Goverment fools. (Illinois)

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Jim1969
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Date Joined Jul 2009
Total Posts : 2042
   Posted 6/3/2011 5:47 PM (GMT -6)   
I have just now become aware of the new preferred medication list for medicaid in the state of Illinois.

Changes made from last year's list that effect either me or my wife are Cymbalta, Lyrica, and my diabetic testing supplies.

I take Cymbalta for diabetic neuropathy and my wife Lyrica for fibro. Now the only med really left to us is neurontin, which we have both tried and had to take tons of it to feel any effects, most of them negative.

Up until last year I had used One Touch as my meter of choice when the state decided to no longer allow that product. I was given a Freestyle meter and test strips instead. I fought with those test strips for 2 months, as they draw samples from the side of the strip instead of the bottom like 95% of meters do, and got to the point I refused to use it. After doing a lot of research I found the Bayer Meters tested the same way as the One Touch and were approved. Since I already had been given a new meter I had to buy the Bayer meter myself, but at least the state covered the strips. Now I am going to be forced to change meters again and 2 of the only 4 options are the stinking Freestyle meters I hate. It looks like though the other 2 options use test strips like the ones I am used to, but it still means having to get used to a new meter. (I wonder how much the state is spending providing so many people with new meters every year). What is really stupid is that the test strips for the Freestyle meters have the same retail cost as most of the meters they are no longer allowing. I wonder what kind of sleezey backroom deal they made with the makers of Freestyle to pull this one off.

I know that Illinois and many states are in a world of hurt financially but these types of changes are simply stupid and put a lot of people's health and quality of life at stake, and while there is a procedure to get non approved drugs approved, here in IL at least you would have better luck going shark hunting in the Mississippi river as you have to have documented proof of having tried every OTC drug and Rx'd drug on the preferred list for that class of drugs before they will approve anything else.

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 6/3/2011 6:08 PM (GMT -6)   
Just FYI...from what I know speaking to my PM Dr...although I'm in VA...if the Dr. writes "medically necessary" not just on the prescription...But sends a letter to Medicaid about how a certain medication is needed over another...they will cover it...The changes are about 'preffered'...but not absolute..

This is what my Dr. has told me...as VA and most states have a list like this..

Medicaid is jointly funded by both the Federal and State governenments but is managed by the States...

I would contact your Dr. and see what he says on this..because Lyrica has been approved and is the 'preffered' medicine for Fibromyalgia....I would think that the Dr. can get this one covered as opposed to Neurontin...

As you mentioned....so many States are hurting financially...and won't say which party is looking to completely get rid of Medicaid...but most people know...

I hope that your Dr. can find a way to help you all out!!
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

Jim1969
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Date Joined Jul 2009
Total Posts : 2042
   Posted 6/3/2011 9:17 PM (GMT -6)   
My wife's doctor just finished going 4 rounds with the state over her Lyrica script. According to the state neurontin is "just as effective". rolleyes


Illinois is a rough state to deal with in regards to Medicaid. Before being put on dilaudid my PCP had a couple of medications she wanted to try me on. She provided a lot of paperwork about why the meds should be approved including all of the other meds I had been on, how they either did not work or the issues I had taking them and it was still denied.

While I doubt it will do any good I spent about an hour tonight emailing my state senators and reps about this type of BS.

So many meds are used "off label" anymore (meaning they are used to treat conditions other than what they were originally marketed for) that it is quite stupid to "ban" that drug totally.

For example, Cymbalta. It is commonly "classed" as an anti-depression drug but it is often prescribed to treat nerve pain as well as non specific pain like that of Fibro.

What is "amazing" is that IL will continue to cover Cymbalta if it has been prescribed for depression prior to April 1st, but not if it is prescribed for any other reason.

