health insurance denies perscription coverage

[shannon paul]

What is the name of your state? michigan medicad health plan h.m.o. is dening coverage for script of oxycontin that i have been on 3 years. straight medicad had been paying bill for two years then michigan medicad made most clients have an h.m.o. including me they have paid it for almost a year and now dening claim i understand the price is costly for these pills but they are what work for me.i am on high dosage, but never ever have been a problem according to doc.i am perscribed oxy for 3 traumas to back wich has caused 4 bulging disc degenerative disc disease spondalosis and floating fragments also had nerves in eye burned wich eventually was removed wich still gives headaces, phantom paines and eye strain what are my chances of winning a appeal with out attorney?

 

[ALawyer]

You should get your treating physician's written statement explaining why this highly addictive and often abused drug is essential for you, in the dosage you are taking, and why other drugs do not work (naming others s/he has tried), and send it in, with a polite demand for reconsideration and a detailed explanation for an as to why they are denying reimbursement for the drug.

Keep a copy. Also, see the bad faith section under insurance law on FreeAdvice.com.