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142
Veteran Member
Joined : Jan 2010
Posts : 7298
Posted 3/27/2016 8:19 AM (GMT 0)
PSA is up just a bit in March, 3 > 3.8.
Finally I clinically qualify for Xtandi, but insurance denied it regardless, as I am supposedly "too far gone".
Appeals are in motion.
Todd1963
Veteran Member
Joined : Oct 2008
Posts : 3626
Posted 3/27/2016 8:28 AM (GMT 0)
What the heck. Too far gone. What the hell does that mean. I call bullcrap
Todd1963
Veteran Member
Joined : Oct 2008
Posts : 3626
Posted 3/27/2016 8:34 AM (GMT 0)
What are you doing up so late
142
Veteran Member
Joined : Jan 2010
Posts : 7298
Posted 3/27/2016 8:36 AM (GMT 0)
Todd,
The pitiful excuse for a call center rep took it in the arse after she read back the comments. hated to do it, but was called for.
Having been a JP, my path to the state attorney general is muscle memory. Emails flew seconds after that call. Monday will be interesting.
142
Veteran Member
Joined : Jan 2010
Posts : 7298
Posted 3/27/2016 8:40 AM (GMT 0)
Late is relative. Neighbor hosted movies, so late it was. And I'm so angry with the system ....
I've fought so hard to survive six years when my estimate was three, some lame admin won't kill me now!
Todd1963
Veteran Member
Joined : Oct 2008
Posts : 3626
Posted 3/27/2016 8:43 AM (GMT 0)
Kick ass and take names brother
Todd1963
Veteran Member
Joined : Oct 2008
Posts : 3626
Posted 3/27/2016 8:45 AM (GMT 0)
I know you deleted my last post but you really can call me bro
Todd1963
Veteran Member
Joined : Oct 2008
Posts : 3626
Posted 3/27/2016 8:50 AM (GMT 0)
Oh well. It's 2 am here. Headed to bed. Kick ass and take names
142
Veteran Member
Joined : Jan 2010
Posts : 7298
Posted 3/27/2016 9:02 AM (GMT 0)
No deleted posts here. This is the real world.
I should be in bed, but am roaming the property, taking down burned out bulbs inventory. I'll make someone's day ugly tomorrow, Easter or not.
Ken
Regular Member
Joined : Aug 2015
Posts : 379
Posted 3/27/2016 2:57 PM (GMT 0)
darn it! Hang in there, give em hell.
ETA - Don't know if this will help or not, but it has been my experience that finding out whoever regulates, such as insurance regulator in your state, and any other potential regulators, along with threatening to file formal written complaint as you suggested with Attorney General may help.
The cold hard fact is that, the actual complaint is likely something they will resolve with legal staff handling and will not cause them any long-term grief.
However, often it is just easier for someone to approve what you want than go through the hassle of responding to written complaints, and all the hassle of a response.
In addition, if your US Senator or Congressman sits on any insurance committee or has received donations or is lobbied by the Medical Insurance industry, lobbying works both ways. Many people would be surprised at how common it is for staff members of Senators or Congressmen to assist constituents in such manners. Unlikely for you to actually get to speak to a Senator. However, I have heard of staff members assisting constituents on matters far stranger than this.
It won't hurt to make some calls, if federal does nothing, see if your state level people sit on Insurance regulation committees. You usually can look up committee assignments on-line.
logoslidat
Veteran Member
Joined : Sep 2009
Posts : 7585
Posted 3/27/2016 4:05 PM (GMT 0)
Ive taught you too much 142…. do they have moderators at the call center? tee hee
ziggymonster
Regular Member
Joined : Aug 2010
Posts : 457
Posted 3/27/2016 6:32 PM (GMT 0)
That is total bs. Back to fight.....it is a pain but complaints to the insurance commissioner with copies to your state senators.....you will ultimately win but such hassle.
BillyBob@388
Veteran Member
Joined : Mar 2014
Posts : 4906
Posted 3/27/2016 7:12 PM (GMT 0)
Bozolidat said...
