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To: Karliner

If you are having difficulty getting meds you needcovered by your insurance the following might help The booklet is for medicare, but the same info applies to private insurance:

How to Booklet re Rx Appeal Rejection:
http://www.medicarerights.org/partd_appeals_manual.pdf

Federal Regulations re Rx Appeals, giving time frames for ans by ins co:
http://www.federalregister.gov/articles/2005/01/28/05-1321/medicare-program-medicare-prescription-drug-benefit

Brand vs Generic:
http://www.merckmanuals.com/home/ag/sec02/ch015/ch015b.html


123 posted on 09/24/2011 7:58:24 AM PDT by algernonpj (He who pays the piper . . .)
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To: algernonpj
Not yet but I will have. I just went through two days of hell( second time in less than 6 months)for utilization reviews on my LIFETIME workers comp insurance in which they denied everything until I see a doctor AGAIN to renew prescriptions. It just happened when I saw this thread. Dang, I use albuteral and I cannot begin to think of the many times that inhaler has saved me from a worse attack by nipping it in the bud. I've had pneumoniax5, been shot at( scars to prove) in a war, am 80+ percent disabled from an assault when I was working with ...I better not say, but it took three long years fighting workers comp then my pension fund( add another 1.5 years for that) and it took my senator to help before I finally got it.

That's the short story. I am one of the few that worked through a 50% disability from the army, and never spoke of it with all the work I had AFTER my honorable discharge but dang, it's impossible the hoops they make me go through and who is eating it? Me with no meds and the pharmacist who was kind enough to have filled prescriptions in hopes he'll get paid. p>

I WANT to work but have not found an employer that will hire a part timer...GRRR I'm skilled and am in the process of going through a pharmacy tech licensing because I know my pension ain't gonna cut it in the next few years. Dang if anyone has a part time job in Humboldt County let me know, I really want to work.

So far I'm doing okay except the danged review I must do and the pharmacist who is out a lot of money until they sign off on my meds..damn them. Thanks for the links I'll check them and since I have a post on here it's auto bookmarked. Take care and God bless you.PS I do not have mediscre, just hospitalization I think it's part D, but I've never used it or needed it yet)

132 posted on 09/24/2011 9:04:43 AM PDT by Karliner ("If we were real domestic terrorists, shoot, Obama would want to pal around with us, wouldn't he?")
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