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Need Help

baseball2005bbaseball2005 Posts: 77
edited 06/11/2012 - 8:33 AM in Health Insurance Issues

I have BluuCross for my insurance company. My doctor prescribed Lyrica for me. The Insurance won't pay for my Lyrica saying that I need to try Neurotin first(I had been on neurotin for 3 years and it stopped working. I was up to 3200 mg of neurotin. Also denied because I don't have fibromyalgia(sp) and I should try depression pills. Well depression pills and me don't get along. I have RSD and Lyrica really helps with the RSD. Has anyone fought with BC and won their Lyrica.




  • I take lyrica, but my case is with work comp. I know Lyrica is very expensive. and that I know of it doesn't have a real family generic to be purchased as of yet. could have them try a diferent type of anti sezure medication for the time being. as far as I know that's really what Lyrica is used for an anti sezure med. I know for me for the 50mg 3 times a day cost around $360 dollars... hope this helps..
  • Kate,
    In the meantime see if the prescribing doc can give you samples. I know the docs don't have as many samples as they once had seems the drug reps samples have been cut back. But since these docs no your plight with the insurance issue, maybe they can give you samples till you can get it approved. Years ago I had the same issue getting a drug(vioxx i think), for my RSD and doc's gave me samples for it. The reasoning was I wasn't old enough. Thought when I hit 25 I had hit all age requirment things. However, them not approving that drug seems to have worked out in my favor, as it was pulled from the market. Good luck keep us posted.
  • I take a medicine called Trileptal. That's not the generic name, but there is one, and that's what I take. Another one is Carbitro. You might ask about one of these. I have no problem getting a 90-day supply from Medco through BCBS.

  • Hi All,

    Thanks for all the help and suggestions. Tamtam my pain doc does not give out samples. So my husband and I will continue to pay over $200 a month for my Lyrica.

  • baseball, i know the terrible burden of having to pay cash each month for medical care and prescriptions..i had to battle medi-cal to get my Lyrica but it did come through.. i have to pay for my pm visits as well as for Percodan. it is a big, vicious cycle.. keep trying and i hope it comes through for you.. L, Jenny
  • Hi All,

    I would just like to thank all of you who posted to help me ans listened to me. The good news is my lyrica was approved finally and picked up my prescription with just my co-pay last night. Thanks all again.

  • Kate,
    That is great news glad you finally have the meds you need without paying the full amount. Sometimes persistence pays off. I know sometimes it seems hopeless, but they want you to give in and not try with hopes you will go away. Good for you to keep perusing this.
  • So glad to hear you got the approval!!! Hope you feel better. Have you gone to the ortho surgeon yet?

    Liz and I went to a Bluegrass Festival today, boogie woogied in our chairs, lol.

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