Does anyone know if Fentora can be covered by your insurance when not prescribed for cancer pain

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New Member

Date Joined Oct 2011
Total Posts : 11
   Posted 10/16/2011 2:17 AM (GMT -6)   
I have been prescribed Fentora for non cancer pain and recieved a voucher for 28 free tablets. Will insurance cover this medication when the patient doesn't have cancer, but recieves a doctors letter statiing that the patient needs the medication? Also is it possible that the Duragesic Brand of the fentanyl patch is still around? You know I'm going to take this time to vent and inspire a little. For those of you out there who are suffering in pain, because your pain management doctor is under treating you, there is hope out there. I was ran through the mill and finally found a doctor that understood my condition and is getting my pain under control. I have been through multiple doctors for various conditions and am still on a quest to find the right GI doctor for me. Recently I had a colonodcopy done, in which the doctor said one wasn't needed even though i had severe crohns. Long story short, I forced him to perform one on me and a precancerous growth was found, more inflammation and extreme scarring. Prior to this he advised me that I did not need one for another 10 years. Luckily I made him do one or who knows where I would be then. I was also awake during the colonoscopy which caused severe pain and I made it clear to him several times but still had to suffer. The colonoscopies from past doctors were not even felt as I was put to sleep.  That GI felt all I needed was asacol for severe crohns disease thus the reason I left that one and now have this one. So now I am attempting to find another GI doctor, but its just so stressful trying out new doctors and trying to find the right one. Our entire family has been stricken with sickness, as my mother has fought HIV AIDS for 30 years, so I use her infectious disease doctor as my primary care doctor.

Veteran Member

Date Joined Jul 2009
Total Posts : 2042
   Posted 10/16/2011 3:37 AM (GMT -6)   
Quite honestly this is a question only your insurance carrier can answer since every policy is different.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

Regular Member

Date Joined Aug 2010
Total Posts : 215
   Posted 10/16/2011 3:57 AM (GMT -6)   
With my insurance company, even though its retail cost is 269 for 90 count each month, I pay 20 bucks. Its covered because my doctor called my insurance company to pre-authorize the medication.

Therefore, if your insurance company allows for pre-authorization from the doctor, that might be good enough as its still a pain related condition (and falls under its prescribed use). However, I would recommend calling your insurance company directly and then speaking with your doctor if the results are unsatisfactory.
MRI revealed disc bulge and test injections revealed RA. Radio Freq procedures helped for months, but pain is up and im having the procedure done again. Currently on 75 mgs of Nucynta (tapentadol - A MOR + NRI) 2 to 3 time per day and Soma 350 as needed.
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