help anybody go o the methadone clinic

[eckerkhoff04]

i all ready post this message in another form but they said i might get more help over here

Okay my name is Chad i was usein  oxy 80's about 10 a day then i whent to heroin for about 2 months then i desides to gt help i have been in the methadone clinic for abouta year now i am on 80 Mgs witch do me good for the mos part till late at night and the next morning till i go i am kinda not feeling that good but what i am askin is about insurance the clinic does not take insurance i have caresource witch i have called over and over and they tel me i need to go to the docture and get on the pills witch is gunna be hard to do plus i am additic but  i dont understand there is like 2 people out of the 500 people that go to the clinic that has to pay for the methadome and the insurane pays them back when they send in the paper work like a month later but they are turning me down and i don understand  there is a clinic  by Hollwood Casino called EITC witch i heard starting taking caresource about 2 or 3 months ago i dont understand how it can be so hard to get my insurance to help me  when they help here and help people there i have looked on line everywhere and cant seem to find anything about or seem to find any body talking about the samething that i am please if anybody know what i am talkin about know of anything about it o even know of ny Links of people talking about the same thing could help me out would begreat if u ned to know anything else please let me know thank u

[eckerkhoff04]

Okay what i am saying is about 2  people at my clinic sent in there receipts and in about 4 weeks got reimbursed they told me and told me nt to tell anybody they said if all the people that has caresource calls and trys to get reimbursed  they will cut it off so i have not told anybody what also what i was sayin is a clinic 30 miles away started taking caresource 2 months ago i called them and they said to come in i woul have to sign some papers and sign a release so they could find out what play i am on and with they will pay for 50 75 or 100 percent of the dosing and i said okay its just 30 miles away 30 there and 30 back that is alot of driving to do it 5 days even tho one more drug test i pass i would get another take home so i will only have to go monday thru thursday  i just dont understand how that clinic will do that but the one i go to dont they said they have been trying and trying because everybody is coming in and dont have the money to pay for there dose everyday it is hard i never thought how hard it woud be to come up with 12 day everyday so i did tell the clinic about the other clinic and they said they was going to try to get info on how they did it andi got my  receipts and i sent them to caresource for my reimbursement  not weither they do it i dont think so but like i said a very good friend just got a check on monday for 60 dollars when i was on the phone with the insurance they said they could not tell me for sure if i would get reimbursement  but my really good friend tole me on the phone that they told her that she would with her store is no different then mine by the way i have been calling caresouce about 3 times a month for a year  and i do too get a different story everytime  like u said  but if 2 other people can get a check for reimbursement  then they shoud be no reason i cant they said they will look at other clinics around me that take the insurance instead of reimbursement  witch a clinic does not do unless u are a girl and u are gunna have a baby and i told them about the clinic that is 30 miles away and they saidthat ill not change nothing because that  to far for me and also they said witch they have told me this before that i need to go to a docture and get the methadome pills witch they cover maybie this will help u out  if u could fins any more info to help me out thank u very much

[Tuckamore]

Hello and Welcome to the Pain Management Forum.

Congratulations for recognizing that you have a problem and getting clean. I am sure it was not an easy task. You should be proud of yourself.

I have read your posts in the SA Forum and see that TrayCee suggested you post here. This really isn't our usual question but hopefully someone will see this that can offer you better suggestions than I can.

I've worked with insurance companies a lot both in a professional position and obviously for personal reasons. I have learned that some times it depends on who you talk to in the company. I have called three times in one day and gotten three different answers.

Help me understand exactly what you are saying. Are you saying that other ppl with the same insurance are being reimbursed for the methadone. Even thought this is a state insurance not everyone may have the same plan. I do not know.

I have just finished searching the on line information for your insurance company. It did not make me an expert. I cannot find methadone on their drug formulary, meaning the list of medications that they will approve for payment. It appears that recently they may have had some changes in coverage and providers.

So you have submitted your receipts to the insurance company for reimbursement and they have been declined?  They may be looking for a doctor to verify that you require methadone. Insurance companies can be so picky. T's need to be crossed and I's need to be dotted. It make little sense sometimes and often ends up costing them more money.

I suggest that you make an appointment with your physician and explain the situation. He may be able to help you figure out the hoops that the insurance company is requiring you to jump through. I think you need a medical professional on your side to talk with the insurance company. Let them sift through all the requirements.

And you may not want to hear this but I would call again and talk to someone else. If need be give the name(s) of the ppl that are receiving reimbursement for their methadone. Ask why the difference and how they are able to get the reimbursement.

You can also talk to the county office where you applied for the insurance and ask for their help. The more information you gather and the more ppl you have working on this the quicker you may find a solution.

I am not in Ohio but I assume all state insurances are similar. In my state there have been numerous cuts in state insurance and their approved providers and approved drug coverage lists have become shorter.

Good luck to you Chad. Don't give up. This may be a battle but there has to be a remedy of some sort. Hopefully other members will have additional information and suggestions. Please let us know how you are doing. I know this must be frustrating. Hang in there and keep us posted.

Best of Luck to You,
Tuck