Victory Is SWEET!

Dear Lit Loves,
Greetings!  And I must say that for my 100th blog post I am happy to report that I have finally won a major victory:  I fought my health insurance company for coverage of my name brand migraine medication and WON!  This has been an ongoing battle since January 1st, 2014.  And it is not a trivial matter by any means.  First, the only migraine medication that has ever worked for me has been and continues to be CalanSR 240mg.  No other name brand migraine drug or generic migraine drug works period, end of discussion.  When I went to pick up my prescription in January 2014 for CalanSR I almost fainted when the pharmacist informed me my insurance would not cover it and it would be $250 a month!  What did I do?  I paid for it and then went to work battling for coverage.

I enlisted my neurologist because he prescribes it and knows my medication history.  He agreed, the non-coverage was definitely unfair.  I was willing to cover fifty percent too.  So I had to get my neurologist to appeal the non-coverage of my migraine medication to the health insurance company's pharmaceutical board.  Seriously, this took a month.  I was denied coverage.  My neurologist and his very kind assistant Kristin filed another appeal.  I called the pharmaceutical board myself and gave my reasons for requesting the medication to be covered.  Meanwhile, I paid another $250 for another month's worth of CalanSR.  And you know I'm thinking at this point how many Lilly Pulitzer Spring dresses I could have bought with the $500 I've already spent.  We were denied coverage a second time.  Finally, we filed a grievance appeal which after being on the phone on hold for an hour and change, I learned is when you believe your life is compromised to a significant degree by being denied coverage of this medicine.  Well, yes, that was the point.  So my neurologist wrote a dissertation, sent my medical files, and we waited.  Meanwhile, I called at the end of each week to inquire about the status of my appeal.  This went on until last Friday (three months) when I was happy to learn that I've been granted 100% coverage for my name brand migraine medication.  If there is one thing at which I excel it is persistence.  Damn, I feel l like I just won mandatory equal pay for women or something.  So I'm taking myself out to lunch to celebrate.  And yes, I'll be taking my most effective CalanSR medication with a glass of sweet tea today as well.  Victory is SWEEETTTTT!!

Till next time,
Grace