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Medical Forum / Diseases and Disorders / Arthritis / April 2006

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RANT Wellcare denied my Enbrel the U know whats

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RainyB - 25 Apr 2006 16:41 GMT
Hi Everyone,

I am new here. I used to use this group when it was an AOL newsgroup,
that was years ago for me. What I do remember about this group and
alt.psoriasis, was that there was always someone who understood me and
was ok if i needed to rant and freak out a little. Ok so about me: BTW
I'm RainyB

I am 39yr old Female from Boston MA. I have OA, PA, Spondylarthropathy,
pustular Psoriasis and plaque psoriasis. I used to also have really bad
open wound ulcers on my legs {shin to ankle} but thanks to my medical
cocktail, I have been wound free for 3 years now. Previous to that I
had at least one wound open since i was 18 and usually I had 2 or 3
going at once. Shortest healing time was 1 .5 yrs, longest 3.5. Maybe
someone will remember me from way back now.

I have also been on SSDI for over 14 years. My PA and wounds  started
at 18, well before i had psoriasis. All the others just jumped in
around 20.

My Rant is that Wellcare Ins {medicare part D} denied my Enbrel. After
years of suffering with all this crap I finally found the right mix a
few years back. My quality of life is more than I ever could have
expected, and I am a very grateful person. I am of course appealing
along with my Dr. I guess what really rips me is that I worked my a.s
off researching the new Part D plans. Even though Enbrel and
Cyclosporin were not on the fomulary for Wellcare, numerous phone calls
to the Admins at Wellcare assured me this would not happen. I mean cmon
they have copies of my Medical records I sent so this would not happen.
I already proved medical necessity damnit all.

I currently take 2 {50mg} Enbrel injections a week, 300mg Cyclosporin
daily, 40mg Oxycontin 4x daily, 800mg Ibuprofin 3x daily, 70mg Fosomax
1x a wk.

I have tried the Methotrexate and just about every other mix out there
over the years, this one is the one for me.

I guess I am not asking so much for advise, although I will take it. I
also know that if I fight hard enough I will get my meds back. I just
needed to rant so I wouldn't just freak out, and other than the people
who deal with these issues all the time { You ALL} nobody else really
gets how hard this can be.

Anyone else have Wellcare and being treated this way????  Any
Suggestions for better Part D Coverage??
Nann Bell - 25 Apr 2006 19:22 GMT
(((((((((RainyB))))))))))  Man, you make my immune system seem downright
co-operative!  I've only had plaque and inverse Ps and I will be very happy
if the pustular psoriasis stays far away from me!

Interestingly enough, even though my coverage as always been at the mild
level, I was never clear until I was on 2 DMARDs for my PsA.  It was an
enormous relief after 30 years of dealing with Ps on my scalp and some really
tender areas of the body.  I don't even want to think about how torturous the
coverage and complications you describe must have been.

Unfortunately, I have no recommendations about insurance as we aren't ahving
to deal with the Medicare maze yet.  Other places you might get some input or
advice, if you haven't found them already are the message boards for the
National Psoriasis Foundation (www.psoriasis.org) and the psoriasis newsgroup
alt.support.skin-diseases.psoriasis.  Best of luck in winning your battle for
the Enbrel!

Signature

Nann
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Simply the thing I am shall make me live --- William Shakespeare

Nann Bell - 25 Apr 2006 19:26 GMT
> Unfortunately, I have no recommendations about insurance as we aren't ahving
> to deal with the Medicare maze yet.  Other places you might get some input
[quoted text clipped - 5 lines]
> for
> the Enbrel!

Oops, never mind that about alt.support.skin-diseases.psoriasis - I went
there after this group and saw you had already posted there as well!  LOL (at
myself).  Got everything crossed that you get your Enbrel.

Signature

Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare

debbie m - 26 Apr 2006 03:43 GMT
Don't have any advice Rainy.  Just wishing you the best in your
endeavor to get back your meds!

debbie m.
Charrlygrl1 - 27 Apr 2006 19:51 GMT
Hi RainyB, I am 38 and I am from MA as well. I have ankylosing
spondylitis which is one of the spondyloarthropathies.
I am on Enbrel, injectable mtx, Clinoril and Azulfidine. I have
Tramadol for the pain, and Soma for the fibromyalgia.
I have a link here to aid programs from the different drug
manufacturers. Perhaps you could contact Enbrel/Enliven??
I know a few people on other boards that get if for a pretty good
discount.

http://www.rheumatology.org/public/acrast.asp?aud=pat

Good luck to you, my MA neighbor!
Charlene
 
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