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Avatar universal

Insurance says I'm a relapser, so they won't approve continued treatment

Hey yall...I know I said I was going to quit at 60 months, but that should have been MY decision!!!  Got a letter from BlCrBlSh saying "tx after relapse does not meet the criteria for extended tx"...now what if I wasn't knowledgeable, and BELIEVED I had relapsed!!!  what jerks!!  I have been undetectable since about week 20........just had another 48 wk PCR, still und...I know I should write a nasty letter......but I have so little energy...
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92903 tn?1309904711
You know - if you need some extra riba - I'm sure there's plenty floating around on this board. Rarely does anyone finish by taking the last pill in the bottle.  I had some, but, let's just say it went off to the big recycling bin in the sky. I'll bet someone here who finished recently can help you out.
Helpful - 0
Avatar universal
I know they already said this but contact commiment to care so you can keep going if you wish to.  Sometimes Insurance companies get to involved in dollars and not what is really right for the patient.
Helpful - 0
Avatar universal
This is such BULLHORCKY!!!!! I am SOOOO mad right now I could spit, cry, scream...RRRRRRR. Im so flippin' sorry fishdoc. Prayers are yours. Them stupid insurance companys.
Helpful - 0
Avatar universal
Sorry for the melodrama!!  I have 7 shots left, which will take me to the 60 week mark.  I have about 30 days left of ribavarin, because remember I'm off on those because of doseage increase, I take 8 a day.  I guess I am most angry because they sent me an "official" letter saying I'm a relapser.  I keep every single one of my lab works, but what if I didn't??  Also, since when is "extended therapy" NOT the suggested course of tx for relapsers??  Does that mean they won't approve a second tx??  Given my stats, and the available scientific literature, I should probably go for 72, but that option is not available to me......I'll run out of riba about 3-4 weeks before end of tx.  Really, I'm  just pissy these days.....internet has never been restored, and its been down at work a lot!!  Friole, how are you doing?  Is this an issue (approval) your going to have to deal with if you retreat?  Thanks for all the support....I'm having a rough time these days;; son deploys to bagdad in two weeks, my motherinlaw just got diagnosed with stage three colon cancer (shes 89).  Came through the surgery great.....but now what?  Hope yall are doing a little better than me right now!!!  Beamer, hows life tx ing you?
Helpful - 0
Avatar universal
I am so sorry about this -- I really am.  The whole insurance and health care issue is a mess in this country.  In some parts of the world, health care is a right, not a privilege.  I hope you will pursue this to the extent you feel necessary to get what you need.  We are here to support you along the way.  Aiuta  
Helpful - 0
Avatar universal
i have some 'leftovers-assorted flavors&helpers too...if yu really want to keep on trucking?let me know..either way-GOOD LUCK!!!
Helpful - 0
131817 tn?1209529311
You didnt' relapse, you didn't respond quickly, right? I agree with Friole call C2C and get those drugs...you need the doc to give you a script though. Awful how ins. co do this to us! I haven't gotten that far yet, it says on my bottles and shots I have 11 refills, so I figure I must at least have the script! Doubt the ins. co will think so though....no energy to deal with it all either. YUCK!
Helpful - 0
92903 tn?1309904711
Fill us in fisy. You can't leave us in suspense! Hey, BTW how's the love life? Hubby ever get that floppy fish pole workin?
Helpful - 0
Avatar universal
Cr@p.  You need to do the 72 weeks.  Your VL was too high at 12 weeks.  You need to call the assistance programs right away.  How many meds to you have left?
Helpful - 0
86075 tn?1238115091
youre a great gal and I really hope you can get this resolved to your liking...I'll say a word to the universe (sometimes, it actually listens!) about a nice SVR for you...be well...
Helpful - 0
Avatar universal
I'm a little lost too...???

So you where wanting to quit because it was wearing on you... but didn't quit... & now because of the extention, the insurance is calling it relapse???

Well, aren't you glad you didn't quit if that's the case... because if you had, & you did possibly relapse, you know know that the insurance won't cover it....

However since you didn't quit, & didn't relapse & since it's an extention... you can fight the insurance company on that one!

So what are you going to do?

I hope this finds you doing well as can be expected, & in good spirits... & wanted to ask you IF any of this had anything to do with depression & the fact your son soon to be deployed over-sea's??? As you may remember, my step son was deployed last month! Every day is a worrisome one, & I can imagine dealing with that extra stress on TX!!!

Just hope your doing well & wanted you to know I think about you often!
;) Take Care
Helpful - 0
173975 tn?1216257775
"Hey yall...I know I said I was going to quit at 60 months, but that should have been MY decision!!! Got a letter from BlCrBlSh saying "tx after relapse does not meet the criteria for extended tx"...now what if I wasn't knowledgeable, and BELIEVED I had relapsed!!! what jerks!! I have been undetectable since about week 20........just had another 48 wk PCR, still und...I know I should write a nasty letter......but I have so little energy..."

I don't quite understand.  Are you saying you're finished with treatment and don't need any more meds and are furious at the fact that if you WERE still in need of tx the insurance company won't pay?  Is it the principal of the thing?  Are you OK now?  Please explain.  I'm a little dense but nonetheless concerned.

finished
Helpful - 0
Avatar universal
Cant you get the committment to care program to give you the drugs you need to extend? From what I've heard it's pretty easy and quick to get approved and get the meds for free.
Helpful - 0
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