Ask your doc to keep sending prior authorizations. I needed to have the shingles vaccination because I have had the shingles 10 times and it took my doc six prior authorization before Medicaid finally paid for it. She had to keep explaining why I needed it in different ways. You can also ask for a hearing so you and your doc can go in front of Medicaid yourself and explain why you need it. I meal appeal the decision. Good luck.

Most drs won't take their time to go to a hearing because for them it is time they aren't being paid.

Again the insurance agencies decide they know more than your doctor. Cloverset, my insurance company did that a while ago. All medications have to go through them or they will not pay. There are exceptions of course but the only meds I get through the local pharmacy are my pain meds and my anxiety meds. I would hate to have someone go through my mail and get those.

such an odd system. I take Tramadol SR 150mg 2 per day.
I also take Klonopin.
so I wonder if you can change medications so it works

do you have access to a pain clinic doctor. I am not sure which doc you see ?

exactly.. why wont they believe the doctor. can he write to them and say it is necessary ??

I am sorry that this is happening. Sunny in Melbourne

I SAW THE WORD appeal. yes.. with doctors letter.. hope the system is not too slow.

but think about other meds that would work and be approved

all the best

your dr. actually screwed you up on this one. by prescribing the same medication for your extended relief pain medication and your instant release pain medication, i.e. er & ir morphine, your dr. basically put you on a steady "treatment" with the same course of medication, no differentiation between extended relief or instant relief.

the insurance company therefore thinks your taking too much of the same narcotic. why they cut your er dose instead of your ir dose is a bit strange. why the insurance company is comparing morphine, a narcotic for pain control and lorazepam, a benzodiazepine used for anxiety is completely ridiculous and one has no bearing on the other.

you should definitely appeal and strongly provide evidence/research proving the difference of the 2 medications and what they are used for. you should also educate your dr. on the fact that when you take the same medication for both your extended relief pain management plan and your breakthru medication, its all the same med and all considered 1 pain management plan.

good luck

I just had to get a new Dr. due to my old one retiring. The first question I asked was , would he refill my meds like I have been getting them. When he saw I was on Morphine ER 120 mg a day and .5 clonazapam 3x a day he freaked out and wanted me to go off one of them.
He said , We Dr.s got together and decided we were killing a thousand people a year by giving them Pain meds and Benzos together and they werent gonna do that anymore. With a lot of fuss I was able to keep my meds the same for now. I know change is coming though. I had been prescribed by my previous Dr another 60 pills of 15 mg Morphine ER for breakthru pain so I didnt end up in the Emergency Room being called a druggie when I hurt my neck. ( I have 3 bad disks in my neck ) This new Dr. also told me that its policy that when people reach the age of 64 they dont give them benzo's anymore because they become too much of a fall risk. Great, now I can worry ten years in advance. LOL.
I got an appointment at the pain clinic and a Dr. there gave me 4 15 mg morphine a month for my breakthrough pain and told me to refill it monthly even if I am not out.
It really scares me for all of us that the Dr.'s are not wanting to give pain meds anymore. They upped my Gabapenton 300 mg a day ,but those make me so sleepy I cant keep my eyes open. I never feel that way with the morphine or the benzo's. It makes no sense to me that they are so afraid of the combo when I have never been high or even sleepy taking those.
Times sure are changing and not for the better if you have chronic pain. I feel really hopeless as that any of us can make any difference. The DEA is really getting down on the DR.s about prescribing pain meds unless someone has cancer. But , how do they know that our pain isnt as bad as cancer pain?
Im sorry that so many of you are having hard times and I will keep all of you in my prayers. Something has to give. We cant just live with the pain we would have without the pain meds. Its inhuman and just plain wrong.

Just for comparison, generic klonopin 1 mg for 60 tabs is just under $13 at a Walmart pharmacy. It is similar and as effective as lorazepam for anxiety. It does, I believe, shoot me if I am wrong, but it does have a longer halflife which manages anxiety better than the Ativan. It is also less sedating, in my experience.

I agree with Jeremy about Obamacare. They are pushing pain patients under the carpet and trying to forget about them. However, 95% of people will likely suffer chronic pain of some cause within their lifetimes. It's just a fact of the Human Condition. It never ceases to amaze me that the general society thinks less of us because we have chronic pain. That's a passionate subject, chronic pain, for me and I write on it constantly. It's become almost a OCD diagnosis...LOLZ.

I hate insurance companies too, both insurance, pharma, and many MDs are nothing short of criminals. I choose to pay out of pocket, because my drug needs are far less than the Medicare Part D plan for meds. And my meds aren't even covered there either, as far as 5years ago when I checked.

I have read countless reports and studies in recent yrs regarding the OD's where opiates and other drugs are concerned. Not one of the gave any info regarding the blood levels, autopsy results and other important info regarding these supposed OD's. Although several goovernment reports did mention the lack of specific info regarding the OD's. It appears that the connection between opiates and benzos is more media created than fact.

Hi,
I just wanted to say that I think most of what my Dr. told me was BS.
He didnt want to give me my meds and he was using every excuse he could. I think it all boils down to the DEA being on the DR.s backs about meds and Obamacare cutting healthcare and that includes meds.
I am on medicaid and my Mom is on Medicare. We both have noticed big changes in what they will pay for and what services are covered and what arent.. Its only gonna get worse.

The half-life for Lorazepam (Ativan) is around 12 hours for most people while Klonopin runs anywhere from 22 - 50 hours depending on Blood Plasma Levels, Brain Blood Barrier Absorbtion Rates, Mental Illnesses, and a few other factors in individuals.

They both work relatively the same, have about the same addiction possibility and are relatively cheap meds in generic form. With the shorter half-life in Ativan you do have to take more of the med or higher dosages. But both Klonopin and Ativan are standard Benzo's that do the same thing.

95% of people may experience Acute Pain at some point in their lifetime but that's a really high percentage for Chronic Pain. People need to understand the difference between the two. Many folks think that any pain that lasts for more than a couple weeks is Chronic Pain and that's just not the case.