Could use you guy's help

[csus]

help or advice.

Apparently my insurance is going to deny a cialis prescription. Or, more accurately, I will only be approved for 7 pills at a time. With a 7 day supply i'll have to pay a copay every week, that is if they will even allow a refill every 7 days. Have any of you guys experienced the same problem? If so, did you have any success lobbying to get the decision revised to get 30 day 5mg prescription?

My urologist's assistant informed me of the problem and said that the doctor's office received a letter from the insurance stating that only 7 pills at a time will be allowed. She said the insurance company stated in the letter that I will receive a questionaire. What the questionaire will ask isn't clear to me. I suspect the wording is less intended to benefit me and my health than it is to support denying the coverage for cialis

I know cialis must be prescribed for peyronie's treatment, not ED. I'm not sure what the problem is, or what to do. Any help/advice appreciated.

[LWillisjr]

My insurance company stopped covering Viagra, Cialis, Levitra last year  

[Knight]

I had the same issue. My doctor wrote a letter to the insurance company and although it took a couple of weeks we managed to get the 30 day prescription approved, but this is to be reviewed again in 1 year.  

[csus]

Over 55 views, only 2 replies. Am I to assume the vast majority have not had difficulty with insurance denying a cialis prescription?

Given that the PAV cocktail is highly recommended on this site, it's disappointing that some of the old timers or guys with vastly more experience and knowledge won't chime in to offer a bit of advice to help out.

Oh well, I guess maybe the advice given by some of the old timers at times like this stands.....stop with the pity party and quit feeling sorry for yourself. Take up helping little old ladies cross the street and rescuing orphaned puppies, there are people out there who have it much worse than you.

Thank you to Lwillis and Knight for replying. To the rest, i'll let you know if I can find a solution that works to convince the insurance to honor my doctor's course of treatment, which includes 5mg cialis daily. We're all in this together......some more than others, apparently.

[Norm]

I think you can assume the opposite. The rest of us are paying for it because our insurance won't.  ED drugs are usually not covered.  

[csus]

Assumption is the less desired alternative to a bit of feedback.

I'm still fairly new to this crap. I'll likely never get used to it, especially seeing as things are in a constant state of free fall for the worse. I thought I at least had the meds sorted, prescriptions and all. Imagine my surprise and distress to find it wasn't so. From what I understood cialis must be prescribed for peyronie's, rather than ED. Although I was told here in this forum that I should allow my doctor's office handle the insurance company because they frequently dealt with such matters and were the professionals, I discussed that thoroughly with my urologist. He agreed/confirmed that cialis would be prescribed for Peyronies Disease, so the insurance won't think I was just trying to "have a good time".  They are denying the doctor's recommendation, apparently. What am I now to do?

I was just trying to solicit some advice, some help. I thought that was the intent of this forum.

[pretzel]

csus,

I'm so sorry you are having to deal with this disease and having to deal with your insurance company.  Whenever your insurance company refuses coverage they must give a reason for their refusal IN WRITING.  Included with that refusal there should be instructions for appealing their decision.  I believe you have 60 days to appeal.  Check the instructions to be sure.  Your urologist should provide whatever documentation is needed to justify the prescribed treatment.  But YOU are your own best advocate.  Talk to your insurance company.  There is a toll-free phone number on your insurance card.  If you don't get a satisfactory answer ask to speak with a supervisor.  Work your way up the ladder until you find someone who listens.  Document your phone conversations and follow the written appeals process.

Please PM me if you have questions.  I understand the panic and frustration of dealing with unresolved medical issues.