Any recommendations...?

[tammyalonzo33]

I just got my dx on Friday 8/19.  My neurologist faxed over a prescription for Betaseron, but my insurance doesn't want to cover it.  Is this normal?  I thought because this is the oldest med for ms, it would be the easiest to get coverage for.  

[tammyalonzo33]

Thank you for the welcome.  I have been reading the health pages, and I am learning a lot. I am going to let my neurologist's office handle to problem.  I saw the $0 copay, and since I haven't been able to work in over two years, that would be helpful.  I am grateful that my husband is supportive (and provides our insurance), but the bills are piling up!  

I will be back again to learn more;)
Tammy

[Lulu54]

I saw on your other post the mention that they want you to take Rebif instead.  Be sure that your neuro is fine with that - they are both interferons and work the same way.

good luck,
Lulu

[Jifr]

Hi there:

It's been my experience that when the insurance company "doesn't want to pay for something" it's because there is something ELSE they would rather pay for or they want more supporting evidence/documentation.

Sometimes that happens because of how the doctor submitted your information.

Question for you:  How did you find out that your insurance company doesn't want to cover the Betaseron.  Did the Betaseron people tell you that?

[Lulu54]

Hi tammy and welcome to this side of the diagnostic mountain.  I'm sorry you have joined our dx'd club, but at least you have a name for what is bothering you.

As for the prescription, Alex and Julie are so right that you can let the neuro's office take the next go at your insurance company.  Please do not despair about this glitch - if nothing else, there are patient assistance programs from all of the pharmaceutical companies that will also help with the drug cost.  If I'm remembering correctly, betaseron has a $0 copay program for folks with insurance and very good help for those who don't.

Again, I'm sorry for the reasons you've joined us.  Take some time to learn more about MS and you will find that there are a lot of ways you can be proactive with this disease.  

I hope we'll see you around more with questions and just to keep us company.

be well,
Lulu

[jujuminx]

Tammy,
Oh with so much whirling through your head with your new dx, it's so unfair that you are having to deal with insurance issues. So sorry.

  Alex's suggestion is a good one. Call your neuro. They are use to dealing with insurance companies and should be able to make the initial contact with them to see what the problem is.  Sometimes it's all in the way the dx is written up and presented to the insurance companies.

  If for some reason that doesnt work, call them yourself and ask for the person in charge of your account. I have done this in the past when my insurance didn't want to cover a dr that wasn't on the plan.

  Good luck and let us know how it goes.

Julie

[HVAC]

Sorry for the diagnosis. Glad you got an answer. I do not know what to say about the Betaseron. Have you talked to your Neurologist's office? Are they pushing for it or nother DMD?

Alex