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Health Insurance

Prior Authorization?*

Has anyone had to do a prior authorization through Humana Military or Tricare South for Betaseron? I got notified that I needed to switch to an alternative medication because Accredo could no longer dispense it. So, I called my neurologist and they were totally confused about why I should take an… Read More


Hi all, I have a situation and I am hoping there are a select few out there who can identify with me and possibly offer some sort of direction.  I am 28 years old, I have no children, I currently do not work because I am a student and with my fatigue, either I am going to put forth my energy towards a job… Read More

Specialty Drug Tier*

There is a bill in the House of Representitives that limits Tier 4 Specialty Drug copays/coinsurance charges to the copay for nonpreferred brand name drugs. The bill is: H.R. 4209: Patients’ Access to Treatments Act of 2012. I've already written my Congressman, he happens to be on the committee that is… Read More

Specialty drugs article NY Times

The NY Times had an enlightening/disturbing article on the front page of its Friday, April 13 issue. Evidently, insurance companies are feeling the pain of paying large sums of money for "specialty drugs" and are seeking to modify their coverage. Many states are evidently working to limit our out of pocket… Read More

Changing Insurance?

My husband is currently in the military so we have Tricare. However, he has a mechanical engineering degree that he wants to use so he will be ETSing (getting out) of the Army in 2015. I was wondering if anyone has changed/switched insurances and how that works. Will I still be able to recieve the same coverage… Read More

Medicare drug prices*

Hi Kris, I have a question.  I already called Medicare and my insurance company, and they both told me this could be done, but I would like your opinion.  I lodged a complaint - grievance - with my insurance .   I take a pain medication that is a narcartic that has been a generic drug for at least 15 or 20… Read More

Medicare and health insurance for 2015*

The proposed patient improvement change to part D as well as other medicare issues is online and must be commented on by March 7 of this year. If you want to read it, google pro patient improvement to part D and you will get the whole thing. The proposed change for pharmacies  is: 29. Effects of any… Read More

RE:finally have insurance but need doctors

So my fight is finally over! I went to my hearing on the 27th and I've been approved for my disability! After 3 years of fighting, praying, begging, and otherwise suffering through pure hell I did everything right and got a fully favorable judgement from the ssdi judge at the hearing. I hope I'm not counting my… Read More

Stressing about Dr. bills.....

I was diagnosed with MS in January. My doctor wants me to have an MRI every 6 months to check progression as I have lesions she worries may affect my ability to walk in the future. I am still covered on my parents insurance (until May next year, which is something else I'm worrying about) but these MRI's are… Read More

Medicare and health insurance

Since I have been fighting UnitedHealthcare I have fould out: Medicare is a federal contract and medicaid is state. If you have a complaint against your insurance provider you call your regional medicare office for kansas nebraska missouri and iowa the number is 816.426.5783, if it is a complaint about… Read More

TSA Employee with MS*

I have worked for the federal government (specifically TSA) for 11 years and this year I've been diagnosed with MS. It has become quite difficult to do things as I normally did. I haven't disclose the condition yet. My doctor tells me to seek reasonable accommodation, but I talked to the union vice-president… Read More

health insurance

i am employed and receive my health benefits through my employer i pay 480.00 a month for like an 80/20 plan with a 3000.00 deductable. medications are reasonable i have 90 day plan. my question is it is getting harder for me to continue working full time to receive my health benefits then what is available. i… Read More

Gilenya Denied by Insurance, what next?

My husband is newly diagnosed with MS.  He was given a perscription for Gilenya, but Blue Cross Blue Shield denied his request.  His doctor (Columbia Prespbyterian) sent a letter to appeal. Denied again.  Basically, BCBS said they would not cover Gilenya until tried Copaxone first. He would need to show that… Read More

Aflac and MS for short term disability

Does anyone have AFLAC short-term disability in addition to their normal health insurance coverage?  I'm covered under my husbands policy for health insurance however my employer just started offering AFLAC as a supplemental.  Having MS doesn't automatically disqualify me, however there are certain stipulations… Read More

Help with diagnosis

I have insurance but a very high deductible and 30% co-pay even after I meet that. I'm convinced I have ms. After 10 years of everybody including doctors blowing me off when i felt something wasn't right, I am progressively worse. To the point I fear losing my basic mobility. All my symptoms point to ms. I can… Read More

Social Security Disability

I recently received a continuing disability review report  from Social Security about my disability with MS.  It's really freaking me out and causing me extreme anxiety.  I was diagnosed with MS in 2005 and currently take Copaxone to help with relapses and take Gapapentin to help with the chronic pain.  I have… Read More