Thursday, November 6, 2008

Medicaid Insurance Denial for daily Med(Spinal Muscular Atrophy)


On Tuesday we got a phone call from the local Mom and Pop drug store after we had called in refills for one of Elizabeth's daily meds XOPENEX saying it was DENIED and the doctor had to get prior approval before she could get it. Okay.... dealing with something like this has been what has happened to us several times for things recently. I calmly told Christen(Lizzy's Mom) and she called the doctor's office and they said they would take care of it. So, after talking to out docs office and they saying everything is approved we went to go pick it up and the pharmacy said its DENIED still. Okay...... Lizzy has been getting this med since she was 17 months old. She is now 5 years old. This is a daily med what the heck is going on??? Called the doctor back and they said this morning after they got the approval they got a call back saying they needed a Letter of Medical NEED for it . So to get an LMN he has to dictate a LMN and transcriptions has to write it so it will be awhile to see if its gets approved. THIS IS A MED SHE USES DAILY!!!!!!!

Okay, I am so upset it is not funny. In the past month Lizzy has gotten all her equipment applied for with LMNS denied. IL Governor Blagojevich has used the money for special need children to fix our roads. That is totally wrong. I do not know what to do but I will find a way to get her what she needs.
She has been denied in the past 2 months:
1.) MANUEL wheel Chair(hers is too small for her(and also borrowed) and we do not have a way to push her in her power chair when she is sick . She can not sit when she is sick. No Adult controls)
2.) Adult push handle and controls for her power chair
3.) gel pads for her power chair arms (since the metal arms put bruises on her arms)
4.) Stander (we had a borrowed one until she grew out of it)
5.) a desk top for her power chair (so she can use it for school work)
6.) Had to get a prior approval for Carnitor a med Lizzy has to take every day and it took weeks to get it approved
7. Xopenex a daily nebulizer treatment

Okay Governor Blagojevich tell me how all this road work is more important than these children? You suck

2 comments:

Sky said...

holly crap, road work wih special needs money. thats just wrong!!! OMG you had to get prior approval for Carnitor? What is wrong with these people. I wish I could do something to help, if there is anything let me know, ok... I hope you get some answers and results soon. Sheila

Lizzy's Nina said...

Thanks Sheila. I have my state senators office trying to figure out what is going on. This is pure nuts.
Here is what is happening here also
http://www.week.com/news/local/33409689.html If I could afford to move out of this state I would.