Days b4 my next refill of Tardive Meds, Silverscript is denying coverage

As many of you know, I have a neurological side effect from the antipsychotics that I’ve been taking all these sixteen years. It’s like severe Parkinson’s.

I take meds for it. Expensive meds.

Silverscript, my medicare part D, has suddenly cut me off, just days before my next refill. Previously, back in January they said I was covered until next Feb in 2017. Legally, you guys, can they do this?

 

The Nami statistics are thus: For those of us who take an antipsychotic, whether it’s a traditional old school Haldol or Thorazine or an ‘atypical’ like Invega, Geodon or Abilify,  for a decade, they say that percentage of us who will get tardive dyskinesia is 30-60%. And that type of drug is not taken temporarily. Its a drug they give you and tell you you’ll be needing it for the rest of your life. So we’ll all be taking these meds for a decade unless we try to go without them, find out that we can, and get off of them. For me, it’s too late.

It’s also referred to as Parkinsonianism. There is no cure, only expensive symptom management.

I’m on a critical medication for this.  My Part D, Silverscript, who is owned by the wonderful folks at CVS  (wouldn’t that be a monopoly a pharmacy chain owning part D Medicare benefits?) who had approved me thru Feb of next year. Sent me a notice, …..ten days before my next refill that they are cutting me off. I have no time to react.

We have a piece of paper saying that I’m covered through Feb of next year, so how can they cut me off at the last minute? Ideas anyone?  Has anyone done an individual appeal process? The doctor says on their end, they are out of options, have appealed this decision twice. Now I hear about it.

Will they still give me my meds while we are appealing this? Is this even legal?

Days b4 my next refill of Tardive Meds, Silverscript is denying coverage

As many of you know, I have a neurological side effect from the antipsychotics that I’ve been taking all these sixteen years. It’s like severe Parkinson’s.

I take meds for it. Expensive meds.

Silverscript, my medicare part D, has suddenly cut me off, just days before my next refill. Legally, you guys, can they do this?

Before you look away, some of you who are on antipsychotics, especially at high doses, will get this syndrome. It’s called Tardive Dyskinesia or a ‘movement disorder,’ and is also referred to as EPS, (extrapyramidal symptoms). No cure. Only symptom management.

The Nami statistics are 30-50% of patients who take an antipsychotic, whether it’s a traditional old school Haldol or Thorazine or an ‘atypical’ like Geodon or Abilify, if you are on these drugs for a decade, they say that percentage of us will be like Michael J Fox x 60. It’s also referred to as Parkinsonianism. It looks and acts like Parkinson’s.

I’m on a critical medication that is partly paid for by a charitable foundation, Caring Voices Coalition. My Part D, Silverscript, who is owned by the wonderful folks at CVS approved me thru Feb of next year. But we got a notice …..ten days before my next refill that they won’t pay. We have a piece of paper saying that I’m covered through Feb of next year, so how can they cut me off at the last minute? Ideas anyone?

My doctor appealed the decision twice and now we get a letter saying we have a right to an appeal. What they are doing midyear seems illegal. Ideas anyone?