(upon editing I see my questions are at the end of post, thanks for reading)
So, I have some issues with my pain meds. I normally see a nurse practitioner as the DR only does procedures and handles "complex" cases.
It seems every month we changed my script
s. Started with morphine, then OxyContin($200), Opana, back to Oxy(bc of surgery paid the $250 and it was great relief), tried Opana again as it was to be covered , was denied, so back to Morphine.
I found a perfect pain regimen with OxyContin 15mg TID, and Hydrocodone 10mg BID.
Only problem is the Oxy cost over $250 a month, not including any other meds I have to pay for.
I am on SSI and with a $700 budget, that 250 is a huge chunk.
On Nov 1st, medicaid stopped covering Opana as well.
they only cover morphine, Kadian, and Fentanyl(but I'm not sure about
non cancer patients).
I will be meeting with the actually PM Doctor the 19th, and I'm trying to prepare for this appt. the best I can, going in with all the knowledge about
medicaid's new rules and possible options.
I'm thinking that the reason for the appt is
1.see if he will prescribe the fentanyl(i'm really really scared to start this, as you just go up on dose, and hard to get off. I'm 29y/0. Also afraid of the 72hr vs 48 as I have a high tolerance the dr's seem to ignore). and a few other concerns
2. I really fear it will be a "i don't think we can help you anymore" type appointment.
To hold me over to the 19th, i was given morphine 15 TID, and its really not helping, especially being post op.
(even IV morphine in hospitals NEVER help me. Even my parent will tell drs/nurses if I can't that morphine doesn't work for me, even when i was on a ventilator and Heart rate showed pain, after my parents told them to try something other than morphine, it worked just fine.)
I just don't understand why they will pay for such a strong drug like Fent. but not OxyContin or Opana.
Back to the point of the post, sorry....
*How do you address a drug company asking for help to get this type of med?
the coupons I found only got the price down from $275 to $250.
*is there ANY way to get medicaid to approve either the oxycontin or opana?
In the rules it says you have to have a TOXIC reaction, not including itching, GI issues or such but a life threatening reaction(just for Opana).
From what I've seen there is just no way to get the oxycontin approved.
If I call my insurance what questions do I ask? what options at all do I have??
or such I just sacrifice many other things and pay the $250? Only thing is if the dose ever needs increases, so will the price...
my pharmacy is not happy with me, bc before ordering the opana they didn't check to see coverage. So a week later after they ordered(added to the amount they are allowed a month), they tell me its no longer covered So i wasn't able to get it. so they aren' happy "I caused them to get a med they never fill and will count toward their monthly allowance"....not my fault!
Dx's: Depression/anxiety, Non-Epileptic Seizures, repeat Rt. shoulder dis
locations, NERVE damage after if IV infiltration with chemical burn in left arm,endo &ovarian cyst., chronic Lyme I could go on but will spare you all
Meds: ER and BT pain meds, nerve meds, holistic things, muscle relaxers PRN
doTERRA essential oils-Frankinsense, Lavender, Balance,peppermint, Clary sage,
Post Edited (AngMichelle) : 11/4/2014 3:27:36 PM (GMT-7)