2 replies to this topic

[candace]

Hi... I'm new and new to being Dx as a "NARC"

I would like to thank you all for writting about your ups and downs with your medications....

Dx in mid OCT. '07.... insurance will not approve Provigil(sp) :evil: took 2 weeks fighting with them brfore Dr. started me on Ritilan LA 10mg Bid, this worked for about 1-2 weeks.....Changed to Ritilan LA 20mg Bid....Another 2 weeks changed to Adderal 15mg BID with Ritilan 5mg BID, PRN (chaser ) all of this was by Dec. 14th, 07. By the end of Dec. I could sleep on the Adderal....now I can sleep on the Adderal with the prn Ritilan. I see the Dr. on the 14th of this month and he will most likly increase these 2 medication.

What I would like to know is....
[u[b]]Has anyone else gone though this much medication in this short of a time frame?[/u]b].....
I am 50y.o.: 5'5" and 200# (yes I have lost wt. since the beging of Nov. 07.....and I have alot more to go!)
When I am not having "sleep-attacks" I do move......
I am an RN so I know that age, wt. and ht. along with food/fluid intake, other medications you are taking...ect.... may effect the way some meds may work for you.

Anyway, that is my question.

Thank you,
Candace

[Narcolepsy Network]

Hi Candace:

Denying coverage for a particular medication is just one of the ways health insurance companies control cost. This is especially the case with Provigil because it is often prescribed for lifestyle reasons where there is no underlying medical disorder. If you've been diagnosed with narcolepsy through a sleep study, you should be able to successfully challenge the denial through internal and external appeals. Your doctor must be involved in this process. Most, if not all insurance companies and states have procedures in place for requesting expedited (e.g., 48 hours)decisions. Don't take no for an answer until you have exhausted the appeals process explained at http://www.kff.org/c...rguide/7350.cfm. Good luck!

[gurlzylla]

Hey Candace,

I was diagnosed about a month before you and I had to press a little to get my insurance to OK Provigil @ 200mg bid. Basically, they wanted to see proof that I indeed have Narc. w/o cataplexy which essentially meant they wanted a copy of the MLST for independent review. I have had no problems getting the meds since! The MDs office staff warned me that a couple of major carriers were in the midst of a crackdown on people seeking provigil, mainly because they are getting sick of paying for it. Nonetheless, if the dx is there, you should have more cred. with your insurance.

Am I reading correctly that you're an RN? I am gearing up to start my clinical rotations this summer! I'll be ready for the NCLEX-RN in about 18 months.

My doc also put me on 5mg of Vivactil hd, which has since been increased to 10mg. It is relatively inexpensive and I have found that it helps me pop out of bed in the AM. It also "helps" me to not be able to fall asleep at times, but I manage!

Please stay in touch and keep up posted on your quest!