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  • #4728

    As a few of you know, I have systemic lupus with cross over symptoms from some other immune system diseases ('cause you know, lupus by itself doesn't suck enough) and one of the medications that is currently keeping my symptoms under control the best is Rituxin, an IV drug that I get every 4 months. My dose was due last week but my insurance company has suddenly decided that they don't want to pay for it and my symptoms are coming through in full force. Please pray that the insurance company re-evaluates their decision and that I am able to get my medicine soon.

    #169093
    Krissy
    Krissy
    Swirly Admin
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      Maria, so sorry to hear this. Have you tried getting some assistance from the lupus foundation. They have a new program that helps you get your medications. I too have Lupus, and am a member of the foundation. I will check my saved email to see if I have the info.

      In the meantime, saying a prayer that this gets worked out soon, and that your symptoms don't get worse.

      #169094

      Snagg1
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        Please put in an appeal. Insurance can be tricky. You may have to fight for it. I would also look into alteative sources like Kim suggests. I will say a prayer. Good Luck.

        #169095
        Krissy
        Krissy
        Swirly Admin
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          Maria I am sorry to hear that! It didn't work for me, but if it works for you they shouldn't be denying it, especially since you have already been taking it! We are retired military so I don't have to deal with that, but I do have to drive two hours there to see the doctor. My Orencia isn't working real well and I am waiting for my thigh to heal so i can do the drive. But my doctor always makes sure I have emergency prednisone. I don't take much, just enough to make it bearable. I thoroughly recommend having some on hand if your doctor will write the script. No sense being in horrible pain if you don't have to! I sure hope they change their decision!

          #169096

          Oh my goodness Maria!! I wish insurance companies would just leave well enough alone. Don't they realize that some drugs are an absolute must?? What stupid reason could they possibly have for taking it off their list. I will never understand. I hope and I pray that they reevaluate their decision and place it back onto their formulary. Can we petition?? You know, Swirly Girls are known to get things done around here!! Hugs to you Maria. Rituxin has done wonders for our patients with Non Hodgkins Lymphoma. I didn't realize it was used for Lupus as well. It makes sense though. I hope you get your medicine soon. xoxo

          #169097
          Krissy
          Krissy
          Swirly Admin
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            Oh Maria, I'm so sorry. That is just SO unfair. I will be praying for you.

            #169098

            My mom has Lupus, never heard of this therapy… I sure hope things will work out for you though (and now I will get my mom to look into it here in Canada). Big hugs to you!

            #169100

            Oh, girls….Am praying for your medications to be filled and relief for you. This is a rotten shame that they can do this to you….

            #169101

            I hope they reconsider! Sometimes it seems a pain to have it.

            So sorry that you are suffering.

            #169102

            Oh, Maria! I sure hope they change their minds and you can get your medication!

            #169103
            Krissy
            Krissy
            Swirly Admin
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              Oh Maria, I'm so sorry to hear this. I hate insurance companies when they do this sort of thing, especially since they were already covering it. I know when I first had to leave work because of my MS my work insurance didn't want to pay me and I had to fight with them for almost eight months before they finally decided to cover me. I talked to a lawyer at one point and she told me this is what they do, they keep rejecting you and then most people will give up but you just have to keep trying. I totally understand what you are going through,don't let them beat you down. I will keep you in my prayers!

              #169104

              Thanks for keeping my in your prayers. The medicine isn't traditionally used for lupus, but since I have other cross over symptoms, I have a diagnosis of RA also and it seems to keep almost all of my symptoms fairly well controlled. However, you are supposed to take Methotrextate with it, and I am not able to tolerate it. It didn't matter for the last 2 doses, but for some reason, the fact I'm not taking the Methotrextate is now a problem. I'm waiting to hear back from the doctor's office, who will appeal for me if they have to, but were trying to take a shortcut. As for Prednisone – the effects on my symptoms are minimal and the side effects are horrible, so I usually refuse to take it. I was hoping to be able to take the new drug, Benlysta or something like that – but my insurance isn't covering it yet. Oh well, enough whining for now:)

              #169092

              I'll keep my fingers crossed for you Maria. Hope things will work out.

              #169099

              craftysprinkles
              Swirly Scrapper
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                Maria, this is horrible!!! I do pray that your doctor can successfully intervene for you…

                #169105

                Snagg1
                Member
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                  Maria, so sorry pryers going up. Hate fighting with insurance.

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