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Re: Provigil Appeals betty72

Posted by Rick on August 30, 2004, at 19:04:57

In reply to Provigil Appeals, posted by betty72 on August 30, 2004, at 12:50:26

> Has anyone had any success appealing United Healthcare to pay for provigil? After trying several dosage levels, I found 500mg to be very effective. UHC, however, is giving me a hard time saying that the FDA has not approved 500mg doses.
> Thanks

UHC (and Medco, their drug administrator) is awful. But I do think coverage of a drug depends on your individual plan, which is probably driven by your employer. About six months ago Medco said my plan no longer covers Provigil except in some very specific circumstances. I'm not comfortable getting too explicit about how I got the coverage back, other than to say it invloved that facts that 1) Provigil now has an FDA indication for daytime sleepiness due to obstructive sleep apnea, and 2) I weighed *a lot* more back when I had a sleep study done. I handled the appeals process myself; my pdoc wasn't involved. But there might be situations where it's better to get the doctor(s) involved.

Rick


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