Ive taught you too much 142…. do they have moderators at the call center? tee hee
Just can't help but laugh at this little devil sometimes!
Too far gone? They should try telling that to Todd1963!
Jerry L.
Veteran Member
Joined : Feb 2010
Posts : 3204
Posted 3/28/2016 10:10 PM (GMT 0)
I fight with insurance companies and drug stores all the time it seems. Sometimes I laugh, sometimes I get angry. This would be one of those angry times.
Don't be disheartened. It will be approved and you'll get those 4 rather large pills a day...
142
Veteran Member
Joined : Jan 2010
Posts : 7298
Posted 3/30/2016 8:49 PM (GMT 0)
One of my past bosses at the office went after HR, HR went after the insurance company, some other external pressure applied. Review panel reversed the denial this morning, and it is in process.
The most important pressure came from a source I never expected.
Jerry L.
Veteran Member
Joined : Feb 2010
Posts : 3204
Posted 3/30/2016 9:17 PM (GMT 0)
Awesome...
clocknut
Veteran Member
Joined : Sep 2010
Posts : 2906
Posted 3/31/2016 1:44 AM (GMT 0)
Just checked in here and read this whole thread. So glad the stupid decision was reversed. It's easier to cure cancer than it is to cure stupidity, I think. Hang in there, 142.
Tigerfan53
Veteran Member
Joined : Jan 2011
Posts : 935
Posted 3/31/2016 3:35 AM (GMT 0)
Glad to hear it was reversed. You're dealing with too much crap to have to put up that kind of $h1t !!!
celebrate life
Veteran Member
Joined : Dec 2014
Posts : 2112
Posted 4/1/2016 6:59 AM (GMT 0)
You finally meet the criteria to qualify and then get denied because you are "overqualified"? Wow, the cynic really comes out in me on that review. So glad decision was overturned. It looks like you had a good run on zytiga. I hope xtandi works for you even better.
Beth n Gary
compiler
Veteran Member
Joined : Nov 2009
Posts : 7722
Posted 4/1/2016 11:06 AM (GMT 0)
142:
This is infuriating. Glad it worked out, but so sorry you had to go through it.
It's unfortunate that quite often folks are too sick to fight, and insurance companies know that and use that to their financial advantage.
Mel
Ken
Regular Member
Joined : Aug 2015
Posts : 379
Posted 4/1/2016 12:17 PM (GMT 0)
Really glad to hear that it is being reversed.
JackH
Veteran Member
Joined : Oct 2013
Posts : 2037
Posted 4/1/2016 3:36 PM (GMT 0)
Timely posting in the "New" PC InfoLink site also about
the cost of the drug enzalutamide (Xtandi)...same as 142 writes about
.
http://prostatecancerinfolink.net/2016/03/30/the-price-and-the-politics-of-drug-therapy-for-advanced-prostate-cancer/
The issue discussed at the InfoLink is a protest that given the amount of taxpayer money that was invested in the development of Xtandi for the treatment of CRPC, they are outraged by the price being charged for this drug in the US market. The claim is that this is >300% higher than the price being charged in other countries.
I'm all for allowing companies that develop products on their own dime to be allowed to charge what a customer is willing to pay for the products. But this is not the case here, or with many other drugs.
Isn't Todd1963 on his way to Chi-town soon for patient-led protests in favor of prescript
ion drug cost reforms?
Pratoman
Forum Moderator
Joined : Nov 2012
Posts : 9890
Posted 4/1/2016 3:47 PM (GMT 0)
Nice work142 congrats
compiler
Veteran Member
Joined : Nov 2009
Posts : 7722
Posted 4/1/2016 4:01 PM (GMT 0)
142:
I'm sure that's a big relief.
ONWARD!
Mel
InTheShop
Elite Member
Joined : Jan 2012
Posts : 11468
Posted 4/1/2016 5:08 PM (GMT 0)
Good to hear you got that worked out.
Insurance companies are a pain.
Andrew
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