that your daughter is having so many problems with her insurance. There is only one tip that I can offer you and that is maybe the doctor can write his bill to be submitted to insurance in a different way. For example: When I had my ECHO done to check for a PFO because of the migraines the insurance company would not cover it but the cardiologist wrote it up as I was getting a ECHO done because of potential high blood pressure and they covered it completly.
I also know that if her insurance won't cover a prevenative medication that your daughter could try an antidepresent, which I have read helps migraines (ask your doctor) and sometimes works as a preventative. Topamax can be written up for seizure activity or potential seizure activity. I know when my migraine problems first started they thought my third ventrical was enlarged and then they thought I was having seizures and I think that's the only reason why my CAT Scan, MRI, MRA, and EEG were covered.
I hope this helps. I know it is frustrating especially when dealing with the doctors. I hope she feels better soon!

LJO
New Member


Date Joined Jul 2007
Total Posts : 3
   Posted 7/25/2007 3:10 PM (GMT -6)   
Thank you all--she's seeing her dr. again out of desparation and does get some samples. Good idea if she can write it up as something else--this is insane. I SO sympathize with all of you who have migraines!!!

texansarah
New Member


Date Joined Jul 2007
Total Posts : 2
   Posted 7/25/2007 7:39 PM (GMT -6)   
Hi there. My one other thought is to try acupuncture and chinese herbs that they prescribe. That's what I've been doing for the past year, and have had some relief. I still need some of the regular drugs (triptans) but perhaps the acupunture can help prevent them enough so that she can get by on samples from her PCP. Good luck to you!
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