Dealing with Insurance companies is

[ Follow Ups ] [ Post Followup ] [ Cluster Headaches Messages ]
NEW cluster headache email group! Click Here to learn more!

Posted by Ike ( on February 05, 2002 at 14:15:57:

In Reply to: got this from Roberts, about the limiting on Triptans.... posted by melissa on February 05, 2002 at 12:16:00:

a "BITCH" at best. I was, however, able to secure larger than normally allowed quantities of both Maxalt-MLT and Imitrex. The procedure with my Ins. Co.(Humana) was to have the doctor contact the "Pharmacy Review" department. Most Insurance Companies have one of these. Once he had made the call, and faxed the necessary information, I was able to get more that normal of both meds. Once the "approved period" ran out, I had him do it again.

I don't use much Imitrex, since the Maxalt will do it for me in an acceptable length of time.(Normally) I was able to make a deal with the Ins. Co. where I can get 90 Maxalts the first month and then 25 per month for the remainder of the year. If one is not chronic, and has recurring cycles, this should be enough to get through most cycles. Assuming, of course, you have time to "rat hole" some of the 90 before the cycle starts. I don't need any at this time, but I still fill every script when it is available. Maxalt is double foil wrapped, so the likelyhood of it going stale is minimized.

As far as Imitrex stabs are concerned, I was originally allowed 3 packages(six injections) per month. After doing the deal with the review dept., I was allowed twice that(12 injections)

While this is not enough for those that are going through the worse period of a cycle, and Imitrex is the only med that works, it is far better that the original six.

I would assume that this will not work for everyone or with every insurance company. It may depend entirely on the Doctor and his ability to communicate with the insurance co. Since no two cluster sufferers are exactly alike, it is safe to assume that no two insurance companies or doctors are the same.

I hope this helps at least one person that reads this.

Keeping the Faith,


Follow Ups:

Post a Followup




Optional Link URL:
Link Title:
Optional Image URL:

[ Follow Ups ] [ Post Followup ] [ Cluster Headaches Messages ]



Click Here!