NiNi53
Veteran Member


Date Joined Mar 2011
Total Posts : 816
   Posted 6/3/2011 9:40 PM (GMT -6)   
Jim1969, I am going out on a limb here and taking from your name 1969 is the year of your birth.  I hope I am not overstepping any boundaries here.  Be that as it may, Im thinking maybe it time for a little radical movement, only now unstead of riding in VWs or VW buses, we will be in walkers, wheelchairs, canes any and all of the tools we need to make our quality of life better.
 
I simply do not understand why everything is a fight, who decides across the board, what medications are right for you, your wife, not the doctors who at least know what you need and will try to get it for you.  Politicians?
 
Ok, enough I know I am on thin ice here, so I will leave you with these thoughts "we all (cp patients and all other diseases and conditions listed) have to be allowed to have some choice in the way and the how we are being treated with the disease of chronic pain.  We already have to prove just how badly we hurt, 24-7 no one seems to really care.
 
If any of us is fortunate enough (and I am) to have a good pain management doctor, then why must we continue to have to fight for our "our" doctors orders.  It seems it should be simple, you need this, here you get what you need so you can get out of bed each and every day.  Just to get out of bed.
 
Ok, think I have said enough, maybe to much.  Please I am hoping all have low pain days.  Tender hugs to all.
 
I have know idea why this is now typing sideways of sorts, I better get off this thing before I do something to it that makes it have to be fixed.
 
 
degenerative disc disease, fibromyalgia, osteoarthritis, neuropathy, lumbar laminectomy july 1998 no help, rechargeable neurostimulator unit low right back w/lead wires to left side and right leg unit not working just sitting there.i am 57 years young in may will turn 58. i have 2 grown daughters, 25 and 29. i have 2 grandchildren, 9 year old grandaughter and 5 yr. old grandson

momtofourangels
Veteran Member


Date Joined Apr 2010
Total Posts : 2265
   Posted 6/3/2011 10:03 PM (GMT -6)   
Oh Jim I'm sorry that you're having to go thru this. Like I said the other day on my post, these people think they know what they're doing, but they don't. I hope you get some help by writing the politicians in Illinois. This is so rediculous.

It looks like they would be spending a lot of money making you and the other diabetics change meters every year. How crazy. I have diabetes, and I hope New York doesn't get any crazy ideas.

I wish you and your wife lots of luck with the cymbalta and lyrica. It's really not fair for someone like the government tellimg you what you can and can't take for your pain.

Well, I guess I better stop before I go too far. I know it's very aggravating.

love and soft hugs
Loretta
Dx: osteoarthritis, bursitis in left hip, Osteoarthrits in right hip, compression fracture in thoracic spine due to falling on frozen ground March 2001 , ddd, spinal stenosis, bone spurs, osteoarthritis in spine, osteoarthritis in both knees
Meds: Fentanyl patch, oxycodone, otc: BenGay, Tylenol Arthritis on occasion

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 6/3/2011 11:28 PM (GMT -6)   
Sadly in many ways it is no different than having private insurance. In the end it is the bean counters who rule the day.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9664
   Posted 6/5/2011 4:12 PM (GMT -6)   
So, very sorry your having to go thru this, I'm not even looking forward to doing medicare
when I get older, as it is aweful...no one takes it down here, doctor's are refusing to accept new medicare
patients as it doesn't pay...heck if it doesn't pay now what will the future have???
It's horrible to treat our seniors so and yet the illegals know how to take advantage of it....

I was in the er a couple of years ago due to an asthma flair, yet the illegals got taken care of faster than I did
and I have insurancce...they know how to work our system...

Actually, they've found bull sharks in the Mississippi river, it's the only shark that
can do both types of water, so yeah finding a shark in the Mississippi river is easier...
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 6/6/2011 6:51 PM (GMT -6)   
I got a reply back from one of my state rep, for what it is worth.

The reply basically said sorry, there is nothing we can do about it as we have no say or influence over this matter.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9664
   Posted 6/6/2011 8:08 PM (GMT -6)   
Jim sincerely sorry about this situation your in...wish I had the right magic words
for you to give you hope...prayers....
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******
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