Hostage of "bureaucracy"

[me2]

Hi Alysia,
I don't know if this program applies where you are or if there might be something else like it Insurance and Co-pay Coverage - RITUXAN® (rituximab)

I once received assistance with getting a medication directly from the drug company (I can't remember which company at the moment. The drug was Myfortic) to get a medication I needed but was not covered for under my insurance. I know each drug company has programs to help people get medication who are not covered.

[annekat]

That's good info, Kirk. I bookmarked it in case I ever need RTX.

[Alysia]

Thanks for the info, me2. good to know that.

after 5 days of phone calls and a lot of nerves, I got it: the med & getting the treatment in hospital.
I guess maybe someone else ,wouldnt have get it, someone less desperate then me, and less assertive, not to say aggresive I reached to the head of ombudsman of the health service and only then I got it.
Im feeling like after a war...

Thanks again everybody here for your support. you give me power.

[annekat]

Glad to hear that, Alysia! That kind of stress you have been going through is not good for us Weggies, or anyone! But congratulations on your persistence and getting the medication approved!

[JeanMarie]

Yeah for you!!!!!!!!!!!!!!!! That's one battle won!!

[drz]

Thanks for the info, me2. good to know that.

after 5 days of phone calls and a lot of nerves, I got it: the med & getting the treatment in hospital.
I guess maybe someone else ,wouldnt have get it, someone less desperate then me, and less assertive, not to say aggresive I reached to the head of ombudsman of the health service and only then I got it.
Im feeling like after a war...

Thanks again everybody here for your support. you give me power.

Good job, and best wishes for some real helpful benefits from the treatment.

[rebekah]

Yay! I'm so happy to hear that you got it approved, Alysia! Looking forward to hear you're feeling better after starting the treatment.

[Alysia]

I need to vent, please...
I have to do my second RTX in 24 sep and 8 october, now 500mg each. I send all the papers to the health service 2 weeks ago, and I am waiting for their approval…
Yesterday it turns out that they are not willing to approve it.
They wrote to my wg-doc that rtx had no effect on me therefore they are not approving it.
WHAT ??!!??
My doc sure answer them, rtx did wonders to me. according to the law here it is my right to get it: it is written in ministry of health that in wg I deserve to get rtx.
Money. This is what is all about. They don't care about people life. I hate them.
Do I have to start shouting again like in the first time ? I can shout very well when needed, but why should I ? my poor aching throat… I am tired.
Thank you so much for being here and for listening.
I would not survive without this place.
I love you

[NikkiNicole]

This is what I fear in the future. I go to a hospital called Kaiser. It's a big company here in the USA. It's not the greatest but they have all the doctors and specialists in their company so you don't have to go far if you are referred to a specialist (unless you need to see a different one like me and end up going to one of their other facilities). So far, I've not had anything out of pocket because my employer and my husbands employer pays for their best coverage. However, ... if things get any worse or if we get our new "Obama-care" (Universal Health Care). I don't know how that will work since I pay for my own coverage. I am so confused.
Start screaming my dear, I am sorry that you have to scream.
I have a co-worker who is excellent at yelling at doctors. She does it for me sometimes. I can send her to you only if you promise to send her back.

[drz]

I need to vent, please...
I have to do my second RTX in 24 sep and 8 october, now 500mg each. I send all the papers to the health service 2 weeks ago, and I am waiting for their approval…
Yesterday it turns out that they are not willing to approve it.
They wrote to my wg-doc that rtx had no effect on me therefore they are not approving it.
WHAT ??!!??
My doc sure answer them, rtx did wonders to me. according to the law here it is my right to get it: it is written in ministry of health that in wg I deserve to get rtx.
Money. This is what is all about. They don't care about people life. I hate them.
Do I have to start shouting again like in the first time ? I can shout very well when needed, but why should I ? my poor aching throat… I am tired.
Thank you so much for being here and for listening.
I would not survive without this place.
I love you

Appeal it as quickly as you can. The squeaky wheel is the one that gets the grease. They know many people won't and that is what they count on to save money. But if you pursue it they will generally cover you unless they have some clear loop hole to deny it. I often have to have my doctors send it things two or three times to get some things paid. Here in the USA the threat of a lawsuit often gets them moving the right direction. Your doctor may have to clarify that benefits of RTX aren't like an antibiotic in showing immediate positive changes since it can take several weeks to work. The people in positions or hired to deny benefits are seldom or almost never as knowledgeable about your treatment needs as your treating doctor so that is in your favor and they know that too when push comes to shove.